Head Lice

There is much myth and misinformation surrounding head lice causes and treatment. Parents are often concerned that their child could be ostracized because of lice, and it is important that their fears are allayed, and they do not try to use various treatments simultaneously. Pharmacy teams are essential in delivering accurate and helpful advice to patients.

The Facts

• Infestations of head lice mostly affect children aged between 4-11. • Head lice are tiny grey-brown wingless insects. When hatched, they are the size of a pinhead and 3mm long when fully grown. • They cannot fly, jump or swim, but are spread by head-to-head contact when mature lice climb from the hair of the infected person to the head of another person. • Head lice feed by biting the scalp and sucking blood through it. • Eggs are cemented to hairs close to the root by female louse where they are kept warm by the scalp. 7 to 10 days later, after the lice have hatched, the empty eggshells (nits) remain. They become more noticeable as hair grows and the shiny white shells are carried away from the scalp. • As female lice can reproduce again after 7 days, all lice need to be removed from the head before the sixth day after hatching to break the cycle. • Head Lice cannot be prevented, but weekly detection combing is the only way of finding lice quickly.

Diagnosing Head Lice

An active head lice infestation must be diagnosed before using any medicated treatment. Given their colour and size, head lice can be hard to see. The most accurate method to confirm an active head lice infestation is detection combing using a head lice comb: • Use a special fine-toothed head lice comb with a tooth spacing of 0.2-0.3mm; this comb can trap even the smallest lice. It is most effective on wet hair but can also be used on dry hair. • Wash hair using ordinary shampoo, then apply a lot of conditioner and leave it in.

Untangle the hair first using a wide-toothed comb. Once the comb moves freely through the hair, switch to the detection comb. • Make sure the teeth of the comb start at the root of the hair with the bevel-edge of the teeth lightly touching the scalp to detect nits at the root.

• Draw the comb down to the ends of the hair with every stroke, and check the comb for lice. If lice are detected, remove them by rinsing the comb. • Comb the whole head of hair section by section then rinse out the conditioner and repeat the combing procedure.

Treatment Options

Treatment should only be applied if an active louse one that is living and moving is found. NEVER as a preventative measure. Only one medicated treatment should be used at a time and the manufacturer’s instructions should always be followed. Head Lice are treated predominantly in three ways: • Pesticide treatments: There are various pesticide treatments available, and these work by poisoning the lice. The pesticide treatments available, Malathion and

Permethrin, work by poisoning the lice.

However, lice are becoming increasingly resistant to these pesticides in part because of inappropriate and overuse of these agents over a long period. • Non-pesticide treatments: These are still insecticides, but physical ones and are seen as more scalp friendly. They work by using

Dimeticone, which immoblises the lice to prevent spreading. • Alternative Treatments: Like detection combing, wet combing needs to be performed every three days. It may not be as effective as the other treatments, and it will take longer for the infestation to clear. Electronic nit combs are also available.

After Treatment

Whatever treatment is used, detection combing two or three days after will show if it has been successful. If nits are found, it doesn’t necessarily mean that the treatment hasn’t worked – they may just be empty egg cases. If live lice are found, the treatment may not have been successful. The treatment will need to be repeated on your whole household.

Prevention

If someone suspects there is a case in the family, they should check for lice immediately and make sure that whoever has them cannot have the opportunity to spread them to someone else. Touching heads, sharing hats and combs are just some ways that head lice can be transferred. Children’s hair should be checked regularly with a lice comb and children should be made aware of the ways that they can spread.

WWho? Generally, children aged 4-11

WWhat are the symptoms? An itchy scalp. Lice may already have

been found

HHow long have they had the symptoms? Crucial to assessing which

product to use. Size of lice, are there eggs only?

AAction already taken? Customers may have already tried a shampoo,

or combing the nits out

MMedication: Anyone with psoriasis, sensitive skin, or asthma should

use non-pesticide remedies