Head lice

Updated 27 January 2016

The truth about head lice

Parents should be reassured that personal hygiene has nothing to do with head lice and it can't cause physical harm, says an expert.

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Although lice do not cause serious physical harm, they can result in a lot of emotional distress because many people still mistakenly believe they are a sign of poor hygiene, an expert explains.

Head lice bite into the scalp to feed on blood, but these bites are usually not painful, but  a lice infestation can strike fear in families for a number of reasons, including the stigma of being deemed "dirty," explained Dr Andrew Bonwit, a paediatric infectious disease expert at the Loyola University Health System in Illinois in the US.

Read: What are head lice?

He reiterated that a lice infestation was not a reflection of a person's cleanliness."Personal hygiene and socio-economic status have nothing to do with having or transmitting head lice. The head louse is an equal-opportunity pest," explained Bonwit.

"The infestation is usually a nuisance and almost never a serious problem in itself." There are other common misconceptions about lice, Bonwit pointed out. 

In order to ease parents' fears, he dispelled the following myths:

Myth: Pets spread lice. "Animals are not known to carry head lice, nor transmit them to people," Bonwit said.

Myth: Sharing personal items spreads lice. "Although it's probably best not to share such items as combs, hairbrushes and hats, these do not seem to transmit the pest," Bonwit added. "Transmission of lice seems to occur only by direct head-to-head contact from one person to another."

Myth: Kids with lice should be sent home from school immediately. "The American Academy of Paediatrics does not endorse 'no-nit' policies that exclude children from school because nits are present," Bonwit noted. "In fact, even the presence of mature head lice is not considered a valid reason to exclude children, only a cause for prompt referral to the physician for treatment."

Myth: Lice carry disease. "Head lice do not transmit serious infectious disease," Bonwit explained.

Although lice often cause a big stir, they are tiny and often hard to spot.

Read: Causes of head lice 

"Lice are very small," said Bonwit, who is also an assistant professor of paediatric infectious disease at the Loyola University Chicago School of Medicine.

"The lice produce eggs, called nits, which become strongly cemented to the host's hair shafts."

Nits look like small, dark spots on the side of the hair shaft. Although the infestation isn't painful, it can be itchy, Bonwit cautioned.

"Sometimes the patient has been so itchy that he or she scratches the scalp to the point of minor skin infections and even causing some enlarged lymph nodes on the back of the neck or behind the ears.

Read: How to comb out head lice 

"While these changes may alarm parents, they aren't directly harmful."

The US Centres for Disease Control and Prevention reports that up to 12 million lice infestations occur each year in the United States among children between the ages of 3 - 11.

"Parents and school staff may become understandably upset by outbreaks of head lice, but it's important to remember that if the problem occurs, it is treatable, although repeat applications of medicine are usually needed," Bonwit said.

Read: Watch out for back-to-school head lice 

The most common lice treatment is over-the-counter or prescription shampoos or lotions that must be applied to the scalp, left on for a specified time and then rinsed off. Often a fine-toothed comb is also needed to remove nits to prevent further infestation.

"The life cycle is about seven days from the laying of the eggs to the hatching, so a second insecticide treatment is recommended after the first application," said Bonwit.

"If the treatments are used as directed, problems other than scalp irritation are unlikely to occur."

Read more: 

Treating head lice  

Preventing head lice 

20 head lice myths debunked



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