Few things make people’s skin crawl more than things literally crawling on their skin. With “back to school” adverts all over the shops and radio, the annual issue of head-lice isn’t too far away. No matter how clean you keep “little Johnnie’s” head, if “little Jimmie” sitting beside him has an ecosystem on his head to rival the Amazon Rainforest, it probably won’t be long before “little Johnnie’s” head is blossoming with life too.
Pediculosis Capitis is also known as head-lice or nits. On American TV, you might also hear it referred to as “Cooties”. Head-lice usually infest the head although they can be found on body hair too. Head-lice are generally spread from direct head-to-head contact with an infested person, which is why children are more likely to pick them up with the “rough and tumble” of school playtime. They can be transmitted from shared bedding or clothing but this is less common. Head-lice do not carry other diseases unlike some body-lice. Contrary to popular myth, they cannot fly or jump from one head to another, nor can they burrow into the skin.
The first symptom of a head-lice infestation tends to be itching. The lice bites the host’s scalp and feeds on the blood and it’s these bites that become itchy. The bite marks can be difficult to see on the scalp but are more obvious on the neck if the host has long hair. The best way to check for an infestation is to take a white sheet of paper and a lice comb. The hair should be combed through from root to tip and any lice present should drop onto the sheet of paper and be easily seen. They are about the size of a sesame seed. Although previously recommended that all members of a house-hold be treated, it’s now encouraged to only treat an individual where a live infestation has been confirmed.
Treatment should consist of a combination of combing with a head-lice comb and use of an insecticide. The hair should be combed through daily, from root to tip. The hair should be left wet with plenty of conditioner, because lice are less able to move when wet.
There are many insecticide treatments available over-the-counter. Some products claim to work after a 10min application, offering a quick-fix solution, but clinical studies do not support this approach. Similarly, there is no clinical evidence to support the use of tea tree oil in head-lice infestation.
An insecticide such as Malathion (Derbac M) should be applied thoroughly to dry hair, left on for 12hrs overnight and then washed out. A 50ml quantity should be enough to treat an adult head. A child may use proportionately less, depending on thickness of hair. I would recommend repeating this treatment seven days later.
These two methods used together should eliminate the vast majority of infestations. It should be noted that no treatment is 100% effective and resistance is growing to insecticides among head-lice. So if one insecticide doesn’t work the first time then a different one should be chosen for the next treatment. A huge problem is re-infestation as the lice do a tour of the classroom. There is no effective chemical treatment to prevent re-infestation, and it is very frustrating to treat the problem effectively and send them back to school, for them to return home with a new batch. If you are aware of head-lice on other children in the classroom, then consistent daily combing with a lice-comb is the best and really, only form of prevention. As always, consult with your pharmacist about the best treatment option for you or your family.
Cormac Harte M.P.S.I.
Tel: 052 6121205
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