Infectious Disease Ward: Head Lice
Hello my fellow future doctors. I know I said last month I was going to be doing bedbugs, but then I discovered something far worse, and a lot more fun to write about. For this third edition of the Infectious Disease Ward, I bring you: HEADLICE! If you haven’t already gone ‘ew’ yet, you will soon enough. After all, little bugs that hang out around your scalp and pretend they’re Dracula…not fun. For you. For me on the other hand…lots of fun. So without further ado, onto the article!
Disease: Head Lice
Background Info: About 6 to 12 million children in the United States contract Head Lice each year. According to Kidshealth, “The head louse is a tiny, wingless parasitic insect that lives among human hairs and feeds on tiny amounts of blood drawn from the scalp. Lice (the plural of louse) are a very common problem, especially for kids.” The CDC describes it as, “The head louse, or Pediculus humanus capitis, is a parasitic insect that can be found on the head, eyebrows, and eyelashes of people. Head lice feed on human blood several times a day and live close to the human scalp. Head lice are not known to spread disease.”
Symptoms and Diagnosis: Head lice are really, really small. In fact, sometimes they are so small that even if you squint hard, you still can’t see them. They aren’t germs, just really, really annoying. When looking for head lice, you should watch out for things like their eggs. They’re usually a brown or yellowish color, near the scalp (where it’s nice and warm for the eggs,) and can easily be mistaken for dandruff. It’s actually more likely to see an egg than the adult bug, especially if the egg has already hatched. When the egg hatches, it will turn a white color, and stick to the hair. This is when it’s easiest to see them. If it’s adult lice you’re looking for, the adults tend to be either grayish white or a yellowish color and aren’t any bigger than a sesame seed. It only takes one or two weeks for a baby to become an adult, and every few weeks the process repeats itself. The adult lays eggs, the eggs hatch, and the feeding on the scalp continues (Kidshealth).
Depending on how sensitive a person’s skin is, this might not happen for weeks while they have lice. However, that person may feel things moving on their head, or a slight tickling. For others, a rash may occur. Extreme scratching can lead to things like bacterial infections, so instead of continuing to scratch, it might be better to just go to the doctor.
Unfortunately, a patient can’t just rely on looking for symptoms. Sometimes symptoms simply aren’t there. Generally lice are most common in children, but adults can contract it as well.
Transmission: Head lice are highly contagious, and anyone can get it. They move by crawling, since they can’t fly or jump like other insects. It’s generally spread by skin to skin contact, but if you use an object someone with head lice has also used, it’s very easy to contract it. Things like hats, combs and brushes, scarves, and general clothing are great spreaders of lice. Only use your own stuff, and you should be fine. Hair-to-hair contact though, that’s the best way to get head lice, and anyone who has had that kind of contact is at the greatest risk (CDC).
Treatment: "The biggest problem today is that lice have become resistant to the over-the-counter stuff," said Anna Albano-Krosche, owner of the head lice removal salon, The Lice Lady of Westchester in Elmsford, N.Y. (Health.com)
Furthermore, prescription medications can be poisonous to the patient and may not even work. Home remedies may be effective, but have not received the necessary study to truly recommend them as treatments. Much like the treatment for recurrent warts, typically a combination of treatments is needed over several weeks or months to rid the victim of this parasite. Here are a few suggestions for treatment, but this list is certainly not all of them:
"No matter what kind of [lice-killing] product you use, the combing is the key," Albano-Krosche of Health.com recommended. “You cannot get rid of lice until you've picked every last egg.” Therefore, nitpicking and combing is stage one of any treatment. This must be done regularly because if even one egg is left over, the parasite simply lingers and continues to breed.
Pyrethrins come from chrysanthemum flowers which make a naturally occurring insecticide. Unfortunately, while this remedy used to be highly effective, lice now seem to be developing an immunity to this tried and true treatment. Still, this is the first round of medications most doctors recommend combing through the hair after picking out the nits (baby eggs). Permethrin is a synthetic of Pyrethrins, and it too is suspected to be much less effective than it used to be.
A less toxic, yet not well understood, treatment is olive oil. Combing olive oil through the hair is suspected to suffocate the parasites. This treatment needs to be applied overnight and then place a shower cap over the hair for the night. Repeat as necessary.
After shampooing with your choice of insecticide, hair drying is thought to be a way to kill up to 98% of the eggs by using a hand dryer on the highest heat. Unfortunately, live lice don’t die as easily using this method.
Another possible insecticide is Spinosad. In trials of people 4 years old and up, this medication had a cure rate of up to 86% of lice within 14 days after treatment. That’s right, this medicine killed all. In the mind of this author, I didn’t exactly understand why you wouldn’t start with this particular product as opposed to frustrate yourself with the other four solutions.
Complications: While head lice is not considered high risk for creating secondary infections, scratching the scalp while infected can lead to open and oozing infected sores. In the opinion of this author, the real complications from head lice come from the stigma associated with the infestation. How exactly does one explain that yes they wash their hair daily, and the only reason they contracted head lice is that they accidentally rubbed against the wrong tree?
Tune in next month for: What? Hmmm…Let’s make this more interesting. Here are the symptoms so you can guess what you’ll see next: This illness starts out with a runny nose and then, “Infection and inflammation of the bronchi and the bronchioles leads to symptoms of a __________________ that typically include a wet cough that produces white or yellow phlegm, shortness of breath, and fever. ______________ are common and can occur at any time of the year, although most cases happen during the winter months.”
-Healthgrades.com
Sources:
"20 Ways to Kill Head Lice." Health.com. N.p., n.d. Web. 02 June 2015. <http://www.health.com/health/gallery/0,,20641598,00.html>.
"Head Lice." Complications. N.p., n.d. Web. 02 June 2015.
Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 24 Sept. 2013. Web. 02 June 2015.
"Head Lice." KidsHealth - the Web's Most Visited Site about Children's Health. Ed. Rupal Christine Gupta. The Nemours Foundation, 01 Apr. 2015. Web. 02 June 2015. <http://kidshealth.org/parent/infections/common/head_lice.html>.
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