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Digestive Health > Related Conditions > Lice
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(Head Lice · Pediculosis)

In this condition factsheet:

Diagnosing Lice

Head lice or nits are the easiest to see, usually on the scalp and nape of the neck and over the ears. Adult lice are approximately the same size as a sesame seed. Body lice are more difficult to find, but they usually can be detected in the seams of underwear. Pubic lice are found on the skin and hair of the pubic area or on the eyelashes.

Finding a louse or nit is not easy. They are barely visible to the naked eye, especially on blonde hair, where they hardly show up at all. When looking for head lice, check behind the ears, close to the scalp at the back of the neck, and on top of the head. Using a fine tooth louse comb is far more efficient than simple visual examination. Be on the lookout for their tiny white glistening eggs or little gray hatched ones, which will be firmly attached to the hair shaft, usually close to the scalp. Lice excrement looks like flecks of brown dust.

Treating and Preventing Lice

Medication for lice includes lotions, cream rinses, and shampoos. For head lice, both pesticide and non-pesticide products are available. Apply the medication to the affected body areas as directed. Some people find that the effectiveness will vary with the type of product and thoroughness of application. Repeated treatments may be needed and are usually recommended. Ask a pharmacist for complete directions on how to use specific products and for recommendations on treatments based on the age of the affected person and the type of infestation. Note that this step gets rid of the existing adult lice.

Removing the remaining nits with tweezers or a fine comb is the next task in getting rid of lice. This can take several hours per head depending on the length of the hair and the number of nits. In the past, some schools had "no-nit" policies for children returning to class. Now, these policies are considered outdated and unnecessary.

All lice treatments should also be used on other affected family members (head lice) and sexual partners (pubic and body lice) at the same time as the infected person. Then, everyone treated must recheck once a week for a few weeks to ensure that there are no signs of lingering lice.

Alternative treatments to remove and kill lice, including "natural" treatments such as tea tree oil and aromatherapy; or "home remedies" such as mayonnaise, petroleum jelly, olive oil, and tub margarine are not currently recommended because there is not enough scientific evidence that they are effective.

Here are some anti-lice strategies:

  • Teach children not to share hats, headphones, combs, brushes, or bicycle helmets, and to report any head itching.
  • Keep long hair tied back and away from the face.
  • Check children's hair regularly, especially if they are scratching a lot.
  • Wash all personal items that have come in contact with the head of an infested person at the time of a lice outbreak, such as hats, towels, and pillowcases, in very hot water (above 66°C or 151°F) and dry in a hot dryer for at least 15 minutes.
  • Because lice can't survive away from humans, nonwashable things such as pillows can be dry-cleaned or sealed in airtight plastic bags for 10 to 14 days to kill lice.
  • Don't use a pesticide spray to "disinfect" your house. These products can be toxic, and don't help control head lice.
  • Soak all brushes and combs in hot water for 5 to 10 minutes or wash them with a pediculicidal shampoo.
  • Thoroughly vacuum items such as rugs, furniture, mattresses, pillows, and any other surface where someone may have rested their head. Do not forget the car seats.

Many parents are reluctant to report their children's lice to school officials due to embarrassment, but it's extremely important to do so to help control its spread. If head lice are noticed, also alert other people who may have had contact with your child.




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