Recommendations from the Centers for Disease Control and Prevention for treating head lice infestations.
Before applying treatment, it may be helpful to remove clothing that can become wet or stained during treatment.
Apply lice medicine, according to the instructions contained in the box or printed on the label. If the infested person has very long hair (longer than shoulder length), it may be necessary to use two bottles. Pay special attention to instructions on the label or in the box regarding how long the medication should be left on the hair and how it should be washed out.
WARNING:
Do not use a combination shampoo/conditioner, or conditioner before using lice medicine. Do not re–wash the hair for 1–2 days after the lice medicine is removed.
Have the infested person put on clean clothing after treatment.
If a few live lice are still found 8–12 hours after treatment, but are moving more slowly than before, do not retreat. The medicine may take longer to kill all the lice. Comb dead and any remaining live lice out of the hair using a fine–toothed nit comb.
If, after 8–12 hours of treatment, no dead lice are found and lice seem as active as before, the medicine may not be working. Do not retreat until speaking with your health care provider; a different medicine may be necessary. If your health care provider recommends a different type, carefully follow the treatment instructions contained in the box or printed on the label.
Nit (head lice egg) combs, often found in lice medicine packages, should be used to comb nits and lice from the hair shaft. Many flea combs made for cats and dogs are also effective.
After each treatment, checking the hair and combing with a nit comb to remove nits and lice every 2–3 days may decrease the chance of self–reinfestation. Continue to check for 2–3 weeks to be sure all lice and nits are gone. Nit removal is not needed when treating with spinosad topical suspension.
Retreatment is meant to kill any surviving hatched lice before they produce new eggs. For some drugs, retreatment is recommended routinely about a week after the first treatment (7–9 days, depending on the drug) and for others only if crawling lice are seen during this period. Retreatment with lindane shampoo is not recommended.
Supplemental Measures: Head lice do not survive long if they fall off a person and cannot feed. You don’t need to spend a lot of time or money on housecleaning activities. Follow these steps to help avoid re–infestation by lice that have recently fallen off the hair or crawled onto clothing or furniture.
Machine wash and dry clothing, bed linens, and other items that the infested person wore or used during the 2 days before treatment using the hot water (130°F) laundry cycle and the high heat drying cycle. Clothing and items that are not washable can be dry–cleaned or sealed in a plastic bag and stored for 2 weeks.
Soak combs and brushes in hot water (at least 130°F) for 5–10 minutes.
Vacuum the floor and furniture, particularly where the infested person sat or lay. However, the risk of getting infested by a louse that has fallen onto a rug or carpet or furniture is very small. Head lice survive less than 1–2 days if they fall off a person and cannot feed; nits cannot hatch and usually die within a week if they are not kept at the same temperature as that found close to the human scalp. Spending much time and money on housecleaning activities is not necessary to avoid reinfestation by lice or nits that may have fallen off the head or crawled onto furniture or clothing.
Do not use fumigant sprays; they can be toxic if inhaled or absorbed through the skin.
As the new school year kicks off, teachers are eager to fill their students’ heads with knowledge. But, unfortunately, teachers are not the only ones eager to get close to the heads of vulnerable students.
Head lice infestation is also prevalent around this time of year. One way of them spreading can be as simple as head-to-head, back to school selfies, or sharing hats or brushes.
And there is a new breed of these pests that is harder to get rid of.
A study in the "Journal of Medical Entomology" says that head lice in North America have evolved into a new, more powerful strain that are less susceptible to traditional lice treatments and over the counter aids. The study shows the most resistant strain is in Georgia.
These lice, deemed “super lice,” have been spreading across the U.S. since the 1990s.
“They’ve mutated,” Elizabeth Scobercea said. “Just like we, as humans, build immunity to certain medications, the bugs have done the same. As they’ve evolved overtime, they’ve become stronger and their immune systems are able to attack the chemicals they’re ingesting.” Scobercea is the director of operations for Atlanta’s Pediatric Hair Solutions, a clinic that performs lice inspections and treatments.
The tiny parasites do not carry diseases, but can cause discomfort and itching and spread easily from person to person. Once they spread, lice can be extremely hard to get rid of.
“An estimated 6 million to 12 million infestations occur each year in the United States among children 3 to 11 years of age,” Center for Global Health spokeswoman María-Belén Moran said. “Some studies suggest that girls get head lice more often than boys, probably due to more frequent head-to-head contact.”
Parents are often at a loss for what to do when these unwanted critters show up in children's hair. The Centers for Disease Control and Prevention in Atlanta warns about secondary health affects from using stronger, more deadly medications to kill lice, especially on children. The CDC recommends seeking a doctor's advice if a primary use of over the counter treatment does not work.
In response, some parents have turned to home-type treatments, such as soaking the scalp in natural oils for periods to smother the lice and eggs. According to the Mayo Clinic, some of those treatments have positive affects. Though many or all of them also include the ages old remedy of using a fine-toothed nit comb to clean the insects from the hair.
And a new, chemical-free method of treating head lice has been developed to combat super lice. Scobercea at the Atlanta clinic uses AirAllé treatment, which starts at $85, can be pricer than over the counter medications. The treatment uses a solution on the scalp and hair, then a customer comes to the office where a machine sends streams of dehydrogenated air through the hair, which dehydrates and kills remaining lice and eggs.
Without active treatment, head lice will remain and can spread.
“There is really nothing to prevent them from getting worse,” Scobercea said. “The way their life cycle works, the bug will mutate by the time the egg has hatched, and they procreate pretty quickly. They can lay up to 200 eggs in their lifetime.”
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