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Health Tips for Parents

2006 Issues

What’s the best way to treat lice?

What’s the best way to treat lice? Head lice — a very common and treatable problem among children 3 to 12 years old — are tiny, wingless parasitic insects that live among human hairs and feed on extremely small amounts of blood drawn from the scalp. Although annoying, lice are not dangerous and do not spread disease. However, they are contagious and precautions must be taken to prevent their spread to other children, notes Heide Woo, M.D., pediatrician at Mattel Children’s Hospital at UCLA.

The first symptom of head lice is an itchy head. Of course, there are many causes of an itchy scalp, but a child who continues to itch and who develops sores from scratching may have lice. Some children also complain of a tickling sensation or something moving around on their scalp.

How to spot lice
Though very small, nits and lice can be seen by the naked eye. Nits are the tiny eggs laid by an adult female that may look like dandruff at first glance, but brushing or shaking them off can’t remove them. Nits appear oval, about the size of a pinhead, and either yellow, tan or brown. Lice lay nits on hair shafts close to the scalp, where the temperature is perfect for keeping warm until they hatch. Lice eggs hatch within one to two weeks and within a week can grow to adult lice, which are no bigger than a sesame seed.

Nits and lice are most commonly found at the nape of the neck and behind the ears. Check for nits and lice by parting your child’s hair into small sections.

Treating lice
Over-the-counter and prescriptionstrength medicated shampoos, creams or lotions are adequate to kill all the lice and their eggs, but the nits will still need to be picked out. Most schools will not re-admit students with lice until all the nits and lice have been manually removed. “The eggs are extremely difficult to pick out,” says Dr. Woo, who notes that special combs and products that can loosen the nits can be helpful.

It’s not uncommon for treatments to be unsuccessful due to incorrect use or because the lice have become resistant to a chemical in the shampoo. Start with the over-the-counter products and be sure to follow the instructions. If that fails, prescription medications may be necessary. The doctor may recommend repeating treatment in seven to 10 days to make sure all the nits have been killed, because even one nit left behind can lead to a reinfestation. Do not use treatments on children under 2 years old except under a doctor’s care. Excessive scratching can lead to a bacterial infection; in that case the doctor may prescribe a topical or oral antibiotic.

Preventing lice
Lice are highly contagious and can spread quickly from person to person especially in group settings such as schools, child-care centers, slumber parties, sports activities, camps and even playgrounds. They spread mainly through head-to-head contact, but sharing clothing, bed linens, combs, brushes and hats can also spread lice.

To prevent reinfestation:
• Use a fine-tooth comb on your child’s hair after regular shampooing every three to four days for two weeks.
• Wash and dry on hot settings all bed linens and clothing worn recently by anyone who’s been infested.
• Dry clean bed linens, clothing, stuffed animals and plush toys that can’t be washed, or put them in airtight bags for two weeks. • Vacuum carpets and any upholstered furniture (in your home or car).
• Soak hair-care items such as combs, barrettes, headbands and brushes in rubbing alcohol or medicated shampoo for one hour. You can also wash them in hot water, or throw them away.

This information is provided courtesy of the pediatricians at the Mattel Children’s Hospital at UCLA. UCLA Healthcare pediatricians are conveniently located in your neighborhood. In addition to our Children’s Health Center in Westwood, we have offices in Brentwood, Culver City, Manhattan Beach, Santa Monica, and West Los Angeles. Additional information can be found on the UCLA Healthcare web site at www.healthcare.ucla.edu or by calling 1-800-UCLA-MD1 (1-800-825-2631).

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