Head Lice

Because of the itching and the subsequent scratching some children develop infections of the scalp and this can result in lymph node enlargement and hair loss. For unclear reasons lice are rarely seen but the nits are commonly found in the hairline at the nape of the neck and above the ears. Sometimes a secondary dermatitis develops on the neck and earlobes and this is generally treatable by treating the lice and using topical steroids to quiet the itch. The treatment of choice is permethrin 1% cream rinse (NIX) applied for 10 minutes with a repeat application in 7-10 days. All household members should be treated at the same time. Nits can be removed with a fine- toothed comb after a 1;1 vinegar-water rinse. Clothing and bed linens should be laundered in very hot water or dry cleaned and brushes and combs should be thrown away or washed with NIX for 15 minutes and then boiled.

Head lice outbreaks occur every Fall in schools and there is usually a tremendous outcry from parents and administrators to remediate the situation. The best way to handle these outbreaks is to insist on school wide education regarding controlling the infestation when it occurs and then frequent and thorough head checks for new cases.