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By Oyinwa Alex-Okoh

Oyinwa Alex-OkohIt is that time of the year again, when students are winding down the summer vacation and anticipating the start of the new school year. Unfortunately, back to school season correlates with head lice season, and it is important to arm ourselves, as well as our kids, with defensive measures to avoid getting infested by these dreaded bugs! Head lice infestations are most commonly found in children ages 3-11, and the Center for Disease Control estimates that up to 12 million people are affected each year in the United States.

What are head lice?

Head lice, Pediculus humanus capitis, are a parasitic insect that feed on human blood. Although they are most commonly found on the scalp, they may also live in eyebrows and eyelashes of some hosts.

How are head lice spread?

Lice do not fly; they crawl about the scalp and hair shaft. Therefore, they are transmitted from person to person by close head-head contact or by sharing such things as hats, towels, clothing, brushes, and other hair care accessories. Lice can live on soft furnishings, such as cushions, for up to 48 hours; hence they can be spread by sharing pillows or bedding with infected individuals.

If lice are non-pathogenic, why are they such a big deal?

Scratching of the scalp could cause skin irritation and this might give opportunistic bacteria a chance to cause more serious disease or infection. Itching can also be a source of discomfort.

How can I prevent head lice?

Don’t share personal effects such as hats, combs, towels, and bedding—avoid bringing such objects belonging to other people in contact with your head.

How do I know if I have lice?

The signs and symptoms of lice include: itchy scalp which often leads to scratching of the scalp and sometimes back of the neck. Although lice are microscopic insects, they can be observed with the naked eye, so examining the scalp under bright light and with the aid of a microscope can be used to diagnose a lice infection.

How do I treat head lice?

There are two classes of FDA recommended over the counter (OTC) medications: pyrethrins and permethrin (a synthetic form of pyrethrin) lotion, which are available under various brand names. Both medicines are pediculicides, i.e., they kill only the live lice but not the eggs and hence have to be reapplied about nine days after initial treatment to kill lice that hatched after the first treatment and before they lay eggs themselves. If the OTC medication proves ineffective, consult with your healthcare professional before proceeding with further medication. It is possible that the lice may be resistant to the active pharmaceutical ingredient in the drug.

There are also prescription drugs, which a health care professional can prescribe, and these drugs might be particularly useful against lice that are resistant to OTC medication.

Many head lice treatments are not recommended for children under the age of two, and modifications have to be made when treating patients that fall into this demographic. The American Association of Pediatrics (AAP) recommends 1% permethrin, which is ovicidal and kills about 80% of the eggs; a second dose is applied on the ninth day to treat any lice that may have hatched from the surviving eggs.

Another common, albeit less effective, way to get rid of lice is by combing damp hair with a fine-tooth comb daily for a period of about two weeks. Natural oils such as tea tree, peppermint, eucalyptus, and olive oils may also be used in conjunction with combing. Such methods are not recommended, as they do very little to combat head lice.

What ever medication is used, it is important to follow the label instructions and avoid continuous application of the product. If treatment fails, please seek professional medical advice. But as the back to school season gets in full swing, avoid lice altogether by warning your kids to not share objects that have touched someone else’s head. They may be itching to get back to school, but itching while back in school would be a lot worse.

Oyinwa Alex-Okoh is currently a graduate student in biotechnology at the Catholic University of America, DC. She holds a BA in psychology from American University and a premedical certificate from Elms College, MA.