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Public Health Solutions
District Health Department
995 East Hwy 33, Ste 1
Crete, NE 68333-2562
888.310.0565
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Head Lice
What are head lice?
Head lice are parasites which infest hair, eyebrows, and eyelashes. The louse, a small, flat wingless insect, responsible for human head lice is Pediculus humanus var. capitis. The human head louse has a three stage life cycle: nits, nymphs, and adults. The nits (eggs) are laid by fertilized adult females are firmly glued to body hair or clothing. After seven to ten days, nymphs emerge from the eggs. The nymphs must feed within 24 hours to survive. Depending on the temperature, the nymphal stage lasts 7 to 13 days. Fertilized females produce 250 to 300 eggs over the next three to four weeks before dying.
How are head lice spread?
The louse is spread by direct and indirect contact with an infested person. Indirect contact includes using the same hair brush or comb as an infested person.
What does head lice infestation cause?
The major complaint of head lice infestation is itchy scalp. Scratching can lead to abrasions which can become infected with bacteria. A secondary bacterial infection is characterized by weeping and crusting of the scalp.
How long can head lice be spread person-to-person?
Human head louse can be passed person-to-person for as long as the lice or egg remain alive. The eggs and adults can survive for about seven to ten days without feeding.
Who is at risk of head lice infestation?
People from all social, ethnic, and economic background are at risk for head lice infestation. Infestations can reach epidemic levels among schoolchildren.
What preventive measures can be taken?
Avoid direct and indirect contact with infested people. For children in a group setting, directly inspect for head lice regularly.
What is the treatment for head lice?
- A lice infestation will not go away on its own. Some treatment method must be applied in order to resolve a case of head lice.
- Regardless of method used to treat a live infestation the manual or mechanical removal of lice and nits from the hair is crucial.
Chemical
Several insecticidal treatments (pediculocides) are available that are effective against head lice:
- pyrethrin liquid with piperonyl butoxide (RID®, A-200 Pyrinate®) 1% permerthrin creme rinse (Nix®)
- malathion (requires a prescription)
- Lindane used to be presribed, but is no longer recommended for use in treating youth for head lice due to toxicity and side effects.
Make sure to follow the instructions carefully, and do not use these chemicals as a preventative measure—doing so will not prevent infestation, and will only expose your child to chemicals unnecessarily. If chemical treatments are selected, manual lice removal via “wet-combing” in conjunction with treatment is still necessary for 100% effectiveness.
Non-Toxic
Because of increasing lice resistance to pyrethrin and permerthrin, and due to parental concern about the health effects of chemical lice treatments, more attention has been brought on the use of non-toxic alternatives to these insecticidal shampoos. In addition to avoiding any potential health impact, these treatments do not contribute to the building resistance of lice to insecticidal chemicals. As with chemical treatments, non-toxic methods must be done repeatedly to end the infestation, as they are not effective against lice in all stages of development (i.e. they will not kill/remove lice eggs, so additional treatment is necessary to kill or remove newly hatched lice).
- Daily use of a metal ‘louse’ or ‘nit’ comb on wet, conditioned hair over the course of 2-3 weeks is time consuming but can be highly effective if parents are diligent about treatment. In a recent study one version of this method, called BugBusting (www.nits.net/bugbusting), was found to have the same or better results as chemical treatment.
- A few commercial products claiming to treat lice in a non-toxic fashion include Hair Clean 1-2-3, Follicel, LiceFreee!, LiceOut Gel, Nuvo, Lice Off, Lice R GoneÒ, and RidÒ Pure Alternative. Their specific methods and ingredients vary, and most have not been scientifically confirmed for efficacy.
Treating the Home
Spraying the entire home or classroom with pesticides is not effective, healthy or necessary.
- Combs and brushes should be soaked in a pediculocide or bleach solution for one hour.
- Bedding/clothing should be washed in hot water, dry cleaned, or dried on a hot setting
- Vacuum using a HEPA-filtered – don’t forget the car seats.
- Anything that cannot be cleaned can be bagged tightly and left outdoors for 3 weeks. Without a human to feed on the lice will die on their own.
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