Head Lice, Here They Come

Cases of head lice are on the rise and treatments are being rendered ineffective due to increased drug resistance. It’s more likely than ever that your child will be afflicted: what you need to know to be prepared.

My original working title for this article was going to be "Lice: They’re Not Just For Dirty People Anymore!", but I thought that that title might strike some readers (Barbara Robinson’s Herdman children, for example) as offensive. It does, however, address one of the more common historic beliefs about lice: that people living in unsanitary, and often poor, conditions were more likely to be afflicted than those in shiny, clean, more affluent neighborhoods. In fact, it was often thought, they were the only ones responsible for spreading the varmints around.

Who can forget the shocked reactions of poor Fee and Padraic Cleary, the parents of the central character, Meggie, in Colleen McCullough’s novel, The Thorn Birds, upon finding lice in their little girl’s hair? "’…filthy lot of flaming pigs! [said Padraic]…when I think of [her] giving her lice to Meggie, I could go into Wahine and tear the whole filthy greasy caf down!’ he exploded." As you can see, references to cleanliness being an issue in the spread of lice are not uncommon.

For years now, the perception has been that lice is something that only happens to other (dirtier) people, but with 6-12 million cases of lice expected to strike U.S. schools this year, it is apparent that lice infestations will strike households of all levels of cleanliness; in fact, some researchers believe that lice actually prefer cleaner hair, because it makes it easier for them to attach to the hair shaft (an argument many children will try to use to their advantage when it comes to bath time).

So if it is not cleanliness (at least, not cleanliness alone) that is responsible for sudden outbreaks across the country, then what is causing them? Any parent who has ever received a "lice letter" from their child’s school can answer that: sharing combs, brushes, or hair accessories; sharing hats (and that includes things you might not think of immediately, like batting or riding helmets); sleepovers (can you hear the wail of outraged tweens everwhere?); circle or story time; riding on the bus, etc. Because lice do not fly or jump (they have to crawl), anything that involves head-to-head contact puts your child at risk.

If that sounds like pretty much every activity in which your child may be currently engaged, you’re right. But children have always engaged in these activities, so why do there appear to be so many more outbreaks now than in the past? Researchers have some theories, one of which is that with more children with both parents working outside the home, more children are in group-care situations than in years past, providing more opportunities for lice to spread from one child to another.

Another theory, more scientific than social in nature, has to do with a growing resistance among lice to the prevailing treatments of the day. One of the more common ingredients in lice-treatment shampoos and kits, permethrin, has been shown to be ineffective in 50 to 90% of cases in a recent study. That drug-resistance makes it harder to stop an infestation on one child from turning into a school-wide epidemic.

The social stigma associated with a child having lice does not help matters, either. Parents are desperate to avoid other children who are rumored to have lice (though it doesn’t seem to affect their children’s interest in playdates at all) and, if their own child is found to be afflicted, it can be mortifying for those parents. Some may ignore the problem completely, or even try to hide it. Complicating matters is the long gestational period for the eggs to hatch into nymphs and then into adult lice: many experts put the "incubation period" at anywhere from ten days up to two weeks; that means you may not see anything moving around on your child’s head for nine days, and think you’re home free, but then see your worst nightmare crawling across your daughter’s forehead on the tenth day.

So what can a fearful parent do? First, check your child regularly. If you’re not sure what to look for, ask your pediatrician or a school nurse they would be far happier to help you do preventative checks than to have to help you figure out how to get rid of the little buggers. Second, pay attention to letters that come home from your child’s school. Sometimes schools will only send letters home to the parents of one particular class, but if you hear about another class at your child’s school being infested, begin regular checks of your child’s head. Third, never, ever, even in the absence of an active outbreak in your child’s world, let them share anything that allows for head-to-head contact, not even for a minute. Fourth, there are some products out there that claim to be lice-repellent, for example, products containing tea tree oil or lavender (there are a number of shampoos, conditioners, etc. that are available), and for those products, there is some good anecdotal evidence of their efficacy, but do not, under any circumstances, use lice treatment products on your child in the absence of a verified infestation. The active ingredients in most of the treatments are pesticides and highly toxic; unnecessary use or overuse of them is harmful to children and is what is being blamed for lice’s increasing resistance to them. Fifth, after sleepovers, birthday parties, etc., wash your child’s clothing/linens in the hottest water possible and dry them on a high setting for 20-25 minutes. Anything that can’t be dried, seal in a plastic bag for several days. If your child is invited to a sleepover, have the courtesy to do a thorough check of your child beforehand, and if you suspect there may be an infestation, do not send your child.

Lastly, if the moment should come when you discover the dreaded things on your child, vacuum, bag, wash, comb, nitpick, inspect, repeat; vacuum, bag, wash, comb, nitpick, inspect, repeat, and try to keep your composure. Yes, lice are nasty, yes, it is grueling and time-consuming and irritating to deal with an infestation, but with the numbers increasing every year, chances are very good that your child will be faced with an outbreak at some point, along with most of the children on your street. Whether you’re rich or poor, a neat freak or a laissez-faire housekeeper, lice are coming, and they’re hungry; be vigilant to make sure your child is not their next meal.

By Julia Tagliere
Published: 10/7/2008

 

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