Ever wonder why people hesitate to share hair brushes or hair ties? Why is hair hygiene is such a big deal? Why do people just others by how clean their hair appears? While the basis of these questions is about hygiene and self care rituals that we value in our society, part of the concern is related to one, tiny issue. That tiny issue is lice.

What are lice? Firstly, the singular form of lice is louse. These tiny insects often infect hairy places (like the scalp) and feed on our blood. They are mostly spread by head to head contact, but they can also be spread through personal items such as headwear, hats, combs, or brushes. I was relieved to find out that lice cannot fly, so near but non-touching contact to an infected person does not put you at significant risk. Additionally, these little guys can only live for 1-2 days without feeding, so getting lice from furniture or the floor is limited. The reason there is so much fuss about lice is that these little bugs can cause itching, scalp irritation, or sores. You may have an allergy to them or by scratching the itch, you could introduce a secondary infection that will worsen your symptoms! It is surprising to note that head lice are not a sign of poor hygiene because people of every cleanliness level can be affected by lice. Additionally, although lice can cause symptoms like itchiness and discomfort, they don’t carry diseases. You can read (and see) more about lice here (beware, there are pictures!)

Head lice prevention: School aged children are at the highest risk of lice because close contact and play with others means that they are more likely to come into personal contact with another person. (As an adult, I can’t think of the last time I shared a hat with a coworker! It just doesn’t happen as frequently as it does with children.) There is no current FDA approved lice prevention product available. Most suggestions are not well regulated and should be undertaken with the understanding that there can be significant risks involved. Do not try homeopathic solutions without checking with your doctor first. Mayo Clinic notes that many formularies include “plant oils such as rosemary, citronella, eucalyptus, tea tree and lemon grass.” You can also disinfect brushes by cleaning them and soaking them in hot water. However, the best tool for prevention is behavior. Limit head to head contact with others. Don’t share personal belongings, especially items that come into contact with your head or hair. Also, avoid coming into contact with clothing, sheets, and materials that a known infected person has used. This will lessen the possibility of the lice being transferred to you. It is important to note that the CDC warns against using fumigation sprays or fogs because they are not effective against lice.

Head lice treatment: It is currently recommended by the CDC that any person with an active lice infection be treated. Additionally, any person who has knowingly come into contact with the infected person should also be treated so that they limit the outbreak and reduce the spread of lice. First and foremost, if you think you may have a lice infection, consult your physician. They will be able to guide your treatment plan and may be able to tell you if the lice in your area is resistant to standard treatments. Lice treatments can be bought over the counter or prescribed. These medications usually come in a combination of 2 categories, pediculicides and ovicides. Pediculicides kill only the lice. Ovicides kill the eggs. For the best treatment, it is ideal to choose a formulation that does both. Follow the instructions on the packaging and be aware that some methods require more than a one time treatment (often a repeat treatment a few days after the first one). Using a fine tooth comb in conjunction with this is also ideal to ensure that all of the nits have been removed from the hair. Additionally, anything that has had contact with the infected person in the past 2 days should be washed in hot water to kill the lice. (Anything used more than 2 days ago is considered safe because lice cannot live longer than that without a host for food). Any item that cannot be washed should be quarantined in a plastic bag for 2 weeks. As always, there are natural and homeopathic alternatives for lice treatment readily available by a simple search on the internet. This list Health.com list contains both over the counter lotions such as Spinosad and alternatives such as olive oil. The American Academy of Dermatology reminds us that some treatments fail because of population resistance and unregulated treatments, although effective, can have unforeseen risks. This could include unsafe ingredients, reactions with other products you have used, or even toxic effects. As always, do not undergo treatment without the guidance of your physician. If necessary, he or she can provide a referral to a dermatologist.


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