by Carol Evans
When Traci Bryant’s son first went to preschool in 2013 at age 4, she says he brought home a special treasure with him – lice. And before she knew it, it had spread to both her 7-year-old daughter and herself.
School’s back in, and reports of lice again are on the rise in area schools. In fact, it’s been widely reported in the news recently that a strain of “super lice” is now affecting children in more than 25 states, including Alabama, according to reports from researchers at Southern Illinois State at Edwardsville.
What does that mean for Bryant and other parents, if lice rear their ugly little heads again? “What happens over time when a product is overused or not used as directed is that it will cause the insects to develop resistance to the treatment,” says D’Ann Somerall, DNP, FNP-BC, assistant professor, assistant MSN program director and family nurse practitioner specialty track coordinator at UAB School of Nursing. “We are seeing this a lot with antibiotics, so it really isn’t that surprising that this has happened [with lice].
“What has happened is that the lice have developed a gene mutation against the most common substance in the over-the-counter lice treatment, pyrethroids, which makes the pyrethroids ineffective,” Somerall says. So, what do we do now?
There are many misconceptions about lice, says Somerall, a mother of six but one of the biggest is that lice are only a problem for the poor. “It has nothing to do with how clean or dirty your home or school may be, or how clean or dirty your kids may be. Affluent schools, rural schools, urban schools – anyone from any socioeconomic background can get head lice, no matter how clean their hair or home,” Somerall adds.
Stephanie Armstrong, RN, a registered nurse at Greenvale Pediatrics-Brook Highland, says lice “aren’t dangerous but they are a nuisance and can be difficult to deal with.”
Lice go where people go, Somerall adds. “They can’t jump or fly. They crawl. So kids playing together, heads touch, they share hairbrushes. Interestingly, the CDC states that head lice are less common among African-Americans than other races, as the thought is that the claws of the louse can’t grasp the hair shaft as well in African Americans than in other races.”
The Centers for Disease Control and Prevention at www.cdc.gov says that head lice do not survive long if they fall off a person and cannot feed.
HEAD LICE SYMPTOMS
According to Armstrong, some of the symptoms of head lice include itching and scratching. Parents may also notice small red bumps or sores from scratching, and children may complain of feeling like something is moving around on or tickling their heads.
If your child is showing symptoms of head lice, they should be easy to identify, says Armstrong. The lice and the nits (eggs) can be seen by the naked eye. “Usually at the nape of the neck or behind the ears there are small eggs that are attached to the hair shaft,” Armstrong says. “They may be white or yellowish brown. They look different than dandruff as dandruff flakes away pretty easily and quickly, while lice eggs are pretty hard to pull out.”
GOT LICE? NOW WHAT?
So, your child (or you) has lice. What do you do?
“There are two different opinions on this based on evidence and information,” Somerall says. “One opinion is to treat with an over-the-counter (OTC) treatment, and if it is not successful then request a prescription such as Sklice, Natroba or Ulesfia.
“The other,” Somerall continues, “is to skip the OTC treatment and go right to the prescription medication. Right now, it is up to the parent to discuss with their pediatric provider what he or she believes is the best option.”
Treatment for lice is highly effective, Armstrong adds. Options include OTC medication shampoos as well as more natural shampoos designated for treating lice. “The key is to follow directions carefully to avoid recurrence,” she says. “Most treatments require a follow-up application after 7-10 days. This is to kill any newly hatched nits.”
Still, it is important to keep in mind that lice medication is a pesticide, Armstrong stresses. Applying too much or using it too often can increase the risk of causing harm. Read and follow directions on any packaging precisely.
When Bryant’s family had the “lice attack,” she said she tried Nix, Rid, and even the crazy mayonnaise, shower cap and petroleum jelly on heads overnight. They still weren’t lice free. “Then I read about tea tree oil. It can be found in the pharmacy department for around $5…I put two drops in about three tablespoons of their regular shampoo and then combed it through their hair again. I was absolutely shocked that this worked…and a couple of drops in your regular shampoo will keep them away,” Bryant adds.
When treating the person, the CDC warns you also need to treat their surroundings. Have the infected person put on clean clothing after treatment. Because lice cannot live long after falling off a person, a few simple housecleaning activities will help. Most important, machine wash and dry clothing, bed linens and other items that the infected person wore or used during the two days before treatment on the hottest cycle possible, dry clean, or seal in a plastic bag for two weeks. Soak combs and brushes in hot water for at least five to 10 minutes and vacuum floors and furniture. Because of lice’s short lifespan, the CDC recommends says extensive, expensive house cleaning measures are unnecessary.
If after all the recommended treatments your child still has lice, it could be because some nits were left behind, your child is still being exposed to someone with lice or the treatment isn’t effective. If your child still has lice two weeks after starting treatment or if the scalp looks infected, call your doctor, Armstrong suggests.
HOW TO AVOID LICE IN THE FIRST PLACE
When you know there are issues with lice at school, a few things can help, Somerall says. Keep long hair in ponytail or braids. This keeps the hair from coming in contact with other heads/hair.
“Keep your kids from sharing things that touch the head: ear buds, hats, combs, brushes,” Somerall points out. “If you have a child with lice, keep the other children (family and friends) from using the same pillow, bedlinens, hats, etc.”
“While highly contagious, it’s important to remember that lice cannot jump or fly,” Armstrong says. “The only way of transmitting them is by direct contact.”
Lice shouldn’t be embarrassing, Somerall stresses. “I remember the first time my daughter came home saying her head was itching! I found lice and I felt like I needed to hide my head in shame, and I’m a nurse. A few weeks later my neighbor said her daughter had lice a few times. I felt relieved that I wasn’t the only mom whose child had lice. And later I checked my daughter’s backpack and found, wadded up in the bottom of her backpack, the note from the school that there was an outbreak of lice!”