Head’s Up!

Simply thinking about it makes some parents itch. Have ‘nits’ infested the family? asks Prof. Alf Nicholson.

I can sympathise, because there is a reasonable chance of infection if you have a school-going child in the house. It is no cause for alarm, though.

Parasites can be hard work but with a little patience you can wipe them out. And the days of social stigma should be well gone.

After all, head lice do not choose one child’s body because it is grubbier than the rest.

The first sign of head lice is usually itching.

But a lice infestation can go undetected for weeks with no itching at all.

By the time your child starts to itch, there could be a decent colony of them.

Your child will start complaining about itching behind his ear and the back of his neck, even his eyelashes.

Then it spreads to his scalp.

Finding a living, wriggling specimen is your best bet (if anything is alive you will soon know).

What is harder to distinguish the eggs (or egg cases) from all the usual debris in the hair – the fluff, dandruff, or food.

Eggs are pearly, grey, oval and about the size of a pinhead.

They are very like dandruff, but will not wipe off the hair as easily.

They are usually at the start of hair shafts, near the scalp where it is warm, so if you find something further down the hair it is less likely to be nits.

It’s the lice bites that cause the initial itching, but lice saliva and faeces worsen the irritation, causing your little one to scratch even more.

Lice feed on human blood, so head lice spend their entire life on someone’s head, apart from the odd short break on a hairbrush or a hat.

Parasitic insects

They are parasitic insects (pediculosis capitis), roughly the size of a sesame seed, and the female louse is the real villain.

She lives on average for 30 days and can lay up to ten eggs (nits) a day.

So if you do nothing about your child’s lice, he will soon host a fine colony.

In reality though, an infected child will have fewer than 12 live lice on his scalp at any one time.

The eggs will cling tightly to the shafts of his hair, close to the scalp where it is coziest.

It is this warmth which allows them to incubate, and the larvae emerge eight to ten days later.

‘Opportunistic’

Head lice do not jump. They are very opportunistic though, and will climb quickly from hair to hair.

They can also be taken by surprise.

Combing hair can build up enough static electricity to physically eject an adult louse- over one metre from the host head.

But travel is more usually by head-to-head contact.

Household pets cannot pass them on because they do not host them; lice are only partial to human blood.

They can, however, get passed on through shared hats, hair accessories, hairbrushes, rugs or pillows (an adult louse can survive up to two days without human blood).

If in doubt…

Is he infected? If in doubt, always check the scalp within an inch of its life.

Insecticides (lice medications), used with the bug busting technique (see sidebar) are the best treatment for lice. Bug busting alone will only work for a very committed, and time-rich parent.

A lice medication is the starting point. Many lice treatments are not for younger children, so always check the label to make sure the one you choose is age appropriate (your pharmacist will usually help).

I do not advise ivermectin for children as there can be side effects, especially of the treatment is not used correctly.

As with any medication, it is essential to follow the direction on the pack – if the treatment fails, it’s nearly always because of faulty use of the medication, such as applying it to over-wet hair or using the wrong dosage.

Or it could be because your child has been re-infected by somebody else (it happens!). Checking hair between treatments and removing any nits is very important.

Bug Busting

Along with the use of an appropriate over-the-counter head lice treatment, bug busting is essential in finding and removing lice and their eggs.

It is simply wet combing the hair with a special fine-toothed comb and hair conditioner.

• Shampoo your child’s hair to soak the head lice and condition it to make his hair slippery (yes, they do lose their grip!). The comb can then gently hook them out.

• Comb very carefully, from the roots to the end of the hair.

• Check the hair for lice and eggs after each sweep and clear it. Wipe the comb with a white tissue or tap it on to a white surface so you can see the contents. A magnifying glass is very useful.

• When combing, work from front to back or side to side, making sure you catch every piece of hair. Pay special attention to behind the ears and top and base of the scalp.

• Electric combs cost more and offer no great advantage.

• If you find lice or eggs, you will need to continue combing for a minimum of two weeks. Combing should be done every three days and for at least 30 minute each time if the hair is long.

Taken from “When Your Child is Sick” by Professor Alf Nicholson and Grainne O’Malley (2^nd Edition, Gill Books), available from all good book shops at €24.99.  The information is not intended as a substitute for your own doctor.