Baltimore Health Examiner - Lice: an elementary school plague

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POSTED April 28, 12:43 AM

Two years ago my daughter had lice.

I tried to tell myself that it wasn't the end of the world, but I didn't really believe that. I was creeped out for weeks and it felt like I did more laundry in those two weeks than I had done in the preceding year. Stuffed animals were packed up in trash bags and quarantined for weeks and I covered my daughter's favorite TV watching couch in a sheet that I washed daily. I was obsessed with murdering every louse and every louse-to-be that had entered my house without permission. It was my temporary full-time job.

A notice just came home from school this week: "There is lice in the grade." Oh no -- not again!! I checked my daughter's hair with trepidation. So far, so good. She is louse-free today, but the risk of recurrence is great.

The earlier lice is discovered, the easier it is to treat. So if you have an elementary school child, you might want to take a peak at his or her hair shafts from time to time. It isn't live bugs that you are likely to see (although it is certainly possible to see one casually traversing your child's scalp). Rather, it is the eggs (called nits) that you can expect to find. These nits are small and tough to see until you know what to look for (see image above). One of my friends discovered that without her glasses her daughter didn't have lice, but with the aid of a bright light and her specs, suddenly the nits were obvious. Good lighting is important. Natural light is best, but a strong indoor light will work too. Put on your glasses if you need them and find a comfy spot because you're going to be there awhile. If you do it right, it should take you at least 15 minutes (often more for kids with long hair) to check the whole head thoroughly. Unless the hair is really short, you'll need clips to hold large sections of the hair out of your way as you examine the hair in one inch sections.

The nits are usually whitish, tiny (smaller than a sesame seed), and oblong. They will be glued onto the hair shafts near to the scalp. Often a favorite nursery spot is the area near the ears, although the eggs can be found anywhere on the head. Unlike dandruff, they won't just flick off the hair. If you find any, take them off and discard them (a glass of water near your nit-picking station can be an effective grave site), so they won't hatch and worsen your problem.

During the lice fiasco of 2006, there was one funny moment. One night I let my daughter watch TV as I checked her hair (a process that took over an hour every night for weeks). A nature show came on and what we saw made us both laugh hysterically. The show was about chimpanzees, and as I sat behind her picking nits from her hair we watched a momma chimp sit behind her daughter picking nits from her fur. It was humbling -- I guess we haven't progressed as far as we thought. There was one difference between us, though.

At least I didn't eat them.

(Image courtesy of D. Scott Smith, M.D.)

Categories: children's health

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Dr. Delia Chiaramonte
Dr. Delia Chiaramonte is the founder and president of Insight Medical Consultants, a private medical advising and patient advocacy company. She is board certified in family medicine and is Medical Director for Hospice of Baltimore.