HEAD LICE

Head lice are crawling insects, only about one-sixteenth of an inch long, that live and multiply in human hair. Lice are not a major health problem, since they do not transmit diseases or cause permanent problems. Nonetheless, the reaction of parents, and sometimes of school staff, has made them a significant health issue.

Lice make their home in human hair, nourishing themselves with blood from the scalp. They can cause reddened, rashlike areas. The average number of lice on an infected child's head is about 10. Their eggs (called nits) stubbornly attach to the hair shafts - most often in the back of the head or near the ears - and cannot be shaken or brushed off. When should you suspect lice? Your child may complain of a very itchy scalp, although lice may be present for weeks or months without causing an itch. If you look carefully at her head, you should be able to see the eggs, although some parents may confuse them with dandruff. (Dandruff, however, tends to be loose flakes of skin, while nits firmly attach themselves to the hair.)

Lice are quite contagious and can be spread quickly by close contact with a friend or classmate, almost always by head-to-head contact. Routine head inspections by school personnel usually miss all but the worst cases.

Lice can be difficult to treat. Your doctor may prescribe a treatment or recommend a nonprescription anti-lice shampoo or rinse containing a substance called pyrethrins. Follow the instructions carefully. Your child will probably need to vigorously scrub in the shampoo, working up a good lather, and then rinse thoroughly. This treatment can often take care of both the lice and their eggs, although a second application may be required several days later. Do not treat longer than the manufacturer or your physician recommends. Unfortunately, many lice have developed resistance to most pesticide medication in common use.

Although lice move quickly away from any disturbance in dry hair, thoroughly wetted, their mobility is much reduced. Fine-tooth combing after ordinary shampooing is a simple way to lift out lice. Repeating this process every three days to four days for two weeks is usually effective in ridding a child of head lice. Combing your child's hair with a fine-tooth comb can also remove some nits, as can pulling them off with your fingernails. Be sure to wash the comb thoroughly or soak it in anti-lice shampoo before anyone else uses it.

The presence of lice does not mean that your child has poor hygiene habits. Anyone can get lice, even if she bathes or shampoos every day. As a preventive measure, discourage your child from sharing combs, brushes, towels or hats with friends.

Many schools have policies about children with lice. In most of these schools, students with live lice are sent home when the lice are discovered; those students who have only nits and no live lice are usually sent home at the end of the day with a note, although it is likely that if nits are present in a child who has not received treatment, live lice are also there. Students can be readmitted to school once they have been treated. Some schools have "no-nit" policies, stating that students who still have nits in their hair cannot return to school; however, since many anti-lice shampoos effectively kill the nits, many schools do not feel this extra restriction is needed.

Cooperate with the elementary or middle school by notifying the staff if your child has become infected. Although school personnel and parents used to overreact to the presence of head lice in the classroom, this type of response is hopefully a thing of the past. Most people now recognize that lice can happen to anyone and do not pose an emergency situation.