Head Lice

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Thinking head lice?

Let's see if your child has head lice and how to get rid of it.
Pharmacist

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Lice are tiny parasites that live in the hair and feed on blood from the scalp by biting on the scalp thus making it itchy.

Note that it has nothing to do with poor hygiene and there is no evidence that lice prefer clean or dirty hair. They feed on blood, not dirt or skin cells on the scalp.

Just a few questions should help out.




Mother looking at a child's hair

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Head lice

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Why think head lice?

What make you think your child has head lice?
Pharmacist

Let's answer that first.

 

Is it that someone in the house has it?
Pharmacist

 

Yes?

 

Did he or she come in close contact with someone who has lice?
Pharmacist

 

Yes?

 

Is it because of tickling movement in the hair?
Pharmacist

 

Yes?

 

Did he or she share hats, towels, or combs with someone who has head lice?
Pharmacist

 

Yes?

 

Are you thinking head lice due to child's irritability and difficulty sleeping?
Pharmacist

 

Yes?

 

Is it because someone in the school has it?
Pharmacist

 

Yes?

 


If you still think your child has head lice, let's continue.
Pharmacist

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Head lice

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Is the child experiencing intense itching of the scalp?
Pharmacist

 

Yes?

 

Any small, red bumps on the scalp, neck or shoulders?
Pharmacist

 

Yes?

 

What about crusty, oozing bumps on the scalp?
Pharmacist

 

Yes?
Probable infection due to the scratching.
Pharmacist

It would be better to see a pediatrician to rule out any infection. And if there is an infection get the appropriate treatment for it.

Anyway, before you do that or if the bumps are not too bad, let's see if you can find some lice.

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If you answered "No" so far, chances of lice infestation is slim.
Pharmacist

Let's continue and see if we can find lice.

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Head lice

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Looking for lice

You will look for adult lice or nits.
Pharmacist

The following are needed:

  • Disposable gloves

  • Magnifying glass (optional)

  • Bright light or daylight.

  • Clean towel

 

Good.
These instructions are for who is looking for lice on someone else's head.
Pharmacist

With the gloves on (Using a magnifying glass if any):

Look behind the ear and back of the head near the neckline.

Let's answer a few questions when you have looked briefly.

 

Yes?

 

Do you see anything like tiny white oval eggs or adult moving lice?

(See "FYI" to know if it is dandruff or nit.)
Pharmacist

FYI

 

Yes?
Treatment is recommended if even one egg is found. But let's look further.
Pharmacist

 

Now, look at the base of the hair near the scalp for eggs (nits).

Did you find something within ¼ inch of the base of hair shafts?
Pharmacist

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They should be oval shaped, very small and hard to see. It may be yellow, white or even the same color as the hair.

According to the CDC: If crawling lice are not seen, finding nits attached firmly within ¼ inch of the base of hair shafts suggests, but does not confirm, the person is infested.

Nits that are attached more than ¼ inch from the base of the hair shaft are almost always non-viable (hatched or dead).

FYI

 

Yes?

 

Look for some adult louse. Should be tan to grayish-white in color.

Anything like that?
Pharmacist

They should be about the size of sesame seed (1/16 to 1/8 of an inch) with six legs.

 

Yes?
Let's see what a pharmacist recommend to treat this head lice.
Pharmacist

According to the CDC, the diagnosis of head lice infestation is best made by finding a live nymph or adult louse.

Nearest Clinic Continue

 

If still nothing.
You will have to use the Wet Combing method.
Pharmacist

It is more time consuming but it has been proven to correctly identify lice in 90% of cases, compared with a 29% accuracy rate for visual inspections.

To do wet combing, you will need:

  • Regular hair conditioner.

  • A quality (non-plastic) lice comb.

  • Hair clips for separation.

  • A de-tangling comb.

  • Pin tail comb.

  • A bowl of hot water to rinse the lice comb.

  • White paper towels or rags.

When you have most of these, let's continue.

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Yes?

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Head Lice

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Wet combing directions

Follow the directions in the list form below.
Pharmacist

For ease of use, swipe left or right on a completed step to hide that step.

 

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Head Lice

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Did you find any lice or nit?
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Head Lice

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Let's get an over-the-counter recommendation to treat this head lice.
Pharmacist

According to the CDC, the diagnosis of head lice infestation is best made by finding a live nymph or adult louse.

Clinic Pharmacist

 

 

 

 

 

 

Head Lice

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Well, treatment is recommended if one nit is found within ¼ inch from the scalp.

If nothing is found no treatment is recommended.

According to the CDC: If no nymphs or adults are seen, and the only nits found are more than ¼ inch from the scalp, then the infestation is probably old and no longer active — and does not need to be treated

Note that:
You have to find lice or eggs to use the over-the-counter shampoos or lotions. These shampoos do not prevent lice infestation.

Would you like to see what a pharmacist recommend to get rid of head lice anyway?

Or think you should go to the nearest urgent care clinic to you?

Clinic Pharmacist