How to prevent, treat head lice

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by Dr. Art Mollen, Special to azfamily.com

Video report by Tess Rafols

Posted on July 23, 2013 at 10:32 AM

Updated Wednesday, Oct 30 at 9:29 AM

PHOENIX -- Head lice are tiny insects that infest the hair on your head, as well as the eyebrows and eyelashes.  Tiny louse eggs called nits are tightly attached to individual hairs and may be difficult to see. 

Lice are easily spread, especially among school-age children.  Lice cannot jump or fly but are spread by direct head-to-head physical contact, sharing clothing (i.e. hats) or bedding, and sharing combs or brushes with someone who has head lice. 

Having head lice does not mean you have poor cleanliness.  Head lice do not carry diseases.

Signs and symptoms

  • Extremely itchy scalp
  • Small red bumps
  •  Tiny white nits on the hair
  • Crawling sensation on the head

Lice are easier to see in bright light and by parting the hair to see close to the scalp.  They are also easier to see near the ears and the nape of the neck.

Treatment
Over-the-counter lotions and shampoos that contain pyrethrin (A-200, Pronto Plus, Rid) or 1-percent permethrin (Nix) are often the first choice.  These products may continue to kill lice for two weeks after treatment. Many clinicians recommend a second treatment seven to nine days after the first. 

There is no clear scientific evidence that lice can be suffocated by home remedies such as mayonnaise or olive oil, but they may be suffocated by Cetaphil cleaner.  Tea tree oil is another helpful natural remedy.

It is very important that the nits are removed. 

Hats, scarves, coats and bedding should be washed in hot water and dried in a hot dryer for at least 20 minutes.

Most products come as a shampoo, crème rinse or lotion.

Itching may persist even after successful treatment. 

Negative side effects can include nausea and headaches.

If lice infest the eyelashes, applying petroleum jelly (such as Vaseline) to the eyelashes several times a day for a week can kill the lice.

The most common way to kill body lice and eggs is to wash clothing and bedding in hot water (130 degrees) or higher in a washing machine.

Permethrin cream 5 percent (Elimite) is used to treat head lice or pubic lice. It is applied to the skin or scalp, left on for eight to 14 hours and then rinsed off.

Ovide is used to treat head lice.  It is applied to hair on the head, left on for eight to 12 hours, and then rinsed off. Lice are still present seven to nine days later.

Lindane shampoo is used to treat head lice or pubic lice.  It should only be used when other products fail to get rid of lice.  Lindane contains potentially harmful toxins.

A pill, such as ivermectin, is sometimes prescribed to treat lice when the person does not respond to two or more topical treatments.

It is not necessary to remove lice eggs from hair after treatment with topical medicines, but some people may wish to remove them for cosmetic reasons. Most products used to treat lice may cause side effects if not used properly.

There is some concern that lice are becoming resistant to (can no longer be killed by) permethrin or other medicine used to treat lice infestations.
The prescription lotion Sklice (ivermectin) may safely knock out head lice in one 10-minute, comb-free treatment, according to a new study in New England Journal of Medicine.

These treatments work about 50 percent of the time.

Ivermectin is a one-time, one-application treatment that leaves the hair nice when you are done so it is not all goopy and messy.  The lotion is available by prescription and can cost up to $300 if it is not covered by insurance.   


Dr.+Art+MollenDr. Art Mollen's practice is located at 16100 N. 71st St. in Scottsdale. For more information, call 480-656-0016 or log on to www.drartmollen.com.

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