Embarrassing Health Issue (Lice) - Series 2

Lice are small wingless insects. They have six legs with hook-like claws for grasping onto hairs. They feed on human blood. There are three types of lice.

• Head lice may be spread through close personal contact, shared personal items (combs, brushes, hats, helmets, clothing, or earphones), or shared bedding.
• Pubic lice are spread mainly through sexual contact and are very contagious. Most people become infected after a single exposure to an infected person. The lice and eggs may also survive long enough on personal items such as clothing or towels to be spread to another person. A child who has pubic lice may have a history of sexual abuse.
• Body lice are most often spread by contact with personal items, especially clothing and hats. They are sometimes spread by direct personal contact.

Lice are spread from human to human. Pets don't get head lice and can't spread them to humans.

Symptoms

Itching, the most common symptom of all types of lice infestation, is caused by an allergic reaction. Lice bite the skin to feed on a person's blood. The saliva from these bites causes the allergic reaction and itching.

Itching may not occur right away, depending on a person's sensitivity and history of lice infestation. The first time a person is infested with lice, it may take several weeks or months for itching to start or to be noticed. In a repeat case of lice, a person may begin to itch within 2 days of infestation because the immune system reacts more quickly when exposure has occurred before.

Some people become very sensitive to lice bites and have unbearable itching. Others build up tolerance to the bites and have little or no itching, even with repeated infestations.
In addition to itching, symptoms of lice infestation vary depending on which type of lice is present

What Happens
Lice will not go away without treatment. If the initial treatment does not kill all of the eggs (nits), a follow-up treatment may be required 7 to 10 days later to kill the newly hatched lice. Itching may last for 7 to 10 days even after successful treatment.

After treatment, dead eggs may remain in the person's hair until they are removed. Some schools have a policy of not allowing children to return to school until they are free of eggs. 

Treatment

Lice will not go away without proper treatment. Treatment should begin as soon as symptoms of lice are noticed or when live lice and eggs (nits) are seen on the person's body or in clothing. Specific treatment depends on the type of lice infestation.

• Head lice and pubic lice are killed with over-the-counter or prescription medicines applied to the skin or scalp, and sometimes with a prescription pill. The most common way to treat lice is to use medicated creams, lotions, or shampoos that kill lice. Some people use a comb to remove head lice and their eggs in addition to or instead of using medicine.
• Body lice , which live and lay eggs in the seams of clothing, are destroyed by washing clothing in hot water [130°F (54.4°C) or higher] for 5 minutes or more. This will usually kill adult lice and prevent eggs from hatching. Body lice are only present on the skin when they feed and will usually go away if you bathe daily and wear clean clothes.

Children with head lice can return to school or day care after their first treatment. Some schools have a "no nits" policy in which the child can go back to school or day care only after eggs have been removed. "No nits" policies are discouraged by medical experts. Most doctors agree that a child should be allowed to return to class after proper treatment and should be urged to avoid close head-to-head contact with other students. Confidentiality should be maintained so as not to embarrass a child who has head lice.

Itching may continue even after all lice are destroyed. This happens because of a lingering allergic reaction to their bites. Over-the-counter cortisone (corticosteroid) creams or calamine lotion may help. For severe itching, antihistamine medicines (such as Benadryl) or stronger, prescription-strength corticosteroid creams may be needed. Don't give antihistamines to your child unless you've checked with the doctor first. And don't use cortisone cream for longer than 7 days without talking with your doctor. Do not use the cream on children younger than age 2 unless your doctor tells you to. And don't use it in the rectal or vaginal area in children younger than age 12 unless you've checked with the doctor first.

Prevention
Head lice are easily spread among children because kids commonly share hats, combs, and other items. If you or your child has head lice, you can help prevent others from getting it if you avoid head-to-head (hair-to-hair) contact during activities inside the home and outside the home. Also, don't share clothing, bedding, hair brushes and accessories, pillows, stuffed animals, or towels. Frequently examining the scalps of your school-age children may help you discover and treat lice before they spread to the rest of your family. Avoiding prolonged close contact with a person who has lice will also reduce your risk.

Pubic lice  are spread primarily among people who have many sex partners. Reducing the number of sex partners you have may help reduce your risk of getting pubic lice.

Body lice  may be prevented by bathing regularly and changing clothes daily. Body lice live on clothing, not on the body. Washing clothing in hot water [130°F (54.44°C) or higher] will usually kill adult lice and prevent eggs from hatching. Body lice that are on the skin usually go away on their own with daily bathing and wearing clothes that are not contaminated. Medicines to kill body lice are usually not needed.

To help control the spread of lice, you can also clean combs, brushes, clothing, and other personal items to kill lice and their eggs.

Medication

There are both over-the-counter medicines and prescription products to treat head lice and pubic lice. Most products come as a shampoo, creme rinse, or lotion (topical treatment) that is applied to the affected areas, left on for a period of time, and then rinsed off. Doctors sometimes prescribe a pill to treat lice when two or more approved topical medicines have not worked.

If lice infest the eyelashes, your doctor may prescribe an eye ointment for you.

Because body lice live in clothing, not on the body, medicines are generally not needed unless the person is severely infested. The most common way to kill body lice and eggs is to wash clothing and bedding in hot water [130°F (54.5°C) or higher] in a washing machine.