Treating ‘super lice’ a real head-scratcher


What’s itching, gluttonous and perhaps living on your child this very minute?

Lice. Some are super, but generally speaking they’re regarded as not that great.

And people seem to notice them more toward the beginning of the school year.

David Shetlar, Ph.D., a professor emeritus of urban landscape entomology at Ohio State University, said children may have had lice “the whole summer long.” Then they go back to school, where a teacher noticing just one child scratching his or her head will exclaim, “Oh my God! They’ve got lice!”

Technically there are two kinds of lice. The “biting lice” that feed on birds eat bits and pieces of their skin, and sometimes pus if they irritate the skin enough. Pets including domestic birds, dogs and guinea pigs have their own species of lice, but these lice cannot survive on humans.

Lice found on mammals are “sucking insects” and virtually all mammals have one or more species, Shetlar said. Their chewing mouth parts are elongated into “little tiny needle-like structures” which can pierce the skin. Shetlar said when the mouth parts are drawn together it’s like a straw: “They just suck the blood up.”

Humans have three species of lice. Body lice are almost identical to head lice but can live longer off the body, such as on a coat or shirt. “This is the one that really goes gangbusters” during wars, when soldiers are huddled together, the doctor said. They are the only kind that transmit disease, but they are quite rare in North America. There are also pubic lice.

The head louse lives permanently on the body. Occasionally it may wander onto a hat, but it can’t live outside the body for long. They need the warmth of a human body and moisture obtained from blood to survive, Shetlar said. Also, they have very thin exoskeletons and will dry up quickly.

The louse has to lay its eggs on a human hair, with “glue-like material” that attaches the eggs — called nits — onto the hair.

As with bedbugs, lice affect different people differently. Shetlar said he himself is of German, English and Scandinavian descent, and anything that bites him “just causes me to itch like mad.” Others may not be as affected.

If you happen to have a male louse on your head, you’re lucky. (Well, relatively speaking.) They spend most of their time looking for mates, not feeding, Shetlar said. But a female louse, once she has been mated, will eat as much as she can in order to feed her eggs.

Shetlar said prescription anti-louse shampoos contain insecticides, which make some parents uncomfortable. In the Columbus area there are two delousing salons, Shetlar said. Staff there go through one small cluster of hair, then another, with a nit rake — basically, a fine-toothed comb — removing lice and nits from each section of the child’s scalp. Shetlar said the effectiveness of this treatment depends on the person doing it — and the child’s willingness to sit still.

Pharmaceutical companies try to find insecticides that absorb poorly into the skin, so the chemicals don’t get into the child’s system. “In the good old days” when Shetlar was a teenager, other chemicals were used that, if you left them on too long, “You could poison yourself!”

In recent years, “super lice” have been in the news. These lice are resistant to some chemicals used in their treatment. Shetlar said all insects regularly treated with insecticide can develop resistance.

Dr. Ailing Chen, a pediatrician at Caughman Health Center in Findlay, said she and colleagues suggest over-the-counter medications, as they have a “lower toxicity.” If these don’t work, parents can call their doctor for a prescription.

Chen said parents sometimes come to her office saying they’ve already treated for lice three or four times at home. “And they’re very frustrated,” she said — epecially parents of girls with long hair. Parents of boys are more likely to just shave their child’s head if they’re frustrated.

When parents come in, Chen reviews what they are already doing and notes that there are prescription options. Children who are itchy might also take an antihistamine, and may need cream if they create a secondary infection by scratching.

Chen said some lice are resistant — but parents need to follow directions closely, leaving the shampoo on for as long as is recommended, and making sure hair is well saturated. Some conditioners, if used before, can make the medication not as effective.

Also, she said, the medications treat live bugs. They don’t kill eggs, so you’ll need to remove those with a comb. Repeat the treatment after about nine days, in case any eggs have hatched.

Treat siblings, too, especially if they share a hairbrush or may sleep on the same pillow. The exception is infants younger than 2 months old, who should not receive the medications. Instead, remove any lice or nits manually, Chen said.

And, yes, parents can get lice, too. It’s best to treat the entire family at the same time, or the household can become infected again and again, Chen said.

Wash sheets, pillows and clothes in hot water. If there are items that cannot be washed, such as children’s stuffed animals, wrap them in a plastic bag and do not touch them for two weeks. This will give living lice, and any eggs that might be hatching into new lice, time to die off. As for the carpet, vacuuming should be sufficient.

Prevention is also important. Two heads may be better than one, but don’t put them right next to each other. Chen said parents can also encourage children not to share personal items like hairbrushes or hats. And Shetlar suspects head-to-head contact has increased in recent years.

“We’ve created our own lice-spreading method, and that is everybody takes selfies,” he said.

“In spite of what us boys used to say about the girls — ‘you’re going to get cooties from her’ — lice don’t fly,” Shetlar said. “They don’t jump.”

For this reason, Chen is against schools’ policy of removing children from class because they have lice, adding it’s also needless embarrassment for the child. Instead, administrators should send them home and tell their parents to get them treated.

Parents do feel shame about lice and assume it’s associated with being poor or “dirty.” Many, Chen said, are “very shy” about coming forward, whispering to indicate how they say, “We have head lice.” But it can happen to anyone. Chen remembers getting lice when she was a child herself.

“These lice could care less about your living habits, your lifestyle, how rich or poor you are,” Shetlar said. “The only thing they care about: Are you alive and do you have blood?”

Lice policy at Findlay City Schools

The Findlay City Schools policy on head lice is to send home students who have live bugs in their hair. They can remain in the classroom until parents arrive.

To return to school, students must show “improvement of nit removal” and a medicated solution must have been administered. The school nurse or another trained staff member will check for progress on nit removal, and a parent must complete and sign a treatment form. If a student comes back to school with live bugs, or without showing progress on removing nits, the student will not be permitted to return.

Lice letters will not be sent home with students whose classmates have lice, due to confidentiality. Classroom checks are not performed unless the school’s nurse or principal deems it necessary.

The district’s policy is based on recommendations from the American Academy of Pediatrics, Centers for Disease Control, National Association of School Nurses and Ohio Department of Health.

The National Association of School Nurses and the American Academy of Pediatrics are against “no-nit” policies because nits are often unlikely to hatch or be transferred to other students.

Students can be absent for unnecessarily long periods of time if they are required to remove all nits before returning to school.

Arthurs: 419-427-8494
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Twitter: @swarthurs


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