FAQ

Union County Health Department

       6 West South Street - Suite 2
       Liberty, IN 47353
       765-458-5393

Number 1 FAQ. Lice Treatment: “De-Bug”
Answer: The Union County Health Department follows the Centers for Disease Control and Prevention’s (CDC) recommendations for treating head lice. Head lice infestation is very common and is distributed worldwide. Preschool and elementary-age children, 3 to 10 years of age are infested most often. Females are infested more often than males, probably due to more frequent head to head contact. In the United States, African-Americans are rarely infested with head lice. This is believed to be due to the American louse’s preference for the shape and width of the hair shaft over other races.

The life cycle of the head louse has three stages: egg, nymph and adult.

1. Eggs: Nits are head lice eggs. They are hard to see and are often confused for dandruff or hair spray droplets. Nits are laid by the adult female and are cemented at the base of the hair shaft nearest the scalp.

They are 0.8 m by 0.3 mm, oval and usually yellow to white. Nits take about 1 week to hatch (range 6 to 9 days). Viable eggs are usually located within 6 mm of the scalp.

2. Nymphs: The egg hatches to release a nymph. The nit shell becomes a more visible dull yellow and remains attached to the hair shaft. The nymph looks like an adult head louse, but is about the size of a pinhead. Nymphs mature after three molts and become adults about 7 days after hatching.

3. Adults: The adult louse is about the size of a sesame seed, has 6 legs (each with claws), and is tan to grayish-white. In persons with dark hair, the adult louse will appear darker. Females are usually larger than males and can lay up to 8 nits per day. Adult lice can live up to 30 days on a person’s head. To live, adult lice need to feed on blood several times daily. Without blood meals, the louse will die within 1 to 2 days off the host.

Clinical Features: The majority of infestations are asymptomatic. When symptoms are noted they may include a tickling feeling of something moving in the hair, itching, caused by an allergic reaction to louse saliva, and irritability. Secondary bacterial infection may be a complication.

Modes of Transmission: There are two modes of transmission: Person-to-person contact with an already infested person. (i.e. head-to-head) and via fomites.

	Person-to-person transmission – contact with an already infested person. Contact is common during play at school and at home (slumber parties, sports activities, at camp, on a playground)
	Fomite transmission can occur by wearing infested clothing, such as hats, scarves, coats, sports uniforms, or hair ribbons; by using infested combs, brushes, or towels; and by lying on a bed, couch, pillow, carpet, or stuffed animal that has been in contact with an infested person.

Laboratory Diagnosis: The diagnosis of pediculosis is best made by finding a live nymph or adult louse on the scalp or in the hair of a person. Finding numerous nits within 6 mm of the scalp is highly suggestive of active infestation. Finding nits only more than 6 mm from the scalp is only indicative of previous infestation.

Diagnostic findings: Microscopy

Treatment: Requires using either a prescription or an over-the-counter (OTC) medication. Follow these treatment steps:

Treat the infected person:

	Remove all clothing.
	Apply lice medicine, also called pediculicide, according to label instructions. If your child has extra long hair, you may need to use a second bottle. WARNING: Do not use a crème rinse or combination shampoo/ conditioner before using lice medicine. Do not rewash hair for 1 to 2 days after treatment.
	Have infested person put on clean clothing after treatment.
	If some live lice are still found 8 to 12 hours after treatment, but are moving more slowly than before, do not retreat. Comb dead and remaining live lice out of the hair. The medicine sometimes takes longer to kill the lice.
	If, 8 to 12 hours after the treatment, no dead lice are found and lice seem as active as before, the medicine may not be working. See your health care provider for a different medication and follow their treatment instructions.
	Nit (head lice egg) combs, often found in lice medicine packages should be used to remove nits and lice form the hair shaft. Many flea combs made for cats and dogs are also effective.
	After treatment, check, comb, and remove nits and lice from hair every 2 to 3 days.
	Re-treat in 7 to 10 days.
	Check all treated persons for 2 to 3 weeks until you are sure all lice and nits are gone.

Treat the household:

	To kill lice and nits, machine wash all washable clothing and bed linens that the infested person touched during the 2 days before treatment. Use hot water cycle (130 degrees F) to wash clothes. Dry laundry using the hot cycle for at least 20 minutes
	Dry clean clothing that is not washable, (coats, hats, scarves, etc.) or
	Store all clothing, stuffed animals, comforters, etc., that cannot be washed or dry cleaned into a plastic bag and seal for 2 weeks.
	Soak combs and brushes for 1 hour in rubbing alcohol, Lysol, or wash with soap and hot (130 degrees F) water.
	Vacuum the floor and furniture. Do not use fumigant sprays; they can be toxic if inhaled.

All household contacts should be checked for lice and nits every 2 to 3 days. Treat if lice and nits are found. Prophylactic treatment is not recommended. For children under 2 years, OTC or prescription pediculicides should not be used. Treatment in these situations would involve the removal of nits, nymphs (immature adult lice), and adults by hand.

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Send mail to support@uchd.com with questions or comments about this web site. Last modified: 12-31-08

Send mail to support@uchd.com with questions or comments about this web site.
Last modified: 12-31-08