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Back to School Is Time to Start Picking at Nits

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Back to school means it's head lice and nit-picking time again.

Head lice make nests in the hair of what seems like zillions of kids each year.

Nits are their eggs, oval and typically yellow to white, which attach to the hair shaft close to the scalp by secreting a glue.

Lice are small wingless insects about the size of a sesame seed that feed on the blood of their human hosts. They can move quickly but don't jump or fly. They're spread by close head-to-head contact with lice-infested individuals or transferred on clothes, combs, brushes or other items.

Animals are not a source of head lice, so your pet dog or cat is not the culprit.

It's a misconception that head lice are somehow associated with poor hygiene. Anyone with hair can get them, so infestation should not carry a stigma. Lice are more a nuisance than a health problem, though difficulty in getting rid of them can drive parents batty.

Concerns have been raised that some forms of lice have mutated into "superlice" and may be resistant to the active ingredients in over-the-counter head lice remedies.

The first step in treatment is to make sure someone has head lice to begin with and that it's not a case of "mistaken identity" such as dandruff flakes or droplets of hair spray. Look for live lice scurrying about.

Over-the-counter treatments include permethrin (e.g. Nix) or pyrethrins (e.g. Rid), which should be used exactly as directed for maximum effectiveness.

Prescription treatments include lindane and malathion, insecticides usually reserved for resistant cases.

Treatment failure may be due to mistaken identification, faulty treatment procedures or actual lice resistance.

A common problem may be that the lice are killed, but their hatchable eggs are not. Eggs hatch within a few days and the new lice can lay more eggs. If these eggs are not killed or removed, reinfestation can occur.

An alternative to chemical treatment that is recommended by the National Pediculosis Association is the LiceMeister Comb, designed to remove nits and lice.

For more about it and other helpful information, visit the organization's web site at www.

Head lice can live only a day or so off the scalp. Once all lice and hatchable eggs are removed from the head, some experts think it's sufficient to wash and dry (with heat) linens and clothes and to soak brushes and other hair accessories in hot water one time. It seems unnecessary to bag items such as stuffed animals for a lengthy time.

Itching may persist after successful treatment and should not be assumed to indicate treatment failure.


(Richard Harkness is a consultant pharmacist who writes on health care topics. You can write him at 1224 King Henry Drive, Ocean Springs, MS 39564. His e-mail address is Volume of mail prohibits individual replies; selected letters will be answered in his column.)


(c) 2003, The Sun Herald (Biloxi, Miss.). Distributed by Knight Ridder/Tribune News Service.

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