Many of us remember whispering about the classmate who left school early because they had lice, the evasive bug that make scalps their homes. The unlucky, banished kid considered dirty and unkempt, the object of our pity and disgust.
The idea lice are the direct consequence of poor personal hygiene is one of the many myths about the age-old condition. Krista Lauer, medical director of Lice Clinics of America, said lice do not discriminate between the clean and dirty members of our society, or the rich and poor.
Lice are "equal opportunity infesters," said Lauer, who argues it's about time we dispel those stigmas.
Lice infect millions each year
Lice infestations are most common in young children, who often contract the bugs through the way they play and interact with one another.
The U.S. Centers for Disease Control and Prevention reports about 6 million to 12 million infestations occur in kids ages 3 through 11 years old each year.
'Super lice' are more prevalent
Odds are if you get lice, you'll get what is colloquially called “super lice”, an evolved type that has grown resistant to over-the-counter treatments after years of exposure to the chemicals.
Lauer said research published last year in the Journal of Medical Entomology found 98% percent of head lice collected in 48 states were resistant to lice treatment products.
Lice do not jump, swim or fly
Lice crawl. They can't jump, fly or swim.
They're bugs of opportunity, Lauer said, spreading mostly through head-to-head contact.
"That's why we see lice more commonly in young children," Lauer said. "Whenever there's an opportunity for one head to another, that provides the opportunity for lice to move from one head to the next."
Lice are spread in children by playing in close proximity, at sleepovers, while playing video games closely, and even, posing for group pictures.
What about selfies?
Lauer said selfies can be a cause of spreading lice. Anecdotally, she explained, doctors are seeing lice in older kids.
Hats, helmets and hairbrushes
Lice latch onto human hair follicles and rely on sucking blood from a patient's scalp in order to survive. If they're removed from a scalp, they can't live very long.
Therefore, Lauer said, it's "extremely rare" a person will get lice by putting on someone's hat, using someone else's hairbrush or putting on a helmet.
In fact, when it comes to athletics, Lauer said people should use another person's helmet if the alternative is no protection. Why? Head injuries are true medical problems while a lice infestation is a "medical nuisance" with no long-term health effects aside from scratching and poor sleep.
Lice do not carry disease.
What about water?
Taking a swim can't get rid of lice, which go into a type of hibernation state when in water. Lice can survive up to six hours submerged.
What to look for
Parents doing a head check on their children should look for live bugs living close to the scalp and small eggs attached to hair follicles.
A scratchy kid is a good indicator of lice. People with lice also may have a hard time sleeping and may have sores on their head from scratching.
Parents should look for such symptoms particularly after kids have been together, such as after a family vacation or summer camps.
The next step is getting diagnosed by a doctor, pediatric nurse or at lice clinic, which administer a lice removal kit. Removal includes rubbing a gel-like oil on the head, which kills the lice bugs and a special comb to pull the eggs from the hair.
How to avoid lice
Particularly for parents, avoiding head lice is very important. A kid with head lice can easily infect the entire family.
Parents should try to educate kids about not having head-to-head contact with other children and to avoid sharing hats and helmets if possible.
If a lice infestation is found, parents should call the parents of other children who may be infected.
"Don't be embarrassed, this is common," she said. "If anything, it means your kids are engaged with play with other people."