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The dreaded back to school bug

September 06, 2019 by Kimberly Drake

With great enthusiasm, parents across the nation packed up school lunches, loaded up the backpacks, and escorted their children off to the first day of school. As I watched the droves of youngsters push, pull and drag themselves through the front doors on that first day, it was obvious they did not share their parents’ excitement. 

While there’s a lot for parents to love about the start of the school year, there are also some things to dread, such as flu-bugs, stomach-bugs and lest we forget, the bugs that take up residence in the hair commonly known as head lice. It’s these creepy crawlers that probably cause the most anguish, and unfortunately, the tiny nuisances are becoming resistant to treatment, morphing into “super lice” and getting harder to kill, leaving horror-struck parents searching for ways to squash this bug once and for all.

What are head lice, and how do infestations happen?

According to a 2018 Clinical Update published in Paediatr Child Health, the adult louse is a 2 mm to 4 mm long, six-legged, blood-sucking insect which lives on the scalp of humans and can survive for up to three days away from the human host. The head louse feeds on the host’s blood every three to six hours, and the adult female can produce five to six eggs per day for 30 days, each in a shell (nit) glued to the hair shaft near the scalp. Nine to 10 days later these eggs hatch into nymphs that molt several times over the next nine to 15 days to become adult head lice.  

Head lice are thought to spread mainly through direct head to head contact or sharing of hats, combs or other hair accessories and contrary to popular belief, cannot hop or fly. However, they can crawl fast, at a rate of 23 cm per minute, which makes them hard to spot on the scalp. Poor hygiene has nothing to do with infestations, as even the most meticulously clean hair can get a case of head lice. Interestingly, because of the differences in hair texture and curl, African American children are less likely to become infested.

Why are they called ‘super lice’?

The lice of this day and age are not the bugs of previous generations because, over time, they have developed resistance to pyrethroids, the class of insecticides used in the most common over-the-counter lice products. 

According to a 2016 study published in the Journal of Medical Entomology, 98% of lice in 48 states in the U.S. carry genetic resistance to pyrethroids. Although they remain somewhat effective in killing lice, these insecticides also carry some risks. In a 2017 study published in the journal of the Endocrine Society, scientists found a link between pyrethroid exposure and early puberty in boys, and another study in the Journal of Environmental Health in 2015 found that children with higher levels of pyrethroid in the urine also had a higher incidence of ADHD.

So, if an infestation occurs, what can parents do about it?

The FDA approved treatments for head lice are over the counter pyrethroids, which are slowly becoming ineffective, as well as newly approved prescriptions such as Ulesfia, Natroba or Sklice. Other options that have varying rates of success are wet combing and the use of essential oils. Scientists at Consumer Reports have long advocated for wet combing, which is coating the child’s head with conditioner or oil and combing out lice and nits with a fine-tooth metal nit comb. However, researchers who published the 2018 Clinical Update in Paediatr Child Health claim there is little evidence the wet combing method works. This treatment can be time-consuming, requires follow-up combing every few days for several weeks, and can be painful or distressing for the child.

Other home remedy alternatives such as mayonnaise, petroleum jelly or olive oil are often suggested as a treatment for head lice. The idea behind this method is to kill the insects by smothering them, but again, results are inconsistent. Interestingly, a small study in Israel found a natural homemade treatment consisting of coconut oil, anise oil and ylang-ylang oil, was successful in controlling lice when applied to the hair once every five days for about two weeks.

Although the thought of burning down the house probably crosses the mind of a parent who has recently learned their child has lice, you don’t need to go to that extreme when an infestation occurs. Even though the home need not be torched, it will still need a thorough cleaning. Vacuum furniture and carpets, soak combs, brushes and any other hair accessories in hot water for 5-10 minutes or replace them altogether. Also, wash clothing that comes into direct contact with the head or run the garments in the dryer, and wash or replace pillows and pillowcases.

The best defense against “super lice” is teaching children not to share hats and other hair accessories and to do weekly head checks at home. Parents should look for the eggs rather than the lice themselves, which can be more challenging to spot. The eggs are most often found close to the scalp, are about the size of a grain of sand and will be stuck on the hair so well that they cannot be moved. Although horrifying, these little buggers don’t transmit disease, but what they do spread is full-blown panic. With diligence in prevention and treatment, this bug is one that is still capable of being squashed.

Kimberly Drake can be reached at [email protected]

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