Nits and Myths

For most the beginning of a new school year marks the end of summer and the anticipation of cool nights, vibrant colors and the sounds and smells of the pending fall season. Fall of the year is one of my favorite seasons as the smell of chrysanthemums, fodder shocks, and pumpkins meld in the air. The sounds of marching bands, cheerleaders and football fans fill stadiums in the crisp cool nights in communities everywhere. Ah—fall is in the air.

Back-to-school is not always filled with pleasant experiences and lighthearted camaraderie. For some students and parents alike a new school year can be filled with fear and anxiety of anything from a school bully, new teachers and test taking to head lice. Myths often create more fear and anxiety about misconceptions than the truth. Sometimes, myths cause unnecessary emotional and physical pain for the community and unharmed, as well as those directly affected.

Because head lice (Pediculus humanus) have been around for 5.6 million years and found in every region around the world, I have little faith man will persevere in eradicating head lice in the future. A common misconception about head lice is they affect lower classes; however, infestations occur equally among socioeconomic classes. Risk factors include day-care centers, schools, and long hair, with a decreased risk in African-American populations related to differences in hair shafts, according to the Centers for Disease Control and Prevention (CDC). The most common mode of transmission is direct head-to-head contact.

Myth: Lice have wings and can fly or jump
Fact: Lice do not have wings and are transmitted only by direct contact

Myth: Lice infestation are accompanied with itching
Fact: Itching may take 4 to 6 weeks to appear because of delayed sensitivity

Myth: If a family member has head lice, the entire family should be treated
Fact: The infected person should be treated; other family members should be screened and treated only if lice are found.

Myth: Lice can live in carpets, beds and clothing
Fact: Lice can live only for 1 to 2 days once removed from the scalp

Myth: Pets can have head lice
Fact: Lice cannot live on the skin of animals because of differences between hair and fur

Myth: Lice affect only people who are unclean
Fact: Cleanliness will not prevent head lice infestation

Treatment options are pharmacologic therapies or home remedies. It is important to stress, some home remedies may cause more harm than good. Occlusion therapy has not proven to be an effective treatment because lice have spiracles they can use to breathe when suffocation is attempted. I have heard of home remedies such as petroleum jelly, kerosene, vinegar, isopropyl alcohol, olive oil, mayonnaise, and melted butter. I want to stress avoidance of putting anything on a child’s head or hair that is flammable, also wrapping hair in plastic can cause scalp irritation or suffocation.

Two pharmacologic therapy options for head lice are; pyrethrin (RID), but should be avoided if you are allergic to ragweed or chrysanthemums. Permethrin (Nix), again, perform a test dose if you are allergic to ragweed or chrysanthemums. Prescription strength alternatives may be prescribed by a healthcare provider. When in doubt, check it out with your healthcare provider.

Alternative therapies I found interesting in the literature were; tea tree oil, lavender, coconut and peppermint that have shown an overall avoidance of the treated areas by lice. However, none of these therapies showed superior control or efficacy in controlled studies. Nix® PF is available as a pesticide-free spray containing anise and coconut oil, isopropyl alcohol and ylang ylang (a flower oil). However, because this product may be flammable if exposed to direct heat or flame, extreme caution should be used.

Head lice cannot live for more than twenty-four to forty-eight hours after being removed from the body. Therefore, I do not recommend spraying chemicals on bedding or clothing. Wash bed linens or any personal items touched by the affected persons head in hot water or dry them at temperatures >130°F. Vacuuming will suffice for furniture, car upholstery and carpeting.

Head lice can affect anybody, and is not a sign of lack of cleanliness. Please, do not punish children by making them feel less about themselves or they are to blame. Seek immediate treatment and return to normal routines as quickly as possible.
Resources

www.headlice.org
www.cdc.gov/lice/head/factsheet.html

Howard Baker, RN BSN
For questions, comments, or suggestions on topics you want to read about please e-mail me at: howard@howardsbaker.com