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Know your enemy

Frequently Asked Questions About Head Lice

What is Pediculosis?
Pediculosis or head lice are tiny, wingless bugs about the size of a sesame seed or smaller. They have six legs with tiny claws and live only on human scalps. Head lice can range in color from light brown to gray. While annoying, head lice are not life threatening.

How widespread are head lice?
It is difficult to track head lice cases because head lice are not considered a disease and therefore public health departments and the Centers For Disease Control do not routinely track the number of head lice cases. However, schools and manufacturers of lice products estimate head lice cases at 12- 25 million infestations a year in the United States alone. Most of those infested are children under the age of twelve.

Head lice have been infesting humans since the cave days.

How do you get head lice?
Head lice do not hop, jump or fly. They migrate through direct contact with an infested person and their belongings.

Pets do not transmit head lice, and poor personal hygiene does not cause an infestation. In fact, head lice prefer clean, healthy heads.

Head lice do not live in, nor spontaneously generate from, the dirt, trees or the air. They live on the human head!

What are the symptoms of head lice?
The most common symptom of a head lice infestation is persistent itching, particularly around the ears, back of the neck and crown, but some people never itch at all. Repeat infestations can cause some individuals to become super-sensitive to bites. Secondary bacterial infections can occur with excessive scratching. See a doctor if this occurs.

Diagnosis of head lice is usually made by finding nits (lice eggs). Nits are tiny, whitish, oval eggs firmly attached to one side of the hair shaft at an angle. Viable nits are usually, but not always, found within a half-inch of the scalp.

Hint - if you can blow or flick it off, or if it crumbles in your fingers, it is not a nit.

How do you treat for head lice?
Getting rid of head lice is a three-step process. You must kill all the live lice, check for and remove all the nits by combing and manual nit picking, and do a reasonable job of cleaning the infested person's belongings and home environment.

Please make sure you have head lice before treatment. Many people misdiagnose head lice and treat themselves or their children with chemicals unnecessarily.

What are Pediculicides?
Pediculicides are the pesticides used to eliminate head lice. Familiar over-the-counter brand names include: Rid, Nix, Pronto and Clear. These products contain insecticides (pyrethrin or permethrin) and should always be used with caution. Check with your pharmacist or doctor to determine which product is safe for your family. Never use these products if you are pregnant or nursing, or on infants under 6 months of age. Follow the directions exactly when using them.

Misuse of these products i.e., leaving them on longer than the directions state or applying more treatments than specified by the manufacturer, puts children at risk for overexposure to chemical pesticides.

Also, children with allergies may be at more risk for allergic reactions to pesticides.

A prescription medication called Kwell should never be used. Kwell contains Lindane, a powerful neurotoxin and possibly carcinogenic pesticide, which can cause serious side effects including seizures and even death. Consumer Reports has petitioned the Food and Drug Administration to remove this pesticide from the market. Children and the elderly are particularly vulnerable to Lindane toxicity.

Are head lice becoming drug-resistant?
People should also be aware that according to entomologists, any insect over time can develop resistance to pesticides. It is not surprising therefore, that many consumers, health professionals and entomologists report that head lice have become resistant to pediculicides.

However, failure to follow directions, non-compliance and failure to pick nits manually can also result in a persistent head lice infestation.

Predictably, consumers are frustrated and confused as to how to proceed.

What should I do if I have used pediculicides and still have head lice?
If you have used a pediculicide correctly and still have live lice or new nits, you probably have a persistent case of head lice. According to the Palm Beach County Head Lice Task Force and the Head Lice Treatment and Prevention Project at Florida Atlantic University College of Nursing, persistent head lice is defined as three incidents of live lice found over a 6-week period.

If you have head lice that have resisted treatment, do not continue to use additional chemical treatments in the hopes that they will work. They will not, and such chemical treatments were never meant to be used repeatedly.

Instead try a treatment program called Head Lice to Dead Lice . This pesticide-free treatment has proved extremely successful in eliminating persistent head lice infestations. The Five-Step Battle Pan outlined in both the video and book incorporates the use of olive oil as a smothering agent. The smothering program is non-toxic and has a high success rate when followed as directed.

Lice breathe through holes in their sides. When you cover these holes with olive oil, the lice will die. However, it takes awhile for them to die, because head lice can shut down their systems for hours. That's why you need to know exactly how and when to use a smothering program.

Click here to learn more about olive oil and the Head Lice to Dead Lice program.

Why is manual nitpicking so important?
Every successful lice removal program must include manual nit picking. Even if you treat with chemicals and/or olive oil you must also incorporate manual nit picking into your treatment program because nothing has proved successful in killing nits.

Lice lay their eggs close to the scalp. It used to be thought that eggs further than 1/2 inch from the scalp were not viable. However, new research indicates that this is not true, especially during warm weather. Therefore, removing all the nits is the only sure way to get an infestation under control.

Getting rid of head lice requires perseverance.

What are DEC plugs?
Skin can become irritated after using a pediculicide. This can result in the formation of desquamated epithelial cell plugs (DEC) which people often mistake for nits. This causes many caregivers to overtreat with chemicals thus continuing the cycle. If you are not sure if you are seeing nits, take a suspected nit on a hair shaft to your doctor and have him confirm the diagnosis by looking at the suspected nit under a microscope.

What if you can't see the nits to pick them out?
Check for and remove nits in bright light - daylight is best. Sit near a window and shine a bright light on the infested person's head. If you have poor eyesight, get someone to help you or purchase a blue vision visor which magnifies nits 2 1/2 times at a distance of 8".

Can you use mayonnaise, butter or vaseline to smother head lice?
Like olive oil, mayonnaise, butter and vaseline are smothering agents. However, unlike olive oil, these substances are difficult to get out of the hair, particularly in the case of vaseline. Children are often repelled by the smell of butter and mayonnaise and both these substances can turn rancid, and cause problems if children suck on their hair.

Mineral oil (including baby oil) is not recommended because it can be harmful to mucous membranes.

Olive Oil is the best smothering agent. It has been lab-tested and found to be effective in killing head lice. Olive oil has few, if any, allergic properties and is relatively inexpensive. The least expensive grade - pumace or restaurant grade - is best. And olive oil can be purchased with food stamps.

Smothering head lice is a safe and effective treatment option, but it can be somewhat complicated. To smother successfully, you have to be persistent and know when and how to apply the smothering agent.

How do you clean the home environment?
Some entomologists believe that you do not have to clean the home environment at all because head lice die very quickly once they are off the human head (36-48 hours), are very slow moving off the head, and nits need a human blood meal within 45 minutes of hatching to survive.

That said, most people are not comfortable unless they do some cleaning of the home environment. The PVP cleaning program (personal items first, vacuuming, etc.) outlined in Head Lice to Dead Lice is a simple and reasonable cleaning program that should eliminate any lice in the home.

If you find yourself obsessing about housecleaning, you need to take a deep breath and refocus your energies back to the infested person's head.

When is it safe to send a child back to school?
Most schools have a no-nit policy to control head lice outbreaks. Generally, when you have completed one pediculicidal treatment & one olive oil treatment (or two olive oil treatments) and a thorough nit combing and manually removed all nits, you can send your child back to school. At this point, there should be nothing left on the head that is capable of moving onto another head.

However, this does not mean your child is lice free. You must continue to check for lice, do the olive oil on specified days and manually remove nits.

Remember, the olive oil treatment program is a twenty-one day program based on the life cycle of the louse. As long as you continue to treat with olive oil on the designated treatment days, your child should not infest anyone else.

If you choose to use only pediculicides, be aware that these treatments are not 100% effective and head lice have developed resistance to many current treatments.

Can you get head lice from a swimming pool ?
Extremely unlikely because head lice shut down in water.

Can you get AIDS from head lice?
There has never been a case of someone getting AIDS from head lice. According to the Harvard School of Public Health, head lice are not known to transmit infectious agents from person to person.

Can heat kill lice?
Yes, lice hate dry heat. You can put clothes, hats, towels, etc in a hot dryer for twenty minutes which should kill lice and their eggs.

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