September 15th – 18th
This long weekend please take the time to nit comb all of your children and look for head-lice. A range of products to treat head-lice are available from local chemists. Information on what to do and how to treat can be found below.
Managing Head Lice Infection in Children
The Scottish Executive has issued new advice about head lice infection. This is based on a report, the 1998 Stafford Report, “Guidelines on the Diagnosis and Treatment of Head Lice”. For your information, I have set out the main aspects of this new advice. The advice is still lengthy so it may be useful to highlight the key changes that it will make:-
- The responsibility for checking for, and dealing with, head lice infection will lie with parents or carers.
- Neither the school nurse, nor any other member of the school staff will check for, or deal with head lice infection.
- The school will not issue letters alerting you to head lice infections in your child’s class. Head lice infections are now so common that such letters could be issued on a daily basis.
- If any member of the school staff notices that a child has a head lice infection, they will inform the parents or carers of that child.
- Because infections are now so common, you should check your child’s hair on a weekly basis.
- If you find any sign of head lice infection you should treat it using one of the methods set out below.
Head lice are small, six legged wingless insects which are pin-head size when they hatch. Less than match-head size when fully grown and are grey/brown in colour. They lie on or very close to the scalp at the base of the hair. Eggs are laid in sacs which are very small and well camouflaged. They are securely glued to hairs where they hatch after a period of 7-10 days. Nits are the empty egg sacs, which are white and shiny – they are often easier to see than head lice themselves. **A head lice infection cannot be diagnosed unless a living louse has been found on the head.**
The primary responsibility for the identification, treatment and prevention of the head lice in a family lies with the parents. Regular checking of the children’s heads is important, but it is a parental responsibility.
Weekly checking, by “wet combing” is an effective means of detection.
“Wet combing” involves washing the hair and applying conditioner, then combing through with a wide-tooth comb to remove tangles. Taking a section at a time, a fine tooth detection comb is then pulled downwards through the hair, keeping the comb close to the scalp (where head lice are often located). The comb is checked for lice after each section. The comb must be fine enough to catch the lice and a pharmacist should be able to recommend a comb for this purpose, if parents are in any doubt. This process should be completed weekly. If head lice are found, all other family members should be checked and, if necessary, treated. Checks should be continued following treatment to ensure that it has been effective and to detect any re-infection.
Once infection is detected, there are two treatment approaches. One is the use of insecticide lotions and an alternative is removal by wet combing, sometimes called ‘bug busting’. Both methods require continued combing to remove any unhatched eggs.
Re-infection can occur if a child has direct head to head contact with someone else who has head lice. It is likely that a child will become re-infected unless the whole family, and all those who have been in close contact with the child, have been checked and, if lice are found, treated.
- Insecticides Insecticide treatment should never be used as a preventative measure as the use of An alternative option for dealing with head lice is wet combing, sometimes called ‘bug busting’. This is a non-chemical approach that involves mechanical removal of all lice from the hair after the hair has been washed and conditioned. With the conditioner still in, the hair is combed gradually using a fine tooth comb, section by section, in order to remove the lice.‘Bug busting’ is time consuming and to be effective, must be carried out every 3 days for up to 3 weeks to remove newly hatched lice. Insecticide treatments offer a more immediate solution to a head lice infection, but some parents may have concerns about using these sorts of treatments. The ‘Bug Buster Kit’ is now available for prescribing by health professionals. Only one kit is required for a family and it is reusable. The kit, which includes an illustrated guide and combs, is available from some pharmacies and by mail order from: Community Hygiene Concern (Charity Reg No: 801371)LONDON Help Line: 020 7686 4321
- Internet: www.chc.org
- incesticidal products on a regular basis may result in insecticidal resistance. Insecticide lotions should only be used when a living louse has been found on the head.
- If live head lice are discovered after the second application, the advice of a health professional should be sought before any further lotion treatment is applied.
- One treatment using insecticide lotions involves two applications of the same insecticide, seven days apart. This is because insecticide lotions do not kill any eggs that may be present at the time of the first application. If eggs hatch and are not treated, the infection will continue. This treatment should be applied by parents at home.
- There are a number of different insecticide lotions available and pharmacists and GP’s can provide advice to parents about these on request. The advice of a health professional should also be sought where whoever is being treated is under 1 year of age, suffers from asthma or allergies, or is pregnant or breastfeeding.
Persistent or recurrent head lice infection
A distinction between re-infection and a continuing infection should be made. If a child still has head lice following full treatment, their parents should take them to a health professional to establish whether it is a re-infection, or if previous treatment has not been effective.
If insecticide lotions are not applied properly or the second application is not given, the treatment will not be effective. Similarly, the ‘bug busting’ approach will not be effective unless parents continue the process every 3 days for up to 3 weeks and have successfully removed all the head lice and eggs.
A major cause of concern for parents is re-infection of children who have been treated following contact with children who have not.
Families experiencing continuing or recurring head lice infection will be assisted and supported, as they would be if their child contracted any other infection. This should include co-ordinated and sustained support and help in the community (including the school) and from health professionals. Repeated head lice infection may be symptomatic of other family stresses or neglect.
If parents have any enquiries relating to any other the above please contact the school directly or The Scottish Executive Health Department, Women and Children’s Unit, St. Andrews House, Regent Road, Edinburgh EH1 3DG.