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Head Lice Treatment

What are head lice?
        Head lice are very small (less that 1/8 inch long), tan-colored insects that live on the human head. They live and lay their eggs (called nits) close to the scalp. The nits are tiny and are gray, white or brown in color. The nits are firmly cemented to the hair shaft.

Who can get head lice?
        Anyone can get head lice--they are not a sign of being dirty and do not reflect poorly upon parents. Head lice are a common problem any place where there are groups of children, such as child care settings and schools.

What are the symptoms of head lice?
         Itching and scratching of the scalp and neck are usually the first sign that head lice are present. The areas most often affected are behind the ears and the back of the neck. If lice or nits are found on the head of one person in a household, the heads of all household members should be checked. Look for:
 
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  • Crawling lice in the hair near the scalp.
  • Nits glued to the hair shafts.
  • They are usually found within 1/2 inch of the scalp.

When do the symptoms appear?
        
It may take two to three weeks before the intense itching is noticed.

How are head lice spread?
        
Head lice are passed from person to person by direct contact, on shared personal items (combs, brushes, hats, scarves, sports headgear, headphones, jackets, and other clothing), or by contact with infested bedding, furniture or carpeting. Head lice do not fly or jump. They crawl and can fall off the head. Lice do not usually live longer than 48 hours off the head. They only lay their eggs while on the head. The nits will not hatch into insects if they have fallen off the head. Lice do not spread to pets and you cannot get them from pets.

What is the treatment for head lice?
        
Lice control products come in the form of shampoos, creme rinses and lotions. Some products are available over the counter from a drug store or drug department; some are available only with a prescription from a physician. It is recommended that the hair first be washed with a shampoo that does not contain a conditioner or creme rinse. Baby shampoo and Prell* are two examples. The head should be rinsed as usual. Some products are to be used on a dry head; others on a head that is damp. Only those people with lice or nits should be treated, because use of these products will not prevent someone from getting head lice.
        Follow the directions carefully. The directions are not the same for every product. Use enough of the product to completely wet the hair and scalp. This may mean using part of a container for very short hair, or two containers for very long hair. The solution must be thoroughly massaged into the scalp, because the scalp is where the lice live--not on the ends of the hair. Leave the product on the head for all of the time recommended. The lice don't always die immediately. It might take up to 24 hours. If live lice are seen two days after treatment, retreat with a different brand.
        
A second treatment, seven to ten days later, is usually recommended to kill any lice that may have hatched. If using a prescription product, carefully follow the directions given by the physician. More than two treatments could be harmful. It is recommended that all nits be removed as part of the treatment. A special fine toothed comb is usually included with the product, or can be purchased separately. Removal of the nits may be made easier by using a white vinegar and water solution or Clear*, a product made to loosen nits. The manufacturers of most lice control products recommend using nit-loosening solutions after treating the head; the makers on Nix* say to use nit-loosening solutions before using Nix*. When using the special comb to remove nits, part the hair into small sections. Start combing as close to the scalp as possible. Wipe the nits from the comb often. After combing, rinse the head. After the hair is dry, recheck the head for any nits that may be left and remove them. After treatment, check the head every day for several days.

How can the spread of head lice be controlled?
        
Combs, brushes and similar items should be soaked for 10 minutes in hot, soapy water or a lice control product solution.
        
Recently worn clothing (including hats, scarves, jackets, pajamas, etc.) should be washed on the hot water setting and dried in a hot drier for at least 20 minutes before being worn again. Items which cannot be washed should be dry cleaned or sealed in plastic bags for two weeks. Items such as sports headgear, headphones, stuffed animals and pillows should also be bagged and stored.
        
Clean floors and thoroughly vacuum carpets, furniture, mattresses, and the seats of the cars. The use of lice-killing sprays is not recommended.

How can the spread of head lice be prevented?
        
Avoid sharing hair care items, clothing, hats. sports headgear, towels, and bedding. Avoid sharing lockers if possible, If jackets and hats must be hung close together, the spread of lice can be prevented by hanging or placing clothing in plastic or grocery bags.
        
Frequently check children's heads throughout the year, especially if they are in child care or school.
        
 *Brand names are used only as examples of products. The health department does not recommend the use of any specific brand.