Focus on Pediatrics: Many myths surround head lice eradication

No need for house-cleaning frenzy

When children return from summer camp, parents expect a suitcase full of dirty laundry, rolls of film to be developed, and lots of stories about the adventure. Many times the children return with something parents don’t expect — a case of head lice.

When this happens, there usually is chaos in the household for several weeks. Mom strips beds daily to wash the sheets, items from camp that might be contaminated are bagged and left on the porch for five weeks, and children have their head scrubbed with a special lice shampoo.

The frenzy is caused by misinformation that has been passed from neighbor to neighbor and relative to relative. It’s similar to the telephone game where a message is passed along, and after several links it is a different message. Incorrect advice causes frustration, paranoia, and desperation, says Dan Sheridan, a telephone counselor at the National Pediculosis Association in Needham, MA.

"People believe that the lice are everywhere, like when they have an infestation of fleas," he says. "However, lice don’t jump or fly. They only live on human heads because they are a parasitic creature." Studies have shown that lice die in about 24 hours if they are not on a head, Sheridan adds.

The best way to rid of lice is to get a good comb and work on nit removal from the child’s hair. Lice are spread when a child has direct contact of the head or hair with an infested individual. They also are spread if a child shares personal articles such as hats, towels, brushes, helmets, and hair ties with an infested individual.

Lice may spread to pillows, headrests, or similar items that are touched by a child’s head when infested as well. The best way to remove lice or fallen hairs with attached nits from upholstered furniture, rugs, stuffed animals and cars is by vacuuming, says Sheridan.

To remove lice from pillows, sheets, jackets, and hats, place the item in the dryer for half an hour on high heat, he says. Parents tend to wear themselves out washing items all the time, and it isn’t necessary. If the item isn’t dirty it can simply be placed in the dryer.

Children are more likely to get head lice than adults because they share personal items and play together. The risks of transmission can be managed more easily if children have their own sports equipment, such as bicycle helmets, and other personal items such as towels for swimming. "Tell kids not to share personal items, but don’t make them phobic," advises Sheridan.

If a child has head lice over and over again, it is probably because parents have succeeded in lowering the infestation but not eradicating it completely. They comb the nits until they can’t see anything and their child is no longer itching. Two weeks goes by and they have another case of head lice. "There probably were eggs in the hair that were not removed. It takes seven to 10 days for the eggs to hatch," says Sheridan.

Once hatched, lice can survive on a human host for about 30 days. The female louse will lay between three and five eggs per day, and it takes about seven to 10 days for a louse to become mature and lay eggs.

To make sure that a case of lice has been eradicated, parents need to continue combing their child’s hair to remove eggs that have not yet hatched for at least a week after they think the lice are gone, says Sheridan. "If parents are thorough and use a good comb, they have really good odds of getting every egg out before it hatches. Parents should keep combing every day until they have gone a week without seeing any bugs or eggs."

Many parents want to use lice shampoo in addition to nit removal. Those who do use such products should do their homework first, advises Sheridan. "There are segments of the population that are very sensitive to these chemicals. They can cause skin irritation and touch off asthma, and overtreatment can cause serious health risks."

The best prevention and control method for head lice is regular screenings. Parents should check their children for head lice before they go off to summer camp so they won’t infect others. Then parents should check children when they return. "It’s a good idea to check children a couple times a year, particularly at those times when large numbers of kids are getting together at summer camp," says Sheridan.