• Original Articles By Dr. Lavin Featuring Expert Advice & Information about Pediatric Health Issues that you Care the Most About

    Don’t Be a Nit-Wit: Putting Lice in their Place

    By Dr. Arthur Lavin

    Don’t Be a Nit-Wit- Putting Lice in their Place

    Lice.

    There are probably no single words that cause such dread and yet pose no harm.

    That’s right, despite the universal horror we hold these creatures in, they are harmless.

    In fact, the evidence is overwhelming that our response to our horror causes far more harm to our children than than the lice actually do.

    Let’s see why this is so.

    What are lice?

    Lice are an insect that can only live on the skin flakes of the human scalp.

    They do not break the skin, they are not an infection.  They are simply a bug that sits on our scalps, usually very unobtrusively.

    The main harm they cause is itch, but the vast majority of people with lice never feel itch or have any idea they are present.

    They carry no known diseases.

    So, they are not a germ, they are not a disease, they cause no disease, and aside from itch, cause no harm.

    They walk around the scalp and lay eggs on our hair.  An egg is a tiny little sac that is cemented to our hair shaft, it cannot easily be removed, and requires a pretty strong tug to strip it off the hair.

    The lice egg is called a nit.

    Nits hatch in a week, and so if you see a nit more than 5mm from the surface of the scalp, it is an empty, dead shell and cannot cause lice to appear.

    Why do we get so upset?

    There must be a very, very deep reason for our revulsion.  I suppose just thinking about a bug on your scalp is upsetting.

    But the revulsion is profound.  We even have a word based on the singular of the world lice, louse.  Something that is pretty bad is said to be lousy.

    But if your child is ever found to have lice, it is important to keep this fact in mind.   Our revulsion is based purely on emotion, the bug causes no harm.

    The Facts on How they Spread

    Lice turn out to be incredibly fragile animals.

    They have to be on the human scalp to live.  

    That fact carries with it many very important implications:

    • The bug becomes inactive and no longer able to live even a few hours off a scalp.  They all die within 48 hours off a scalp.
      • That means it is next to impossible for lice to spread via items such as pillows, couches, hats, any non-scalp item
      • They do spread by contact, sleep overs with heads near each other for example.
    • Lice cannot and do not live on any animal but humans, none.
      • That means you can’t spread lice or catch it from cats, dogs, birds, any animal.

     

    Over the last million years of perfecting their craft, they have learned to be essentially invisible to us.

    The vast, vast majority of people with lice will never know they are there.

    Believe it or not, it takes months for nits to appear, so if you see eggs (nits) on your child’s hair, the lice have been there for at least a month!

    If you see a nit 5mm or more (about an inch) from the surface of the scalp, it can’t spread the lice.

    Nits hatch in a week, so any nit more than an inch from the surface of the scalp hatched some time ago and can’t help spread them.

    Lice are a rich man’s problem.

    Lice like scalp skin flakes.  Every human alive has scalp skin flakes, everyone.  You can shampoo four times a day and keep a hat on to protect your hair, but you’ll still have scalp skin flakes, it’s the price for having skin, well worth it.

    So if you do have lice, it is no comment on your cleanliness.  In fact, lice are one of the only problems seen more in well-off, white folks than other groups.

    The Failure of Quarantine- Far, far more harm than good, in fact, no good.

    Lice do spread, so doesn’t it make sense to isolate the child with them?

    No.

    Studies have proven that by the time a child is found to have lice, they have been walking around with them for more than a month.

    More than a month!

    The nits that are visible are typically long hatched and empty shells, posing no risk of spread.

    So, think about it, your child has been walking around with active lice for a month, the school sees nits and send them home until they are clear.  Sending them home does nothing about the month they were in class with live lice.

    Further, even with school nurses checking heads, the majority of kids with lice never get detected.

    That’s why every single family with lice has found that their child’s classroom seems to keep popping up with lice, even though everyone known with them has been sent home.

    That’s because sending a child with lice home does nothing about the month they were walking around with them before and nothing about all the kids not detected.

    And here is where the harm outpowers the good, by a ton.

    We know from above lice are truly harmless, so any intervention better be harmless or the cure will be worse than the disease.

    Studies have proven that sending a kid home from school imposes a burden of catching up, but also of stigma, it hurts them socially.

    What to Do?

    1. Don’t panic.  Your child is depending on you to handle your revulsion, and do the right thing.
    2. Don’t take your child out of school.  If you come to Advanced Pediatrics, we will write a note for any child with lice insisting the school not send them home as a matter of medical priority.
    3. Don’t worry about nits.  The ones you can see no longer have anything in them.
    4. Don’t use pesticides.  Use harmless techniques that work.  See more below.

    More on treatments.

    Nearly all treatments use pesticides.  We urge you not to.

    The over the counter options, Nix and Rid, don’t work, 98% of lice have a gene to neutralize their impact.

    The prescription insecticides- malathion, ivermectin, and spinosad- kill living beings, and so can harm us.  Malathion is in a class of organophosphate pesticides known to damage the human brain.  Why expose your child to something harmful to get rid of something harmless, so that we feel better?

    So we recommend a process that is 100% harmless and studies show works essentially every time.  Here is the process:

    1. Get Cetaphil and apply it to your child’s hair and scalp.
    2. Blow dry the hair.
    3. Do this three times, once a week.

    That’s it!

    Another harmless approach is to pay a lot at a lice center to have them pick all the visible nits off, or the AirAlle process which removes nits and applies heat.  They work, but they cost.

    BOTTOM LINES

    1. Don’t be a nit wit.   Lice are harmless, so treatments should be too.
    2. Accept our panic and dread, but don’t act on it.  OK, lice are revolting, but your child relies on you to keep your head on your shoulders when upset and make sure actions make sense, that they help, not hurt them.
    3. School policies such as sending kids with lice home never to return until all visible nits are gone do no good and cause harm. Kids with lice should go to school and be left alone.
    4. Lice do not spread via hats and combs, but do by direct hair to hair contact.
    5. No need to boil the home when you find them on your kid’s head.  The lice become defunct in an hour or so off the head.
    6. Treatment should be harmless, insecticides on your child’s scalp are not harmless, don’t use them.
    7.   The best treatment is blow-drying cetaphil three times once a week.

    So let us all shiver in dread together at the very thought of lice, but let’s not hurt our children in response.

    To your health,
    Dr. Arthur Lavin

     

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