Head lice

If you see live lice or lice eggs in the hair and scalp, you are infected. You can easily find lice in the neck or behind the ears.

Other signs that you have lice are:

• Your head is itching
• A dark powder on the pillow or around the shoulders on clothing. It may be the lice stool or sore skin.
• Infected scars on the scalp.

Be aware that lice do not always itch. The itching is a reaction to the saliva secreted by the lice and it may take several weeks after infestation before itching occurs. The more times you have been infected with lice, the sooner the itching will start. So check for lice regularly to ensure early detection.

Head lice are small, 2–3 mm long insects that live on the human head. They can be gray, brown or black – and if they have just sucked blood, red. Head lice are only found in the hair and scalp. They can neither jump nor fly without climbing hairs. They move quickly and avoid light. Lice are very contagious. Those who have recently been infected with head lice rarely have any symptoms and spread the lice without knowing it. Lice are spread through head contact – they creep from one head to another.

Head lice:

• are not due to poor hygiene
• do not spread bacteria or viruses, but can join secondary diseases (eczema, impetigo and pyoderma) 
• do not survive long outside the hair and scalp. They die after 24 hours without a host.

LIFE CYCLE: A female louse can lay from six to eight eggs per day. Follow the louse from egg to adult here:

• eggs – they are small, much like a small pinhead. The eggs are very firmly attached to the hairs near the scalp. They are dark and hard to see. When hatched, the empty eggs are white or translucent. The eggs do not detach themselves, but you need to use a lice comb to remove them.
• young louse – hatch after eight to nine days. The louse continues to grow for nine to twelve days.
• adult louse – live about 30 days in hair and scalp.

Lice are most active in the summer. They spread easily when schools start. Be aware when your child returns to school, tie hair back and check with a nit comb regularly. Compliance with personal hygiene: regular washing of the head; change of underwear and bed linen; washing bedding at high temperature, ironing clothes with a hot iron. Preventing the transfer of personal hairbrushes to others. NB nit comb is not effective unless hair has a lot of conditioner in it as this allows the nits and eggs to detach from the hair strand.

To effectively get rid of lice, you need to combine regular use of a lice comb with a medicated treatment.

Treatments available without prescription include:

• Liquid products containing silicone oil or plant oil that are massaged into the hair and scalp. These cause the lice to suffocate or not to disperse the liquid that forms when they have drawn out blood. How long they will work depends on the product brand and is stated on the packaging.
• Non-prescription drugs that work in the hair and scalp for 24 hours. Drug treatment takes place twice, with the second treatment being done eight days after the first. (NB Lice found only in the hair and scalp, no other hairy parts of the body should be treated. Sometimes lice can end up in the eyebrows or eyelashes. Then sprinkle petroleum jelly over the brows or lashes and they will suffocate.

Whatever treatment option you take, you should continue combing your hair with a lice comb two or three times a week for two weeks after you do the last treatment, to make sure the lice are gone.

If you have a family, it is important that all members are treated against lice at the same time to stop the spread. The same applies, for example, to preschool groups.

Once the lice have left the hair and scalp and ended up elsewhere, they cannot reattach to new hair. Therefore, bedding does not need to be washed. However, you may want to wash brushes and combs for safety.

Lice – again: If you find new head lice despite treatment, you may have followed instructions incorrectly or been reinfected. You should repeat the treatment procedure again, and consider replacing the medicine you used with another.

Schools: If your child has head lice, you should tell your preschool staff or school nurse. Your child may return to preschool or school the day after treatment.

Head lice are not dangerous and therefore you do not need to contact a doctor. All treatments are available over the counter at pharmacies. However, if you have a secondary infection triggered by the headlice, (eg eczema, impetigo and pyoderma) you may want to contact your doctor for advice or treatment.

Apart from following the advice above, you can contact an Appotek doctor to find out which treatments are recommended for your family. You can also get help for any secondary issues that may have been triggered by head lice (eg eczema, impetigo and pyoderma).