Head Lice Questions/Answers (faq)

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Head LiceHead Lice: Frequently Asked Questions

by Barb Ogg, PhD, Extension Educator & Soni Cochran, Extension Associate

The following are typical of the most common questions visitors to the site ask:

QUESTION #1: I have grandchildren and I babysit for them when their parents work. My kids never had head lice when they were growing up so I am pretty clueless about all these treatments. Why are head lice so much of a problem today? My kids try to keep a clean house, but it still keeps happening.

ANSWER: There are a number of reasons for the increased prevalence of head lice today. It used to be that head lice were found primarily in lower socioeconomic families, but upper and middle class families today are dealing with head lice. Some of the contributing factors may be:

  • Increased activities with other children (sports, music, dance, gymnastic) where kids come together. These activities, even though they may be worthwhile, may increase contact with infested kids.
  • The increased numbers of children in nursery school, daycare centers and after school care. Again, there may be increased contact with infested kids.
  • Lice that have developed resistance to many over-the-counter products.
  • Products may not be as effective as they used to be.
  • Parents who are so busy that they don't check their children for lice or treat them appropriately. It should be a routine part of grooming children.
  • Head lice are obligate parasites which means that they must have human blood to survive. They do not survive very well away from their host because they lose their food and moisture source. Lice tend to dehydrate fairly easily, especially when humidity is low and temperatures are high.

The best thing that you can do is to reduce the numbers of lice on your grandchildren. This can be done by treating them with a lice treatment and/or combing hair with oil or conditioner as a lubricant to remove lice and nits. Be sure to use a metal nit comb-the plastic ones are too flexible. It is not necessary to spray surfaces and carpets for lice. Instead, focus your energy on lice and nit reduction on the kids and make sure their parents are doing their part on the weekends and in the evenings.

QUESTION #2: Why is it that my daughter (I also have two sons) always gets lice? The boys don't seem to get them.

ANSWER: Most head lice are probably transmitted when someone comes into close contact with an infested person. Girls are usually more "huggy" and play in closer proximity to playmates than boys and many have longer hair. They also may share combs and brushes during their playtime. Women and children are more likely to get head lice than men, but within family groups, head lice seem to favor some individuals over others. This has been noticed over and over again, but we don't know why.

QUESTION #3: Why do I have more lice problems with my daughter who has the longest hair? I have two other daughters and one son.

ANSWER. Loose long hair is more likely come into contact with lice. It is also more difficult to inspect, treat and comb a person who has long hair so managing a lice infestation is more difficult. Hanging hair is a liability. Putting your child's hair up in a ponytail or bun will be helpful or work with your daughter to choose a new, shorter hair style.

QUESTION #4: My daughter keeps getting head lice. She is free for up to six weeks then we find them again.

ANSWER: One possibility is that the infestation wasn't completely eliminated during the treatment. It takes only a month for a full-blown infestation to get started just from one egg-laying female. This can occur if a louse or two survived the treatment or a few nits hatched after treatment. Survival can occur because lice were resistant to treatment or because the lice product was not used exactly as the label directs. Some of the more common mistakes parents make are:

  • Not using enough product so more kids can be treated.
  • Not using enough product on children with long, thick hair. You may need twice the normal amount.
  • Not treating a second time. Some experts believe that you should wait 10 days to treat the second time and that one week is a bit too early.
  • Using a hair conditioner which can prevent the active ingredient of one over-the-counter product (Nix) from binding to the hair shaft and providing residual activity.
  • No nit removal is done.
  • Another possibility is that your child is 'catching' lice from an infested friend or classroom playmates.

QUESTION #5: Will head lice lay eggs other places than hair?

ANSWER: Yes. When given a choice of hair or flannel, 80% of head lice laid eggs on hair, but 20% preferred to lay eggs on flannel. Adults can definitely be transmitted by sharing hats and scarves and will lay eggs on soft fabrics.

QUESTION #6: Why do you show such highly magnified pictures of lice and eggs-not like what I might actually see when I examine my daughter's hair for lice?

ANSWER: The photos are meant to emphasize the messages of the educational resources Adult head lice are about the size of a small grain of rice and immature lice are even smaller. They are active in the hair. If you part your daughter's hair, you may see lice running down the part line. Nits are about the size of a size of a pin head and you cannot really identify them without a good magnifying glass. A microscope is the best way to determine if the embryo has died or the nit has hatched and the reason for the highly magnified pictures.

QUESTION #7: I am having a hard time knowing what nits look like. And, how would I know if nits are alive, dead or hatched?

ANSWER: Nits are laid on the hair and glued to one side of the hair shaft. They are usually laid on single strands of hair, close to the scalp, but not on it. Nits are not round, but oval. They are light-colored when first laid (yellowish or gray), but darken to a tan or coffee color as the embryo develops. Once the egg hatches, the spent shell remains attached to the hair shaft, but it is white. As the hair grows, the nit grows with it and is farther from the scalp.

QUESTION #8: Do pets carry head lice? How about mice or rats? Birds?

ANSWER: Humans are the only hosts for head lice, body lice and crab lice. Other closely related lice infest monkeys or apes, but not dogs, cats, rodents or birds. Many animal species have their own compliment of lice that cannot infest humans. You don't need to treat your pets for human lice.

QUESTION #9: If lice like clean hair, should I stop shampooing my child's hair to prevent head lice?

ANSWER: No. You will just have a child with lice and dirty hair.

QUESTION #10: I really want to use a home remedy for head lice. Isn't there anything that will be effective?

ANSWER: There is a mistaken belief that home remedies are safe, which isn't true. Some home remedies are very hazardous and should not be used. Combing is a tried and true, old-time remedy for head lice. It has been used for centuries. Studies have shown that wet combing with oil or conditioner is more effective than dry combing. Avoid petroleum jelly which is hard to remove from the hair. Mayonnaise isn't any better than oil or conditioner.

QUESTION #11: How long should I comb my kids with vegetable oil for lice and nits?

ANSWER: You should inspect them each day and comb with oil/conditioner if you find nits or live lice. Use an electronic comb like the Robi Comb to make inspections for live lice easier. Read on for more information about the Robi Comb.

QUESTION #12: Isn't there anything that will help remove nits from the hair? So many products claim to do this, but I am having a hard time finding a product that works.

ANSWER: The protein in the nit glue is chemically close to the protein in hair itself. Any solvents that would dissolve the glue are likely to damage the hair.

QUESTION #13: My doctor didn't recognize head lice even though my daughter had sores from scratching her head. He said that she had "winter itch" How can doctors miss this? AND QUESTION #14: My school nurse and after school daycare provider say my daughter has head lice nits in her hair. I see small white round things that seem to be attached to the hair shaft. But nobody, including me, can see any live lice at all. What could be going on?

ANSWER TO #13 AND #14: One possibility is that your daughter is being incorrectly diagnosed. A recent study by Dr. Richard J. Pollack and colleagues at the Harvard School of Public Health, Boston, Massachusetts, showed that fewer than two thirds of samples, sent by the general public, actually contained lice or nits. Only 53.3% of the samples actually contained a louse or a viable embryo.

Parents and school officials were more likely to correctly identify lice or nits than physicians, but nobody was very good at diagnosing between an active and inactive infestation (i.e., the difference between dead nits and live nits).

What happens when lice are overdiagnosed? Kids are over-treated with lice products and parents are frustrated. Dr. Pollak found that subjects who did not have a confirmed louse infestation were four times more likely than those infested to have been treated with a prescription medication.

The message here is that, unless you see live lice (ones that move) or brown nits, your child may not be infested at all. Be cautious before you come to that conclusion though....it can be difficult to detect an infestation of only a couple lice and tiny ones are very hard to see.

A device that will detect the presence of live lice is an electronic comb like the Robi Comb. It is to be used on dry hair only and will stop humming when it encounters a live louse. It can be a useful tool to detect live lice before they have a chance to lay many eggs and trigger a thorough inspection and combing to remove lice and nits.

QUESTION #15: What can my day care or school do to prevent the spread of head lice?

ANSWER: Studies have shown that children who have individual lockers and assigned clothing hooks had fewer lice than those that shared lockers and hooks. Clothing hooks should be spaced wide enough so that coats/hats/scarves do not touch.

QUESTION #16: I am a teacher (day care provider). I am paranoid about getting lice from my students and am even afraid to get close to my students because I am afraid to get lice from them. How should I wear my hair to keep from getting lice?

ANSWER: Short hair is best. If you want to keep your long hair, wear it up so it doesn't hang down.

QUESTION #17: There is a black child in my child's class at school and her mother says that she cannot get head lice because she is black so she doesn't need to be checked for lice. Is this true?

ANSWER: It is pretty evident that European colonists brought head lice with them to America because our lice are best adapted to infesting non-African American children. In 1985, a study showed that only 0.3% of African-American children were infested with lice compared with 10.4% of non-African American children. This study has been repeated, with similar results. However, in these surveys, there were still a few, rare cases of head lice among African American children.

Interestingly, in Africa countries, native children are infested, but their head lice are adapted to hang onto the oval cross section of curly hairs. Terri Meinking, a head lice researcher at the University of Miami School of Medicine, has received samples of head lice that look more like the African type and has noticed a few more cases of head lice in African American children. However, it is still quite unusual. (If you are interested, refer to Current Problems in Dermatology, Volume 11, No 3; May/June 1999; p. 86-87 for a discussion by Terri Meinking.)

Because infestations among African American are rare, but can still occur, you are encouraged to check the child anyway. As an example, at Lincoln Public Schools, Lincoln, Nebraska , it is the policy that every child (no exceptions) is treated exactly the same so African American children are checked along with everybody else.

QUESTION #18: I am the coach of the T-ball team. A whole bunch of the team members got head lice so we concluded that the batting helmets spread lice from kid to kid. How can I delouse sport helmets during the game to keep lice from spreading?

ANSWER: Try to enlist the help of parents to make sure that their children are lice free. By having several batting helmets, it might be possible to decontaminate helmets after they are used and before the next batter is up. Try vacuuming the inside of the helmet with a portable car vacuum. Parents can also choose to purchase a helmet for their child which would not be shared with the rest of the team.

QUESTION #19: Several kids in the neighborhood have been infested with head lice. I sometimes transport my daughter and neighborhood kids to school, soccer practice and other events. Should I be treating the car seats for head lice to keep her from getting lice?

ANSWER: It is not likely that lice will end up on car seats and upholstery, but it is possible. Surface sprays are not recommended because most of the insecticidal sprays marketed for treating lice can cause allergic reactions for people who have allergies or respiratory problems. Instead, we recommend vacuuming the backs of the seats after transporting kids. A hot car will kill head lice pretty fast so you may not need to worry about this in the summertime.

About the photo above: Head lice do not jump or fly. But, they can crawl through hair very quickly. The louse in the photo above - is on its back. If you look at the end of each leg, there is a "claw". This claw helps the louse grasp the hair

Educational ResourcesReturn for More Head Lice Educational Resource

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