Q. Can you tell me the best way to treat head lice?
-- A.N., Boynton Beach, Fla.
A. I assume you are asking about head lice because you or someone you know, perhaps your child, has this problem. It is a common condition and is usually easily treated.
Head lice are one of a group of tiny parasitic insects that cause a condition known as pediculosis. The insects infest the skin of the scalp (head lice), trunk (body lice), and pubic areas (pubic lice). Lice infestation causes intense itching and can affect almost any area of the skin.
Body lice are usually seen among people living in crowded dwellings and under unhygienic conditions. Pubic lice are usually acquired by sexual transmission.
Head lice infestation is and has been a problem worldwide. In developed countries, it is quite common among children in a school environment; the infestation is easily and rapidly spread to other household members by children. In fact, adults with head lice almost always get them from elementary school-aged children.
Infestation with head lice can be recognized by the presence of small but visible gelatinous nits (eggs laid by the female louse) on the scalp hairs close to the skin. They are most easily seen above the ears and at the nape of the neck.
Head lice are spread by personal contact, by shared combs, hats, etc. So the first step in eradicating the infestation is to disinfect everything at home, especially bedding. Sometimes this may require washing with boiling water and ironing the seams of the clothes. Disposing of infested clothing and bedding may be necessary.
The other setting to be concerned about is the school itself. The school should be notified when an infestation is seen so other parents can be informed of the problem. Also, the school nurse or clinic aid can routinely check the children so they don't reinfest each other.
Permethrin 1.0 percent cream rinse (Nix) and lindane (Kwell) are usually effective medications -- but remember, these chemicals are pesticides. Be sure to use the medicine as directed on the packaging for best results in terms of both efficacy and safety.
Unfortunately, lice in the nit stage are very hard to kill so that new lice may hatch in a few days, requiring repeated chemical treatments. If available, a nit or louse comb should be used frequently to remove both live and dead parasites and eggs from the scalp.