Lice

Overview

Lice are tiny, wingless insects that feed on human blood. They spread from person to person through close contact and by sharing belongings. There are three types of lice: head lice, body lice, and pubic lice. Head lice are found on the scalp, body lice live in clothing and bedding, and pubic lice are found in the pubic area or other coarse body hair. Lice can cause intense itching, a tickling feeling from hair movement, and the presence of lice and eggs on the scalp or body. It is important to see a healthcare provider if you suspect lice infestation, as there are various treatments available.

Understanding the disease

Symptoms

The common symptoms of lice include intense itching on the scalp, body, or genital area, a tickling feeling from the movement of hair, the presence of lice on the scalp, body, clothing, or pubic or other body hair, lice eggs (nits) on hair shafts, sores on the scalp, neck, and shoulders, and bite marks, especially around the waist, groin, upper thighs, and pubic area. If you suspect you or your child has lice, it's important to see a healthcare provider for proper diagnosis and treatment.

Risk Factors

Risk factors for developing lice include close head-to-head or body-to-body contact, sharing personal belongings such as clothing, headphones, brushes, combs, and pillows, and coming into contact with furniture or bedding that has had recent exposure to someone with lice. Lice can also spread through sexual contact, particularly with pubic lice. There is no correlation between lice infestation and personal hygiene or living conditions.

Development

The various types of lice go through different development stages:

1. Head lice: Female head lice lay eggs (nits) on hair shafts close to the scalp. The eggs hatch in 6 to 9 days. The nymphs that hatch from the eggs are immature forms of the louse that mature into adults after 9 to 12 days. Adult head lice can live for 3 to 4 weeks and lay 6 to 10 eggs per day.
2. Body lice: Female body lice also lay eggs on hair shafts, but they can also lay them on clothing. The eggs hatch in 6 to 9 days. Nymphs mature into adults after 9 to 12 days, and adult body lice can live for 3 to 4 weeks.
3. Pubic lice: Female pubic lice also lay eggs, which hatch in about 6 to 9 days. Nymphs mature into adults after 9 to 12 days, and adult pubic lice can live for about 3 weeks. The development process for each type of lice is similar, with the eggs hatching into nymphs, which then mature into adults.

Assessment and Diagnosis

Triage

You should see a doctor if lice are suspected, especially if there are symptoms such as intense itching, a tickling feeling from movement of hair, or the presence of lice on the scalp or body hair. It is recommended to consult a healthcare provider before beginning treatment if you suspect head lice. They can confirm the presence of lice and provide guidance on the appropriate treatment.

Diagnosis

To diagnose lice, a healthcare provider will typically perform an examination of the affected area. For head lice, the provider may use a magnifying lens and a special light called a Wood's light to look for live lice and nits (eggs) on the scalp and hair shafts within 1/4 inch (6 millimeters) of the scalp. For body lice, the provider may check for eggs or crawling lice in clothing seams or on bedding. For pubic lice, the provider may inspect the affected area for moving lice or nits. A healthcare provider may also recommend using a fine-toothed comb to carefully comb through the hair, especially if the examination reveals nits close to the scalp. To diagnose head lice, it is essential to identify a live nymph or adult louse. Identifying nits alone is not enough to confirm the presence of live lice. If you suspect head lice, it is essential to consult a healthcare provider for proper diagnosis and treatment.

Management and Treatment

Complications

Potential complications of lice include secondary infections, skin changes, and the spread of bacterial diseases such as typhus, relapsing fever, or trench fever.

Prevention

While there isn't a surefire way to completely prevent head lice, taking certain precautions can reduce the risk. Here are some steps to help prevent head lice:

1. Avoid head-to-head contact: Encourage your child to avoid direct head-to-head contact with classmates during play and other activities.
2. Don't share personal belongings: Teach your child not to share items like hats, scarves, coats, combs, brushes, hair accessories, and headphones.
3. Regular cleaning: Regularly wash and dry-clean items like pillowcases, bedding, and clothing in hot water and consider using a lice-killing laundry additive.
4. Check for lice regularly: Examine your child's hair and scalp regularly to identify any signs of lice or nits early on.
5. Avoid shared spaces: Discourage the sharing of hats, clothing, and other personal items in common areas such as lockers or hooks.
6. Keep long hair tied: If your child has long hair, consider having them tie it up or wear it in a bun to reduce the risk of lice spreading. Remember that it's not always possible to prevent all contact that may cause the spread of lice, but following these steps can help minimize the risk.

Home Remedies

Head lice can be a common issue, especially for children. While over-the-counter and prescription treatments are available, there are also various home remedies suggested for lice. Some of these remedies include:

1. Wet combing: Using a fine-toothed comb, apply conditioner to the hair, wait for 10 minutes, and then comb through the hair to remove lice and eggs. Repeat the process every few days for a week or two.
2. Olive oil: Applying olive oil to the hair and scalp, leaving it on for several hours, and then shampooing can help loosen and remove lice and eggs.
3. Tea tree oil: Mixing tea tree oil with a carrier oil, like coconut oil, and applying it to the hair and scalp can help repel lice. Be cautious, as tea tree oil can be irritating to some people's skin.
4. Neem oil: Neem oil has antimicrobial properties and is known to help repel lice. Mix a few drops of neem oil with your regular shampoo or conditioner and use as usual.
5. Vinegar rinse: After shampooing, rinse the hair with apple cider vinegar or white vinegar. This can help to remove any remaining lice and eggs.
6. Lavender oil: Applying a diluted mixture of lavender oil to the hair and scalp can help soothe the itching and repel lice. Please note that the effectiveness of these home remedies varies and may not be as reliable as prescription or over-the-counter treatments. Consult a healthcare professional for advice on treating head lice.

Treatment

To treat lice, follow these steps:

1. Use a medicated shampoo or lotion: Choose a nonprescription lotion or shampoo designed to kill lice. Apply the product according to the package instructions. You may need to repeat the treatment in about 9 to 10 days after the first application. Be sure to check the age recommendations before using the drugs on children.
2. Comb wet hair: Use a fine-toothed nit comb to physically remove lice from wet hair. Repeat this process every 3 to 4 days for at least two weeks. This method can be used in combination with other treatments and is usually recommended as the first line treatment for infants younger than 2 months.
3. Wash items: Wash bedding, stuffed animals, clothing, and hats with hot, soapy water (at least 130濮婂宕掑鍏橀崘鍙夋礀閵娧冪С缁舵氨鐣簅r 54濮婂宕掑鍏橀崘鍙夋礀閵娧冪С缁舵氨鐣) and dry them at high heat for at least 20 minutes. For unwashable items, place them in an airtight bag for two weeks.
4. Vacuum: Thoroughly vacuum the floor and furniture to remove any lice or nits. While alternative treatments like mayonnaise, olive oil, tea tree oil, anise oil, or ylang-ylang oil may be used, their effectiveness is uncertain. It's essential to follow the recommended self-care steps and use medicated products to ensure successful lice treatment.

Preparing for medical consultation

To prepare for an appointment for lice, you should:

1. Write down any symptoms you're experiencing, including any that may seem unrelated to lice.
2. Note key personal information, such as when you might have been exposed to lice, whom you might have exposed, and what household items might be contaminated.
3. Make a list of all medications, vitamins, or supplements you're taking.
4. Create a list of questions to ask your healthcare provider about lice treatment, frequency, and precautions.
5. Consider avoiding sharing personal items, bedding, towels, or clothing if you think or know you have lice.
6. If you have pubic lice, avoid sexual activity until you've been treated.
7. Dry-clean or seal unwashable items for two weeks if you can't wash them. Remember to communicate openly with your healthcare provider about your symptoms and any treatments you've tried. Prepare for the appointment by making a list of questions and personal information to ensure you make the most of your time together.