The note comes home from school, day care, or perhaps church that lice is being passed from one child to the next and the school must get rid of lice, nits and eggs as soon as possible. This note strikes fear in the heart of moms everywhere. Most moms grow determined to get rid of lice for good. Hours later you’ve gone through chemical lice shampoos, combed through your child’s hair a gazillion times, placed all the stuffed animals in trash bags and sealed them away to kill these pesky bugs and cleaned every bit of clothing in the house. If you want to know how to get rid of head lice, eggs or nits, naturally or with other treatments, you won’t want to miss this exclusive interview with Richard Pollack, a research associate with Harvard School of Public Health. His exciting discoveries and knowledge are the next step parents need to combat and get rid of head lice forever.
Lori Soard (LS): Thank you for agreeing to chat with our readers about head lice. Can you tell us a little about how your interest in bugs began?
Richard Pollack (RP): I’ve always had an interest in insects, and have focused my career on studying those bugs that directly affect the health of people and other animals. Most of my efforts are focused on mosquitoes and ticks, and the parasites they transmit that cause serious diseases and death around the globe. In the grand scheme of things, head lice are unimportant. Head lice neither cause much harm nor transmit infections. Head lice became of interest to me nearly two decades ago when I learned of frequent ‘outbreaks’ of these creatures in schools across the country. I began to investigate these reported epidemics, and found that they were mischaracterized. They were outbreaks, but not of head lice. Instead, these were epidemics of misidentification and of hysteria. Whereas we found a few infested children in virtually every school (this is to be expected), the majority of the presumably infested kids had been misdiagnosed. They did not have head lice! Thus, my interest in lice (and human psychology) grew, and I’ve retained an active interest in this topic. I’ve even maintained colonies of head lice on myself – in little cages strapped to my arm. Why? So that I might have some available for study. For more information about the biology and management of these fascinating creatures, your readers are welcome to visit my no-cost educational website at http://www.hsph.harvard.edu/headlice.html.
LS: You mentioned that there is a lot of folklore and false information about head lice. Can you explain this in a little more detail?
RP: A complete discussion of the folklore and mistaken notions about head lice could fill volumes. Here are some of the most onerous examples. The fear and loathing associated with head lice stems from the mistaken notions that these insects are caused by, or associated with, poor hygiene or poor housekeeping. In reality, head lice would seem to care little at all how frequently a person bathes or cleans the home. Head lice rarely cause more than mild itching, and they are not known to transmit any disease-causing agents. Thus, they are merely a minor nuisance, not a health problem or a public health threat. Lice are not as readily transmitted or acquired as folklore would suggest. Direct head-to-head contact (with at least one person hosting these insects) is usually required to ‘share’ head lice. Though we’ve all been taught not to share hair accessories, inanimate objects (combs, brushes, hats, headphones, rugs, etc) are rarely guilty in helping to spread head lice. Head louse eggs (often called ‘nits’) are essentially non-transmissible; thus, they pose no measurable risk to anyone else. A child with ‘nits’ is not necessarily infested with head lice. Most of those presumed nits are merely bits of scalp debris and have nothing at all to do with head lice. Those that are real nits are most often already hatched, and will never give rise to another louse again. Therefore, it is important to find a live (crawling) louse on the head hair before concluding that the person is infested with head lice. If you find live lice on your child, concentrate your efforts on his or her head hair. There is no reason to treat the home or school environment. Any louse that drops to the floor or on furniture will soon die and is not a threat to anyone else. Other false notions cause school officials to pursue failed actions to combat head lice. These unjustified steps include screening of children for head lice and excluding presumably infested children from school. Finally, much misinformation is associated with the anti-louse products used for treating a person. If used according to the label directions, the FDA-registered anti-louse shampoos and lotions (pediculicides) should provide far more benefit than risk to a person.
LS: What is the best way to keep your child from getting head lice?
RP: Preventing your child from acquiring head lice may seem desirable, but there are no reasonable means to accomplish this goal. In general, head lice mainly affect children who are social; that is, they have direct contact with other children. A child who is isolated from others will not likely be exposed to head lice, or for that matter, other maladies of childhood such as pinworms, cold and flu viruses, ringworm (a fungal infection), and yet many other common illnesses. Head lice cannot infest a bald person. So, if we all shave our heads, we’d not be at risk of acquiring head lice. This would seem an extreme overreaction to a minor annoyance. Instead, it makes most sense to wait until you have confirmed your child is ‘with head lice’ before you take steps to combat these insects. Despite rumors to the contrary, most children will never ‘get’ head lice.
LS: If your child does get lice, what is the best way to get rid of these little bugs?
RP: First and foremost, relax. Finding head lice on your child often causes distress, but there is no reason to panic or to take extreme measures. Before you apply any treatment, make sure that you’ve found live insects on the hair, and that these insects are really head lice and not some accidental visitor. If you’re unsure about the identity of the creature, compare it to good pictures of head lice or have it examined by an expert (see: http://www.hsph.harvard.edu/headlice.html for images and more information on specimen evaluation). Once you’ve confirmed that your child has live head lice, refer to the management guidance (the flow charts) we offer on our website. You may be able to eliminate head lice by using special combs, by treating with over-the-counter FDA-registered anti-louse products (pediculicides), or by treating with other pediculicides available only by prescription. Home remedies (e.g. vinegar, mayonnaise) are ineffective, and some (such as gasoline and household insecticides) are far too dangerous and cause terrible injuries to children every year. Consult your prescriber or pharmacist for information about the products. Be very wary of other products available from web-based sellers. Their claims of safety and effectiveness may be exaggerated. Look instead for FDA-registered products. Readers interested in steps that school officials might take to battle head lice might be interested in this link: http://www.pta.org/2151.htm
LS: I’ve heard some parents say they feel that lice are more resistant to the chemical shampoos than in years past. Have you seen any scientific proof of this in your studies?
RP: Some populations of head lice are, indeed, resistant to some of the insecticides frequently used to combat these insects. If live lice persist a day or so after using an over-the-counter pediculicide, then it makes sense to contact your doctor to discuss the prescription products that contain other kinds of ingredients.
LS: Anything you’d like to add?
RP: Folks should ‘chill out’ when it comes to head lice. Finding head lice on your child is insignificant compared to real health concerns. Perhaps, the best reaction should be one of relief. Why? Because head lice are just a minor issue and are treatable. Parents of children diagnosed with serious illnesses would readily trade places with someone dealing just with lice.
A very special thank you to Dr. Pollack for taking the time to discuss head lice and treatments and prevention with us. I think he’s cleared up a lot of folklore and misinformation for all of us.