LICEJohnson County Health Department

Amber Terhune, RN, BSN, Health Educator

August 2017

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What they are

• Tiny, parasitic insects

• Live on human hair

• Feed on human blood

• Very common

• They do not:

• Fly

• Hop

• Jump

• Burrow under skin

• Carry or spread disease

Byrne, Sue. Consumer Reports. Lindane: The Dangerous Head Lice Treatment That Shouldn’t be Sold, 5 Oct. 2015. https://www.consumerreports.org/cro/insectrepellent/lindane-is-a-dangerous-head-lice-treatment-that-shouldnt-be-sold

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Where they are found

• Scalp

• Behind ears

• Back of neck near hairline

• Rarely on eyebrows and eyelashes

Tips Curing Disease. Head Lice: Signs, Symptoms, Diagnosis, Treatment and Prevention, n.d. http://www.tipdisease.com/2013/11/head-lice-signs-symptoms-diagnosis.html

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Life cycle

• Nit (egg)

• Tiny, oval

• Yellow or white

• Nymph

• Smaller than adult

• Tan or gray

• Adult

• Size of sesame seed

• Tan or gray

• Survival

• Need blood supply

Greater Vancouver Lice Clinic Ltd. Head Lice Facts, 2011. http://greatervancouverliceclinic.ca/head-lice-facts

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How they spread

• Very contagious

• Direct contact

• Head to head

• Indirect contact

• Contact with hair and head items (comb, hat)

• Contact with bedding

• Not spread by pets

Digital Mom Blog. The Weird Way Lice is Spreading, 23 Oct. 2014. https://www.digitalmomblog.com/teens-lice-selfies/

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Those at risk

• Anyone

• Close contact with infested person

• Children 3-11 years and their families

• More common in girls

• Less common in African Americans in U.S.

Eustace Independent School District. You Can Have Head Lice Without Knowing It, as There are Often No Symptoms, 2016. http://www.eustaceisd.net/nurseLice.htm

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Signs and symptoms

• Itching

• Red scalp

• Sores on scalp

• May feel tickling

• May feel movement

• Difficulty sleeping

• Seeing lice on scalp

• Nits on hair shafts

Gass, Dorathy. 10 Signs and Symptoms of Head Lice, 4 Mar. 2015. http://rmhealthy.com/10-signs-symptoms-head-lice/

Lice Busters. Nipping Head Lice in the Bud, 2013. http://www.licebustersnyc.com/category/faq/about-services/

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How to find them

• Separate wet hair in sections with fine-tooth comb

• Look for live (moving) lice

• Look for nits within ¼ inch of scalp

• Do not confuse things easily removed:

• Dandruff

• Dirt

• Hair product residue

• Hair castsNichols, Hannah and Webberley, Dr. Helen. Medical News Today. Head Lice: Causes, Symptoms and Treatments, 23 Feb. 2016. http://www.medicalnewstoday.com/articles/164492.php

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How it is treated: Overview

• Talk to healthcare professional

• Read and follow all directions

• Different options

• Over-the-counter

• Prescription

• Home/natural

• Dehydration

Virginia Beach Lice Treatment. What are My Lice Treatment Options? 1 Nov. 2014. https://liceremovaladvice.files.wordpress.com/2014/11/headlicetreatmentoptions.jpg?w=568

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Treatment: Over-the-Counter

• Pediculicides (kill lice only, not nits) based on pyrethrin

• Permethrin

• Approved 2 months and older

• Side effects: red, itchy scalp

• Pyrethrin with additives

• Approved 2 years and older

• Side effects: red, itchy scalp

• Do not use if allergic to chrysanthemum or ragweed

Consumer Reports. What You Need to Know About Preventing and Treating Head Lice, 29 Aug. 2016. https://www.consumerreports.org/medical-conditions/preventing-and-treating-head-lice/

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Treatment: Prescription

Medication What it Does Approved Age Warnings

Benzyl alcohol (Ulesfia) Kills lice by depriving of oxygen 6 months to 60 years Side effect: Red, itchy scalp

Malathion (Ovide) Kills live lice and some eggs 6 years and older Highly flammable

Ivermectin lotion (Sklice)

Kills live lice, appears to prevent

nymphs from surviving; Effective

with or without combing nits

6 months and older Side effect: Red, itchy scalp

Spinosad (Natroba)Kills live lice and eggs; Effective

with or without combing nits6 months and older Side effect: Red, itchy scalp

Lindane Kills live lice and eggs

Not recommended: children,

pregnant/breastfeeding, HIV

infection, elderly, less than 110

pounds

LAST LINE TREATMENT. High risk

seizures and other severe side

effects

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Treatment: Natural remedies

Home/Natural Remedy What it Does Examples Notes

White Vinegar May help dissolve nit glueComb through hair from scalp to end with fine-tooth

comb.

Wet-Combing

Wetting: temporarily

immobilizes lice.

Conditioner: easier to

comb hair

Recommended solution for less than 2 months old.

Fine-tooth comb scalp to end twice on wet,

conditioned hair every 3-4 days for 3 weeks after last

live louse.

Essential Oils

Small clinical studies show

possible toxic effect on

lice

Tea tree oil; Anise oil;

Ylang ylang oil; Nerolidol

May lead to allergic reactions.

Not FDA regulated or approved.

Smothering Agents Deprive lice and eggs of airMayonnaise; Olive oil;

Butter; Petroleum jelly

Apply, cover with shower cap, leave on overnight.

One study showed only petroleum jelly effective.

Little clinical evidence of any working.

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Treatment: Dehydration

• Only done at specialized Lice Clinics of America

• Do not try at home with regular hair dryer

• Too hot, could burn scalp

Lice Clinics of America. Express AirAllé® Treatment, n.d. http://www.liceclinicsofamerica.com/how-to-treat-lice/

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After treatment

• Change and wash clothing/linens used in last 48 hours in hot water (130°F, 54.4°C)

• May dry-clean or seal items in bags for 2 weeks

• Vacuum carpet, rugs, furniture, mattresses

• Soak combs, brushes, hairbands, etc. in alcohol for 1 hour or hot, soapy water for 5-10 minutes

• Recheck and fine-tooth comb hair every 2-3 days for 2-3 weeks WikiHow. WikiHow to Get Rid of Head Lice Overnight, n.d.

http://www.wikihow.com/Get-Rid-of-Head-Lice-Overnight

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Retreatment

• Most treatments do not kill nits

• May need retreatment in 7-10 days

• After all eggs have hatched

• Before new eggs produced

Lice Clinics of America. Lice Facts: Everything You’ve Ever Wanted to Know About Head Lice, 2015-2017. http://www.lcatupelo.com/lice-facts/

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Household members

• Check everyone when lice found on first person

• Check everyone every 2-3 days after treatment of person with lice

• Treat any household members found to have active head lice at same time

• Do not treat if no lice or nits

• Some experts recommend treatment for bedmates

Brennan, Dan. WebMD. Head Lice Slideshow: What Parents Should Know, 29 Jun. 2017. http://www.webmd.com/children/ss/slideshow-lice-overview

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What not to do

• Over treat

• Fumigate house

• Use chemicals on hair

• Use hairdryer on treated hair

• Use conditioner before treating

• Wash hair or swim 1-2 days after treating

• Use more than one medication at the same time unless instructed

Healthy Women. Bad News About Head Lice, 18 Aug. 2015. http://www.healthywomen.org/content/article/bad-news-about-head-lice

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Will not go away

• Could be reinfested

• Treatment may be ineffective

• May be improper use of medication

• Call doctor if no improvement after 12 hours

CDPHP. The Daily Dose. Invasion of the Super Lice, 23 Sep. 2016. https://blog.cdphp.com/family-health/invasion-super-lice/

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Prevention

• Avoid head to head contact

• Do not share items such as brushes, hats, hair ties, scarves

• Hang garments on hooks away from other’s belongings

• Do not lie on bedding, carpet, furniture recently used by someone with active infection

• Some over-the-counter products claim prevention

Virginia Beach Lice Treatment. Head Lice Prevention-How Can You Get Head Lice? 2014. http://virginiabeachlicetreatment.com/licetreatmentoptions/headliceprevention/

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Return to school policy

• No federal or Indiana state requirements

• No policies in Johnson County

• “No-nit” policies not recommended

• Check school corporation policy

• Many schools allow return after treatment completed

Frost, Shelley. Modern Mom. Lice Prevention in Schools, 2017. https://www.modernmom.com/a0ddaef4-3b45-11e3-8407-bc764e04a41e.html

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Reporting rules

• Not reportable to:

• Federal

• State, or

• Local agencies

• Make sure to inform:

• School

• Childcare center

• Parents of playmates

Chez Mummy. Flickr. The Dreaded School Head Lice Letter, 31 Jan. 2014. https://www.flickr.com/photos/chezmummy/12480121513

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References

Centers for Disease Control and Prevention. “Parasites-Lice-Head Lice.” CDC.gov, 24 Sep. 2013. https://www.cdc.gov/parasites/lice/head/index.html. Accessed 2 Aug. 2017.

Gupta, Rupal Christine. “Head Lice.” KidsHealth.org, Jun. 2015. http://kidshealth.org/en/parents/head-lice.html#. Accessed 3 Aug. 2017.

Indiana State Department of Health. “Quick Facts: About…Head Lice (Pediculosis).” ISDH: Epidemiology Resource Center, 26 Jun. 2015. http://www.in.gov/isdh/files/2015QuickFact_Head_lice.pdf. Accessed 2 Aug. 2017.

Mayo Clinic. “Head Lice.” MayoClinic.org, 18 May 2017. http://www.mayoclinic.org/home/ovc-20319198. Accessed 3 Aug. 2017.

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