Outwit the Nits

 At my five-year-old niece's preschool, a tony little place in West Los Angeles, the teacher would begin each morning with circle time, during which she would lightly tap each child on the head and sweetly recite the alphabet. My sister-in-law, however, found the exercise a grave public health risk and firmly asked the teacher to stop the communal tapping.

Really, was this necessary?

I turned to school nurse and delousing expert Deborah Meshel and Sharon Lindley, owner of Bugalugz Delousing Salon in Mill Valley to get the gritty details. 

What is lice and how do you get it?

Lice is a tiny wingless parasite that nests in human hair and feeds on blood drawn from the scalp. It is most common in children ages 3-11 (and subsequently their families). In its egg form, lice is called a nit. Most often found at the base of the scalp, nits are oval, whitish, and often confused with dandruff. Once the nit hatches, it is called a nymph, and is about the size of a pinhead. The adult form is called a louse, is the size of a sesame seed, and may be white or grayish in color. These are what can be seen moving on the scalp.

Lice is very contagious, and will busily crawl from little head to little head, particularly when those heads are actually touching. It can also spread through shared hats, bike helmets, other clothing, sleeping bags, bed linens, towels and, of course, hair accessories, combs and brushes. Pets can not catch head lice and pass them on to people (or the other way around).

How do you find lice?

Though tiny, nits and head lice are still visible to the naked eye. A careful inspection of the back of the ears, crown, and nape of the neck with a fine tooth comb and - if necessary - a magnifying glass can reveal nits attached to the base of the hair shafts, on the hair behind the ears, and near the back of the neck or crawling lice on the scalp. You may notice bites or scratch marks on the child's scalp; and the child may complain of irritation or itchiness. Some schools conduct lice checks (mass screenings) and will send a child home until they are nit-free in order to prevent transmission. However, many authorities, including the American Academy of Pediatrics, describe head lice as a mere nuisance and now discourage policies that send kids home.

How do I make it go away?

According to school nurse Deborah Meshel, manual removal of nits is the only proven method to eradicate the lice. All nits must be removed from the scalp, she says, "otherwise they will hatch and mate and start the cycle all over again." Though there is no known shampoo that kills nits, Meshel recommends using a treatment shampoo (her favorite is one called Nix) to help kill the living lice.

We've all heard nightmarish tales of the compulsive housecleaning that follows a lice siting. Though lice are resilient, they don't live more than two to three days off the human scalp. Meshel offers the basic homecare routine below, but warns against the common mistake of spending too much time on cleaning the house. The priority should always be actually removing nits from the scalp.

• Wash bedding and clothing in hot water; dry them on a hot setting.
• Vacuum rugs, floors, and inside cars.
• Store stuffed animals in a closed bag for a couple of nights.
• Discard combs and brushes.

How do you prevent lice?

A case of lice does not mean that your home or child is dirty – the parasite does not discriminate between clean or dirty hair and can affect anyone. Still there are some steps you can take to make transmission less likely. The Center for Disease Control and Prevention recommends the following guidelines for preventing and controlling head lice:

• Avoid head-to-head (hair-to-hair) contact during play and other activities.
• Do not share clothing such as hats, scarves, coats, uniforms, hair accessories.
• Do not share combs, brushes, or towels. 
• Do not lie on bedding or furniture that has recently been in contact with an infested person.
• Machine wash and dry clothing, bed linens, and other items that an infested person wore or used during the two days before treatment using the hot water (130°F) laundry cycle and the high heat drying cycle.
• Vacuum the floor and furniture, particularly where the infested person sat or lay.

Returning to the case of the head tapping preschool teacher, can lice really hitch a ride on a hand?  

According to Bugalugz Salon owner Lindley, it is difficult for lice to hand transfer, "because they have claws." But, she said, "people are obsessed with lice — it's very personal.  And no one actually sees the lice jumping around, so we can never know for sure."  

 Alyson Geller has a master's degree in public health and talks to local doctors and explores health issues that concern us all.