1 What are Lice?

Lice are tiny, wingless, parasitic insects that feed on human blood. Lice spread easily among school-going children either through close contact or through close contact and by sharing things.

Lice can be of several types:

Head lice- They mainly develop on your scalp and are easily seen on the back of the neck or above the edge of your ears. These are most common in children mainly the school going one.

Body lice- these are mainly found in the clothes and beddings and will move over the skin for food. It mainly affects the people who do not take bath regularly or wash the clothes especially the homeless people or transient individual.

Pubic lice- also known as crabs usually occur on the skin and pubic areas. They can also be found on the facial hair, eyebrows, eyelashes, armpits, chest hair or rarely on the scalp.

They could even develop in a person with good personal hygiene and often reoccurs. Therefore, proper treatment is highly recommended.

2 Symptoms

The most common symptom of lice is itching which can be minor or intense and usually developed due to the movement of hair, lice, etc.

The symptoms may depend on upon the type of lice:

Head lice do not show any kind of symptoms at the early stage but after a week or month, there occurs itching as they spread.

Rubbing your skin may turn the skin raw, which usually secrete fluids that may cause infection.

Pubic lice cause severe itching and their bites result in the formation of small marks which usually look like lesion on the trunk, thighs, or upper arms.

This type of lice can cause crusted eyelids if they occur on the eyelashes.

Body lice result in the development of very bad itching mainly during night, causing lesions on the armpits and on the waist, trunk or the area where seams of clothes press against the skin.

Lice and their eggs are found in the seams of clothes but are not present on the skin.

Lice eggs (nits) usually stick to the hair shafts and look like tiny pussy willow buds.

They can frequently be mistaken as dandruff, dead or empty nits from the previous infestation, residues from hair products or bead of dead hair tissue on a hair shaft but careful observation help in accurate identification of lice.

3 Causes

Contraction of lice is caused by being in contact with someone else who has the condition. The eggs usually take around a week for hatching.

They spread easily through head to head contact, which easily occurs between the family members or between the school going, children.

Head lice: mainly spread through sharing items like brushes, combs, hair accessories, towels, blankets, pillows or bedding or through head to head contact.

Pubic Lice: mainly spread through sexual activity and therefore very infectious as the person can receive infection after single exposure to the infected person.

Lice can also survive for a long period of time on the personal items (clothes or towels). The child with pubic lice may have a history of sexual abuse.

Body lice: they most often spread by contact with personal items, especially clothing, and hats and sometimes through direct personal contact.

4 Making a Diagnosis

The lice could be diagnosed by identification of the live adult louse or the nymphs on the body or personal items like clothing, hats, combs, beddings etc.

Before getting in touch with the doctors, it is suggested that one should note down the crucial information about their condition and the infection.

While making diagnosis, your doctor will be interested to know about:

  • The signs and symptoms that you are experiencing which may include any unrelated information that leads you to the doctor’s appointment.
  • Your first symptom of the infection.
  • Personal information that can include the mode of exposure to the lice.
  • Medication: if you are on a certain type of medication or are taking certain vitamins or supplements.
  • The severity of an infection.

Your doctor can carefully comb your child’s wet or lubricated hairs to verify the presence of lice. He can repeat this examination twice.

The doctor may also opt for using magnifying glass or wood’s light to see the lice or their nits on your body.

The absence of lice or live nits indicates that they're probably left from a previous infestation and not evidence of an active infestation.

5 Treatment

The doctor may suggest you some medications that treat lice but use them only as directed.

One must stop sharing personal items like bedding, towels or clothing and should take care of personal hygiene like bathing and wash the contaminated things with hot water.

In a case for pubic lice infection, avoid sexual activity. If this doesn’t improve your condition, consult a doctor.

Head lice Treatment:

Many over-the-counter products like shampoos containing pyrethrin or permethrin are usually first options used to combat lice infestations.

These work best if you follow the directions closely. In some geographical locations, lice grow resistant to the ingredients used in over-the-counter lice treatments.

So, if over-the-counter preparations don't work, your doctor can prescribe shampoos or lotions that contain different ingredients.

The doctor may prescribe any of the following medications:

  • Malathion (Ovide) is a prescription medication that you can apply to your hair and then rub it into your hair and scalp.It is flammable, so you should keep it away from any type of heat sources such as hair dryers, electric curlers, and cigarettes. If you're pregnant/a breastfeeding mother, talk to your doctor before using this product.
  • Benzyl alcohol lotion (Ulesfia) is a prescription treatment that you can apply to the scalp and hair for 10 minutes and then rinse off with water. The treatment is repeated after a week. The possible side effects of this treatment include irritation on the skin, scalp, and eyes as well as numbness at the application site. This medication isn't recommended for children less than 6 months of age.
  • Ivermectin lotion (Sklice) is a topical, single-dose treatment for head lice. You can apply the lotion directly to dry hair and the scalp for 10 minutes and then rinse with water. Do not repeat this treatment without talking to your doctor first. The possible side effects may include eye irritation or redness, dandruff, dry skin, and a burning sensation at the application site. This medication isn't recommended for children less than 6 months of age.
  • Spinosad topical suspension (Natroba) is a newer prescription treatment for head lice. You may apply the medication to dry hairs and the scalp for 10 minutes and then rinse with water. Repeat the treatment after seven days only if live lice are still present. The possible side effects include redness or irritation of the eyes and skin. This medication isn't recommended for children less than the age of 4.
  • Lindane is a prescription shampoo that's sometimes prescribed when other measures fail. However, due to increasing resistance of lice to this medication and to serious neurological side effects, it is no longer recommended as the first line of treatment for head lice.

Body lice Treatment:

If you have body lice, you don't need treatment. However, you must take the self-care measures for maintaining personal hygiene and decontaminating your personal belongings.

If self-care measures fail to get rid of the lice, your doctor might recommend trying over the counter or prescription medications used for head lice.

Pubic Lice Treatment:

For pubic lice, many of the same non-prescription and prescription treatments as used for head lice can be used.

It is highly recommended that you should carefully follow the instructions on the package.

Talk to your doctor about the treatment of lice and nits on eyebrows or eyelashes. Self-care is important, whether you use over-the-counter or prescription medications to kill lice.

After using the medication, make sure to remove each and every dead lice or nits from the infected area and decontaminate your personal belongings to prevent recurrence.

Some over-the-counter products claim to repel lice, but more scientific research is needed to prove their safety and effectiveness.

A number of small studies have shown that ingredients in some products like oils such as coconut, olive, and rosemary and tea tree may work to repel lice.

However, these products are classified as "natural products" so they aren't regulated by the Food and Drug Administration (FDA), and their safety and effectiveness haven't been tested to FDA standards.

Until more researchers prove the efficacy of head lice prevention products, the best approach is simply to take thorough measures to get rid of the lice and their eggs, so that you don't have more lice to deal with.

6 Prevention

It's difficult to prevent the manifestation of head lice among children in child care and school settings.

There's such a constant unavoidable contact among children and their belongings that lice can spread easily.

It's no reflection on your hygiene habits or those of your children, and it's not a failure on your part as a parent if your child gets head lice though some preventive measures could be beneficial.

  • Ask your child to avoid head-to-head contact with classmates while playing and other activities.
  • Instruct your child not to share personal belongings such as hats, scarves, coats, combs, brushes, hair accessories, and headphones.
  • Instruct your child to avoid sharing of places where hats and clothing from more than one student are hung on a common hook or kept in a locker.

However, it's not realistic to expect that you and your child can eliminate all the types of contact that may result in the spread of lice.

Your child may have nits in his or her hair but may not necessarily develop into a case of head lice.

As some nits are just empty eggs. However, nits that are found within 1/4 inch (6.4 millimeters) of the scalp should be treated — even if you find only one — to prevent the possibility of hatching.

Nits that are farther away from the scalp are probably from an old infestation, but should be removed to prevent a recurrence.

7 Lifestyle and Coping

Lifestyle modifications are necessary in order to get rid of lice.

You can get rid of lice with a patient and thorough approach that involves cleaning yourself or your child and any personal belongings that may be contaminated.

These steps may help you to eliminate lice infestations:

  • Use anti-lice lotions and shampoos: Choose from among several over-the-counter lotions and shampoos (Nix, Rid, others) designed to kill lice.
  • Apply the product according to package instructions. You may need to repeat treatment with the lotion or shampoo in seven to 10 days. These lotions and shampoos typically aren't recommended for children under age.
  • Comb wet hair: Use a fine-toothed or nit comb to physically remove the lice from wet hair. Repeat this every three to four days for at least two weeks. This method may be used in combination with other treatments and is usually recommended as the first line of treatment for children under the age of 2 years.
  • After the shampoo treatment, rinse your hair with vinegar. Grab a lock of hair with a cloth saturated with vinegar and strip the lock downward to remove nits. Repeat until you've treated all the hair in this way. Or soak hair with vinegar and leave it on for a few minutes before combing, then towel-dry your hairs.

These methods can help remove nits from the hair shaft:

  • Decontaminating personal belongings: Wash contaminated items like bedding, stuffed animals, clothing hats with hot, soapy water at 1300 F (540 C) and dry them at high temperatures for at least 20 minutes.
  • Seal the un-washable items. Place them in an airtight bag for two weeks. Give the floor and furniture a good vacuuming.
  • Use a plastic painter's drop cloth to cover furniture for two weeks to prevent acquiring another case of lice.
  • Don't do this if you have a toddler who may become tangled in a plastic sheet and suffocate.
  • Wash combs and brushes using very hot, soapy water (at least 1300 F) or soak them in rubbing alcohol for an hour.

8 Risks and Complications

Scratching the skin to get rid of itching can possibly increase the risk of lice development.