Head Lice

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Thinking head lice?

Let's see if your child has head lice and how to get rid of it.
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Lice are tiny parasites that live in the hair and feed on blood from the scalp by biting on the scalp thus making it itchy.

Note that it has nothing to do with poor hygiene and there is no evidence that lice prefer clean or dirty hair. They feed on blood, not dirt or skin cells on the scalp.

Just a few questions should help out.

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Head lice

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Why think head lice?

What make you think your child has head lice?

Let's answer that first.

 

Is it that someone in the house has it?

 

Yes?

 

Did he or she come in close contact with someone who has lice?

 

Yes?

 

Is it because of tickling movement in the hair?

 

Yes?

 

Did he or she share hats, towels, or combs with someone who has head lice?

 

Yes?

 

Are you thinking head lice due to child's irritability and difficulty sleeping?

 

Yes?

 

Is it because someone in the school has it?

 

Yes?

 


If you still think your child has head lice, let's continue.

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Head lice

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Is the child experiencing intense itching of the scalp?

 

Yes?

 

Any small, red bumps on the scalp, neck or shoulders?

 

Yes?

 

What about crusty, oozing bumps on the scalp?

 

Yes?
Probable infection due to the scratching.

It would be better to see a pediatrician to rule out any infection. And if there is an infection get the appropriate treatment for it.

Anyway, before you do that or if the bumps are not too bad, let's see if you can find some lice.

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If you answered "No" so far, chances of lice infestation is slim.

Let's continue and see if we can find lice.

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Head lice

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Looking for lice

You will look for adult lice or nits.

The following are needed:

  • Disposable gloves

  • Magnifying glass (optional)

  • Bright light or daylight.

  • Clean towel

 

Good.
These instructions are for who is looking for lice on someone else's head.

With the gloves on (Using a magnifying glass if any):

Look behind the ear and back of the head near the neckline.

Let's answer a few questions when you have looked briefly.

 

Yes?

 

Do you see anything like tiny white oval eggs or adult moving lice?

(See "FYI" to know if it is dandruff or nit.)

FYI

 

Yes?
Treatment is recommended if even one egg is found. But let's look further.

 

Now, look at the base of the hair near the scalp for eggs (nits).

Did you find something within ¼ inch of the base of hair shafts?

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They should be oval shaped, very small and hard to see. It may be yellow, white or even the same color as the hair.

According to the CDC: If crawling lice are not seen, finding nits attached firmly within ¼ inch of the base of hair shafts suggests, but does not confirm, the person is infested.

Nits that are attached more than ¼ inch from the base of the hair shaft are almost always non-viable (hatched or dead).

FYI

 

Yes?

 

Look for some adult louse. Should be tan to grayish-white in color.

Anything like that?

They should be about the size of sesame seed (1/16 to 1/8 of an inch) with six legs.

 

Yes?
Let's see what a pharmacist recommend to treat this head lice.

According to the CDC, the diagnosis of head lice infestation is best made by finding a live nymph or adult louse.

See "FYI" for CDC (Centers for disease control) tips on how to prevent the spread of head lice.

FYI Nearest Clinic Pharmacist

 

If still nothing.
You will have to use the Wet Combing method.

It is more time consuming but it has been proven to correctly identify lice in 90% of cases, compared with a 29% accuracy rate for visual inspections.

To do wet combing, you will need:

  • Regular hair conditioner.

  • A quality (non-plastic) lice comb.

  • Hair clips for separation.

  • A de-tangling comb.

  • Pin tail comb.

  • A bowl of hot water to rinse the lice comb.

  • White paper towels or rags.

When you have most of these, let's continue.

 

Yes?

 


Follow the directions in the list form below.

Wet combing directions:

  • Apply the conditioner to saturate all the dry hair and scalp.

  • Using the de-tangling comb, comb hair to remove all knots.

  • Using the pin tail comb, separate the hair into 4 or 5 manageable sections.

  • Using the hair clips, hold the sections in place.

  • Undo a section, starting at the bottom of the hair line closer to the neck or behind the ear.

  • With the teeth of the lice comb as close to the root of the hair shaft as possible, pull through the whole length of the hair, from the shaft to the tip.

  • Wipe both sides of the comb between passes on a white paper towel or rag.

  • Thoroughly inspect the white paper towel or rag for lice and nits.

  • Rinse the comb with the hot water and work on small sections at a time.

  • Repeat process until you come to one conclusion or the other.

  • Once all sections have been combed out, remove the hair clips and pass the nit comb through the whole hair working from the shaft to the tip.

  • Wipe on a white paper towel and repeat several times.

  • Rinse out the conditioner, style hair.

  • Soak all tools in hot soapy water, wash towels and rags in a washer at hot setting and dryer if lice wash found.

  • ∗∗∗You may have to repeat this 4 times, every 3 days.∗∗∗

 

 

Alright.
Did you find any lice or nit?

 

Yes?
Let's see what a pharmacist recommend to treat this head lice.

According to the CDC, the diagnosis of head lice infestation is best made by finding a live nymph or adult louse.

See "FYI" for CDC (Centers for disease control) tips on how to prevent the spread of head lice.

FYI Clinic Pharmacist

 

Nothing?
Treatment is recommended if one nit is found within ¼ inch from the scalp.

If nothing is found no treatment is recommended.

According to the CDC: If no nymphs or adults are seen, and the only nits found are more than ¼ inch from the scalp, then the infestation is probably old and no longer active — and does not need to be treated

Note that:
You have to find lice or eggs to use the over-the-counter shampoos or lotions. These shampoos do not prevent lice infestation.

See "FYI" below for CDC (Centers for disease control) tips on how to prevent the spread of head lice.

Would you like to see what a pharmacist recommend to get rid of lice anyway or do you think you should see the nearest children's urgent care clinic to you from the discussions so far?

FYI Clinic Pharmacist

 

 

 

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CDC's prevention and control
(copied text. See website for changes.)

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