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Paging Dr. Frischer - Pediculosis Capitis
WRITTEN BY :   Dr. Alan Frischer

I am writing today about pediculosis capitis – in honor of so many of us who have had our households overrun by this highly irritating, uninvited guest.
Yes, we’re discussing head lice. What are they, where do they come from, and most importantly, how does one get rid of them?
The bane of many parents, the head louse is a tiny, wingless parasitic insect that lives in the human hair and feeds on extremely small amounts of blood drawn from the scalp. Lice (the plural of louse) are a very common problem, especially among 3 to 12 year olds, and for girls more often than boys. Lice will cause the scalp to itch, and small, red bumps sometimes appear on the head, neck, and shoulders. Lice aren’t dangerous and they don’t spread disease, but they certainly are contagious!
Head lice are contracted by coming into close contact with an infected person; by touching their clothing or bedding; or by sharing hats, towels, brushes, or combs. Their eggs (or “nits”) attach quite firmly onto the hair shaft close to the scalp, where the temperature and environment are perfect for them. Although they resemble small white flakes of dandruff, they can’t be removed by simple brushing or shaking. The louse can live for up to 30 days, and their eggs for more than two weeks. Most lice feed on blood several times a day, but they can survive for up to two days off the scalp. They spread easily, especially among children who are often in close, crowded environments…like school.
Treatment is recommended if you find even a single egg. Lotions and shampoos containing 1% permethrin (such as Nix) can be found in stores and don’t require a prescription. If these don’t work, your doctor can write a prescription for a stronger product. However, killing the lice on the scalp is only the first step towards eradicating lice from your home and family. The eggs also must be removed from the hair and from the household:
•Remove the eggs and any surviving lice with a special nit comb. Nits and lice can be difficult to see, so nitpicking is easiest in a well-lit area, with a magnifying glass if necessary. Part the hair down to the scalp in very small sections, looking for both moving lice and eggs to remove. Thoroughly examine the entire head.
•Wash all clothes and bed linens in hot water with detergent.
•Repeat nitpicking in 7-10 days.
•Vacuum carpets and upholstered furniture in the home…and car.
•Never share hairbrushes, combs, bedding, towels or clothing with someone who has or has recently had lice. Soak hair-care items like combs, barrettes, hair ties or bands, headbands, and brushes in alcohol or medicated shampoo for one hour.
Be aware that if a single case of lice is discovered, everyone exposed in the home, school, or workplace must have their head inspected, and be treated if necessary. With proper treatment, lice are usually killed. They can, however, reappear if even a single louse or egg survives!
It is clear that eradicating lice from your household and your loved ones is difficult and demanding. Some families resort to using a lice-removal service, where one can hire extremely patient, very detail-oriented, and clear-sighted technicians who will come to your home and do the treatment and nitpicking for you.
Remind yourself and your children that having lice is not a sign of uncleanliness or poor hygiene. These pests affect people of all ages and socioeconomic status. Also, remember that your household pet cannot catch or pass along head lice to the family.
Don’t hesitate to call your doctor if symptoms continue after treatment. After several experiences with lice in my own home, I’ve found that you may also need to call a therapist for counseling and emotional support!
May you all be healthy and lice-free!
Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

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Published: July 14, 2011 – Volume 10 – Issue 13



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