Head lice

(Provided photo)

With school back in session, I find myself trying to head off many questions about head lice.

Head lice are tiny tan to reddish brown insects about the size of a sesame seed that love to live on the scalp of your child, bite into the scalp, cause itching and scratching, and eventually lay their yellowish-white eggs or nits right on the hair shafts.

They differ from a speck of dandruff in that they are tougher to remove from the shaft of the hair whereas a flake of dandruff comes off easily.

If you are concerned that your child may have head lice, read on for some hair-raising information on the topic.

1. Having head lice does not indicate a lack of hygiene or sanitation on the part of the person who gets them.

Lice can spread whenever children’s heads touch — while sharing a book at school, during sports, sharing combs or other hair accessories, or in the bouncy castle at a party or event. Even taking selfies can put children in head-to-head contact.

2. Treatment involves the use of an over-the-counter product.

This could be anti-lice shampoo, lotion, or creme rinse that your child’s health care professional will recommend. These products contain 1% permethrin and require you to follow instructions carefully. After they are used, parents comb out the now dead lice and nits or eggs using a fine-tooth comb. The treatment is repeated a week to 10 days later. Clothing or bed linens should be washed in hot water and hair care-items boiled or thrown away.

3. What if the treatment doesn’t work?

If this treatment does not work, it may be because it is not head lice at all but a bad case of dandruff or the instructions for the shampoo were not followed carefully. It may also be because head lice have become resistant to the usual treatment and your child’s health care professional can recommend a prescription anti-lice product.

4. Can your child go to school?

Since head lice have usually been present for a month or more when discovered, and because they present little risk to others and carry no health risks except for scalp irritation, a child with head lice detected in school should remain in class but be discouraged from having direct head contact with others. Parents can treat their child before they return to school the next day. No healthy child should be excluded from or allowed to miss school because of head lice. That’s not just my opinion, but that of the American Academy of Pediatrics.

5. Ways to prevent getting head lice.

Of course, the best way to deal with head lice is to prevent them from occurring. Tell your child not to share combs, brushes, hair ties, or hats with other children. Keep your sense of humor and realize this problem, though bothersome, will not affect your child’s overall health and well-being.

Hopefully, tips like these will do far more than simply scratch the surface of your child’s scalp when it comes to dealing with head lice.

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Lewis First, MD, is Chief of Pediatrics at The University of Vermont Children’s Hospital and Chair of the Department of Pediatrics at the University of Vermont’s Larner College of Medicine. You can also catch “First with Kids” weekly on WOKO 98.9FM and NBC5.


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