Speaking of Health – Lice

By Gilda Morales, ANP, DC

With school in full swing, it is appropriate to discuss a common problem that nearly everyone with school kids will experience some time or another—lice.  It is a problem that can spread quickly if not addressed immediately and can infest the head, body of the genital area with one of three species of lice.

Head lice is not preventable, and is commonly found in day care facilities, and contrary to popular belief, affects school age children, regardless of their socioeconomic status.  It is NOT indicative of poor hygiene.

Body lice, on the other hand, ARE found on persons with poor hygiene, and are more common in the homeless and areas, which are crowded.  Pubic lice are more common in teens and young adults.

One head louse can lay 300 eggs in its lifetime, with most infestations starting with 12 to 24 insects per patient, which can survive 3 to 4 weeks close to the scalp.  They attach to the hair shaft mostly on the top and back of the scalp.  The eggs, or ova, hatch within 10 to 14 days and it is the white shell of the nit that is easily visible.

The insects are transmitted by direct contact with infested hair or by sharing combs, hairbrushes, hats, linens or even headsets.  They prefer to feed on the skin of the scalp, and pierce the skin, feeding on blood and injecting saliva that causes itching and a rash.

Body lice are considerably larger than head lice, prefer to live on clothes especially along the seams, and hatch when warmed up.  The incubation period is from 6 to 10 days after being transmitted through clothing or bedding, and can survive up to 10 days on the infected patient.

Pubic lice have a crablike appearance and may also infest underarm hair, eyelashes, eyebrows, but rarely the scalp.  Unlike head lice and body lice, pubic lice are spread almost exclusively through sexual contact.

Body lice can transmit other diseases such as typhus or bacterial skin infections, and pubic lice are usually found in patients with STDs such as gonorrhea or syphilis.

Treatment of head lice is through the use of permethrin, or Nix, followed by a vinegar soak and combing with a fine-tooth comb to remove the nits.  Bedding, clothing, hairbrushes and anything that has contacted the lice has to be disinfected.  Body lice do not require the use of Nix, but requires diligent clothes washing and ironing the seams.  Pubic lice have to be treated with Nix, which is repeated in 7 days.