Head Lice Are Becoming More and More Resistant to Lice Shampoos and other Insecticides

Interesting article in SciAm about the difficulty in treating head lice infestations. “Overexposure to insecticides has bred resistance in the parasites, making it harder than ever to treat infestation." The situation is different in Europe, where they've stopped using insecticides to kill lice and nits and use synthetic oils:

Further confounding matters, the co-pay for visiting a doctor, plus the cost of prescriptions, which may or may not be covered by insurance, can impede patient access to these newer medications. And despite their diminishing efficacy, over-the-counter lice shampoos remain the first response recommended by most doctors, health plans and even the American Academy of Pediatrics.

The situation is totally different in Europe, where treatment moved on from pyrethroids and virtually all insecticides about a decade ago, says Ian Burgess, president of Internationals Society of Phthirapterists (people who study lice). Instead most Europeans now rely on silicone and other synthetic oils to eliminate head lice.

The oils envelop the lice, preventing them from excreting water. As liquid builds up inside the louse, its internal organs start to shut down from the exhaustion of trying to pump out the water. Either it dies of this exhaustion", Burgess says, “or its guts rupture from the liquid.”

What Are Crabs (Pubic Lice)?

"Crabs" is the common term for lice found in the pubic hair of humans. Crabs is a parasite infection medically known as Pediculosis pubis or pubic lice. Barely the size of a pinhead, lice are organisms that live only with the help of another organism, called a host. There are thousands of types of lice, some of which have developed an attraction to humans. The official name for the organism responsible for pubic lice is Pthirus pubis. Other lice that often infect humans are Pediculus humanus capitis (head lice) and Pediculus humanus corporis (body lice). The term "crabs" seems to come from the microscopic appearance of the pubic louse. The pubic lice organisms are visible to the naked eye in affected areas. The lice are typically seen attached to hair in pubic areas, but may sometimes appear in other areas of the body where coarse hair is present (such as beard, chest, armpits, etc.).

The pubic louse is distinct morphologically (somewhat rounded with three pairs of legs on either side of the body from which it takes its descriptive name) from the head and body louse. The female lifespan is slightly shorter (three weeks), and she produces fewer eggs per day (three) than her counterparts. The eggs attach to the base of the pubic hair shaft for approximately six to eight days before hatching.

A new case study in The New England Journal of Medicine tells a torrid tale of an unnamed 65-year-old man who showed up at a dermatology clinic complaining of an itchy crotch. On examination, the man didn’t appear to have a rash or any lesions, so the doctors investigated his pubic area with a hand-held dermoscope.

The first bit of evidence they uncovered was a nit firmly implanted on a pubic hair. And then came the culprit itself—a freakishly agile, crab-shaped parasite moving from hair to hair like it was nobody’s business.

For the dermatologists, it was a classic case of pubic pediculosis—also known as “crabs.” This happens when the pubic louse, Pthirus pubis, infests a person’s hairy nether regions.

“Pubic pediculosis is usually sexually transmitted but can occur after contact with fomites [materials that are likely to carry infection] such as clothing, bedding, and towels used by an infected person,” write the researchers, who work out of Mexico City’s General Hospital. “The condition most commonly affects teenagers and young adults. This patient reported that he had had no recent sexual contact, and no other sexually transmitted infections were identified on screening.”

The doctors prescribed the oral drug ivermectin, and after two weeks the itching was gone. Which is all fine and well—but what about the psychological scars?

Three things you probably didn't know about crab lice.

Crab lice (Pthirus pubis) aren’t crabs at all—they’re parasitic insects that feed exclusively on human blood, and their bites can cause intense itching in their hosts. Often, this itching happens in the pubic area, which is why they’re also known as “pubic lice”—which, it turns out, is actually a misnomer.

• They’re not just spread by sexual intercourse.

Although sexual relations are the most common way to pick up these particular passengers, any prolonged close physical contact can do the trick, including breastfeeding or sleeping in the same bed as an infested individual. A few reports have suggested that crab lice can tolerate being away from a human host for as long as 36 hours, which opens up the possibility that the lice could hang out on previously used towels and sheets to wait for a new host.

• Their closest cousins live on gorillas.

Studies comparing DNA from the three species of human louse with the lice that infest other primates found that the crab louse’s closest relative is the gorilla louse. Head lice and body lice belong to a completely different genus of lice and are more closely related to the lice that live on chimpanzees. But researchers don’t think that humans picked up crabs from screwing gorillas. It’s much more likely that we got them by eating gorillas. Lice are very sensitive to body heat, and it’s possible that way back in the distant past, some gorilla lice abandoned a cooling dead host for the warm human that was butchering it.

• They don’t just live in pubic hair.

Crab lice certainly prefer the pubes, but their short, thick legs are just as well adapted to hang on to any coarse hair on the human body. They’ve been found in armpit hair, beards and mustaches, eyelashes, and eyebrows. They’re not big fans of densely packed hair, so they’re rarely found on the scalp. But if your scalp hair is sparser than average, as in people with curly locks, they might make an exception. Take home message? If you have a head louse infection, you only need to treat your scalp. A crab louse infection means all bets are off. Treat all of your hair. All of it.

How Do I Prevent my Kids from Getting Head Lice at Camp?

Practice Prevention - Lice Away

With kids getting out of school this week and camp season fast approaching.  It is time to give consideration to head lice prevention.  The following tips will help you avoid head lice this summer and if you happen to get head lice there is help readily available.

Educate Yourself and Your Children about Lice Prevention

• Pre-camp registration forms explain your camp’s policy on head lice. They may include some identification and treatment tips so parents can pre-screen children and treat children before putting them on the bus to camp.   Let your children know the things that they can do to avoid getting head lice and how to recognize the symptoms.  Use tools such as educational coloring books, a reputable website, pictures and educational hands outs.

• Get a quality head lice comb so you can check the hot spots once a week.  If you check ahead, you avoid the spread.  Take a peek once a week is a great preventative measure that parents can take.  Don’t be fooled by knock off and copy cat combs with short tines, plastic or poor tolerances.  You can expect to pay $15 to $20 for a quality lice comb, but these will last you a lifetime and can be sanitized between uses for multiple family members.  Finally a quality lice comb has the proper tolerances with long tines that go through the thickest of hair and do not break or tear the hair.

• Keeping hair up and away from other people’s heads is the best thing that you can do to avoid getting head lice.  Sharing hats, combs, brushes, towels, and other hair items are not advised.  Also avoid sleeping on someone else’s pillow or using their blanket.  Pay special attention to sharing sport wear and head gear.  If you need to share headgear such as a helmet, use a hair bonnet under the helmet.  Keep in mind that you may also get head lice from car and bus seats and couches.   Do a visual inspection of the head rest and wipe or blow off the surface before use.  There are some cleaning products available and hair sprays that will leave a scent on the hair and these can help repel lice.

• Ask Camp Directors about the Screening, catching a head lice infestation early is key and it helps to avoid spreading it to others in the camp and creating a severe infestation.   Ask your camp director if they provide help and if they are screening campers and staff as they arrive to camp.  Screening is the best method of keeping lice outbreaks to a minimum.  Keep in mind that all campers and staff need to be checked and that checking must be done on dry hair and within at least the first week of arriving at camp.  – Check-A-Head and avoid the spread.
• Report, Re-check and Treat, Don’t send your child to camp with lice and report it if you do find head lice.  Others need to be told so the campers in the cabin or at home can be checked.  Follow the camp policy on head lice.  If your camp treats campers on site, ask if they use pesticide and make sure follow up is being done.  Most head lice treatments are pesticide based.  Some children are sensitive to this and may not be good candidates for its use.  Speak with the camp about the treatment options.  There are many natural treatment options available and the best tools a camp could have on hand are high quality lice combs.   Treat the camper and then re-check the others in close proximity or in the same cabin.  Keep checking for a two week period and always follow up.
• The Environment, Head lice will die within 24 to 48 hours without a blood meal.  It is best to tell your children to keep their sleeping environment to themselves.  Sharing pillows, blankets, towels and any head gear may result in lice transmission.  There is no need to spray pesticide or to wash pillows and mattresses.  Focus on items that have had close head to item proximity such as pillow cases, sheets, hats, brushed, coats, etc.  Never spray an insecticide on bedding in cabins as the toxic residue will linger for several days and may cause some campers have breathing issues or other reactions. Remember the most important thing about head lice is to practice prevention and to catch it early so it can be treated in a timely and effective manner.  Most camps will experience head lice, but the severity of it can be reduced when everyone works together.

Head Lice Prevention – is it even possible?

When we provide lice removal services in a family’s home, the nice lice experts at Larger Than Lice are always asked “How can we prevent this from happening again?”

We wish there was an easy answer.  Or at least an answer that would guarantee a person would never have to have the head lice experience again.

But the fact is that head lice are an incredibly common infliction and no-one is immune!   Lice can happen to anyone at any time, regardless of hair type, hair color, gender or household income. Lice are common in schools, in daycares, in camps – pretty well anywhere kids (or adults) gather.

How is Head Lice Spread?

Head lice spreads by direct head-to-head contact with someone who has a case. The louse crawls along the hair and simply crawls onto another person’s head via a strand of hair.  Nits, or lice eggs cannot be spread from head-to-head.  Eggs are laid on the hair shaft with a cement-like glue which keeps them securely on the hair until the bug hatches from the egg.

Head lice spread within families, especially if parents and children lie down together, sit closely or sleep together. Lice spreads easily in schools as well because young children typically have close contact with one another, either with desks set side-by-side or during normal play and school activities. Though head lice do not hop, jump, or fly, they do crawl very quickly.

A secondary way of contracting lice is through an object which could have a live bug on it. Items like hairbrushes, hair accessories, helmets, headwear and scarves should not be shared.  It’s even possible for a louse to be left behind on a movie theatre chair or train seat headrest.  Note that this is NOT the typical way to contract lice, but it is possible.

Being in the same room or taking place in an activity in which someone has a case of head lice does NOT mean you will catch a case.  There must be direct head-to-head contact with the infected head.   Activities like sleepovers are an example of where children might have this kind of direct head-to-head contact over a period of time, exposing them to the possibility of contracting head lice.

How to Prevent Head Lice

It’s not an option to home-school every child or put them in quarantine, keeping them from everyday social activities.

But there are a few methods of prevention that might reduce the risk.

Keep long hair tied up in ponytails or even better, braids or a bun. Use tea tree oil or Buzz Off Lice Repellent Hair Spray either by adding a few drops to your regular shampoo, or by making a spritz by adding a few drops to water in a spray bottle. Tea tree oil can be very drying, so only use a few drops (as directed).

• Take a peek once a week. Catch head lice early and it is easier to remove.
• Educate your kids what to do to avoid getting lice and of the symptoms like scratching.
• Don’t share hair items and visually check head rests before laying or placing your head on them.

Parents should be alert to the common sign of head lice – scratching the head.  Watch for children who are scratching or who might even wake up in the night saying that their head is itchy.  Pay attention to kids who are visiting and watch to see if they are scratching their scalps as this could indicate a case of lice.

1. Once a Week, Take a Peek

Regular checking can identify a new case early. If a case is caught early enough, the life cycle of the louse can be interrupted. No further eggs will be laid and a case can be eradicated in just a few days. The best way to screen for head lice is to lather the hair with conditioner and thoroughly comb the hair out with a head lice removal comb (Professional Lice & Nit Terminator Comb), wiping the comb on a white paper towel after a few passes. Inspect the paper towel looking for brownish-colored eggs or actual bugs.

If checking for head lice visually, be sure to use direct sunlight or a very good table lamp. Carefully inspect the hair paying particular attention to the area when the hair shaft meets the scalp.  Look around the ear, nape of the neck and especially the crown of the head, as these are common areas for lice to be found.

When checking for head lice, look for lice eggs attached securely to the hair close to the scalp. Viable eggs will be brownish in color and cannot be flicked off the hair. They have to be removed between the fingernails, with tweezers, or with a good nit comb. Though head lice move very quickly, you may see an actual bug. Lice are the size of sesame seeds and are brownish-gray to caramel in color. They are see-through and can appear to take on the color of the hair.

Preventing Lice in the Community

It takes a community to prevent head lice. Advocating for regular lice screening in the school can go a long way to preventing a head lice outbreak. If children are regularly screened, cases might be identified and therefore treated before they have a chance to spread.

Professional screening staff from Larger Than Lice can provide screening services in schools, daycares and camps. For as little as $3 per head, each child can be checked for lice. School volunteers can also be trained to identify lice so that regular screenings can easily be scheduled.

Stop the Stigma

If you or a family member does contract head lice, don’t panic. This very common condition has nothing to do with cleanliness and it can be treated without the use of pesticides. Millions of North Americans have a head lice experience every year. A whole range of treatments is available and head lice removal services also exist in many communities nationwide.

Is head lice a bigger problem than normal at Elsberry Schools

Four parents attended the Elsberry R-II School Board meeting on Wednesday, April 12 to discuss an issue that left both sides scratching their heads.

During the open forum discussion, Amanda Moyer stood and addressed the board about an issue with head lice.
According to Moyer she feels there is a problem running rampant from Pre-K through High School and she along with the other three parents want all the students checked.

Moyer had found head lice on her young daughter at home and feels that the issue is at the school.
Moyer stated she had contacted the school and spoke to Elsberry R-II Superintendent Dr. Tim Reller. She stated that he told her it wasn’t the schools problem.

“In my opinion and a lot of others opinion it is partly to do with the school,” said Moyer. “I haven’t had it, my son hasn’t had it, my husband hasn’t had it and neither has anyone else in my family. It’s being spread somewhere.”
Moyer went on to say with the constant contact the kids have to and from school that the problem has to be at the school.

“I just think more should be done at the school,” she said. “It’s not just normal lice, they are calling it “super lice” and it’s a lot harder to get rid of.”

Reller stated that he felt the problem wasn’t any worse or different than it had been in past years and stated that the school is following the procedure regarding students with head lice.

The procedure is more strict than other area schools and goes beyond what the CDC recommends.

The nurse is to check each child Kindergarten through fourth grade at the beginning of the year when their hearing and vision screenings are done. After that it is on an as needed basis. High School and Middle School students are checked on an as needed basis since they are old enough to tell someone they are itchy. If a child is reported to have head lice or is found to have head lice that child is sent home When anyone is reported to have head lice a check of their classroom and their siblings classroom if they have the head lice will be performed as well. A note printed from the CDC Manuel for schools is then also sent home with the whole grade level involved.

It was also stated that students were not allowed to return until they have been checked by the school nurse.

After discussion became heated Moyer stated she felt the board was “listening not to fix the problem but to argue.”

Board President Matt Jones asked Moyer what she wanted done from the board. Her answer was to have all students checked.

Jones stated that the board would look into the issue and if the policy needed to be updated or changed they would.

With the discussion only occurring in the open forum discussion and not being an agenda item, the board would have been unable to act on the matter at the meeting.