Recently I have heard a few families ask about head lice so I though I would pass on a little information.
With lice, itching is the most common symptom but many children are not symptomatic. The adult lice or eggs (nits) are found in the hair. Scratching and thus excoriations are common. The nits are visible to the naked eye. Adult lice are quite often not seen.
Treatment
Permethrin 1% is most commonly used and is over the counter. It is quite effective and safe with a low potential for toxic effects. It continues to work for a few weeks after application although often a second treatment is recommended 7-10 days after the first one. Resistance to it has been documented.
Malathion in another drug used. It is an organophosphate pesticide that is highly effective but has some safety concerns and is not recommended in children younger than 2 years of age.
Lindane is the last drug I will discuss. It is an organochloride. It has some toxicity concerns and is considered a neurotoxin and has the potential for central nervous system toxicity. It should be the last option after everything else has failed.
Suffocation: There are no great evidenced based data to say whether suffocation of lice by applying things such as petroleum jelly, olive oil, mayonnaise is an effective treatment. This is not to say that it does not work, but just no good studies regarding this.
There was an article in the journal Pediatrics years ago regarding treatment with a suffocating agent that ultimately ended up being Cetaphil. Here is the link: http://www.nuvoforheadlice.com.
PEDIATRICS Vol. 114 No. 3 September 2004, pp. e275-e279
Control Measures:
All family members should be examined for and treated if nits are found.
The lice incubating in egg cases (nits) are so close to the scalp that removal is difficult even with nit combs.
Medication treatment should be done in conjunction with other measures such as disinfecting pillow cases, bedding and towels by washing them. Temperatures of 128F for 5 minutes are lethal to lice. Putting things in the dryer is another option as heat kills lice.
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