head lice

Head Lice and Bike Helmets

By Marcia Anderson

Head lice have specialized feet for holding onto hair.

Head lice have specialized feet for holding onto hair.

When I visited a local school, I was asked by the nurse about strategies for dealing with head lice – tiny parasites that attach to human head hair and feed on blood through the skin. She said there was a problem in preschool and kindergarten classes where she suspected the children were passing lice through the school’s common bike helmets. The children shared the helmets when taking turns riding tricycles.

The nurse asked three important questions. How should they treat the helmets? Is there something they could spray in the helmets between uses? How should they deal with head lice in the school?

Head lice are very contagious and are transferred by sharing clothes, hairbrushes, combs, pillows, hair decorations, and hats with somebody who has lice. Applying a pesticide to the helmets, in the classrooms, on children’s hats or their clothes isn’t recommended.

To control lice in helmets, the National Pediculosis Association recommends vacuuming and wiping out the helmets between uses. They note that a louse can survive less than 24 hours away from a human host, but the nits (eggs) on a hair left in the helmet could survive up to 10 days. Detachable foam fitting pads and the nylon straps can also be washed.

Courtesy of the Center for Disease Control.

Courtesy of the Center for Disease Control.

The Centers for Disease Control’s head lice guidance states that lice are spread most commonly by direct contact with the hair of an infected person. Spread by contact with inanimate objects and personal belongings may occur but is very uncommon. The feet of lice are specially adapted for holding onto human hair. They would have difficulty attaching to smooth or slippery surfaces like plastic, metal, polished synthetic leathers, and other similar materials. However, hairs left in sports helmets may have lice attached to them so they must be cleaned between uses. It is best to have helmets specific to each child to avoid sharing.

Treatment on clothes, hats and other head gear. There are many ways to treat head lice. The EPA provides information on lice and their control and recommends an Integrated Pest Management (IPM) approach, especially in schools and childcare centers. IPM is a smart, sensible, and sustainable approach to pest control that focuses on prevention.

Once a louse has been identified, the first step is to begin sanitation efforts by washing and heat drying all of the belongings that may have been exposed. This will kill all the head lice and eggs that may be on hairs that are attached to the clothing, pillow cases or other items. Next monitor – check the hair and scalp frequently by combing with a nit comb to see if there are any other lice or eggs.

Prevention. There are different ways to prevent exposure to head lice. Tell your children not to share combs, brushes, hats or clothing with anyone. Vacuum frequently and wash and heat dry anything they may have shared.

School Head Lice Policies. When children return to school in the fall, who is responsible when it comes to head lice? According to Dr. Richard Pollack of the Harvard School of Public Health, “School policies are outdated and written during a time when body lice was a growing concern among residents….However, times have changed and head lice is not the epidemic that it is thought to be. Common misconception of head lice can lead to over diagnosis and unnecessary action.” An effective head lice policy should be included in each school district’s IPM plan. The American Association of Pediatrics guidance on treating head lice states that “No healthy child should be excluded from, or miss school because of head lice and no-nit policies should be abandoned.”

IdentifyUS, LLC, provides a helpful flow chart on managing presumed head lice infestations in schools and a similar chart for home use. Harvard University also provides an informative head lice question and answer page. For even more information on head lice read the Spokane (WA) Regional Health District’s Guidelines for Controlling Head Lice. To learn why lice may be harder to control today than 20 years ago read the 2012 EPA blog Persistent and Possibly Resistant Head Lice.

Having a well-conceived head lice policy, a current IPM-based plan for dealing with head lice, and useful reference materials will enable schools everywhere to deal with the problem if it pops up.

About the Author: About the Author: Marcia is with EPA’s Center of Expertise for School IPM in Dallas, Texas. She holds a PhD in Environmental Management from Montclair State University along with degrees in Biology, Environmental Design, Landscape Architecture, and Instruction and Curriculum. Marcia was formerly with the EPA Region 2 Pesticides Program and has been a professor of Earth and Environmental Studies, Geology, and Oceanography at several universities.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

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Enjoy Summer Camp Free of Head Lice

By Marcia Anderson

Head lice magnified.

Head lice magnified.

Summer camp season always reminds me of swimming, camp fires, s’mores and head lice. Head lice? Yes, my daughter was 8 years old that memorable year and attending a day camp. One evening she was furiously scratching her head and behind her ears. After bathing, I helped comb her hair and, to my horror, discovered head lice. I ran to the pharmacy that evening and picked up an over-the-counter head lice kit. My next few days were filled with washing everything in the bedroom, intense vacuuming and a frenzy of cleaning every corner in the bedroom. Within a few days, the problem was over.

A repeat performance occurred eight years later. My daughter was 16 and attending a series of week-long overnight sports camps. At this age, all girls play with their hair, imitate each other’s hair dos, and regrettably, share hair ornaments. That’s just what girls do. She should have known better! We had a repeat of washing all of her clothing and bedding and vacuuming. I helped her comb the nits (lice eggs) out of her hair. I notified the camp director and her teammates’ moms. Some of the other moms had found their daughters had the same problem.

Head lice are very contagious. You can get them by sharing clothes, hairbrushes, combs, pillows, hair decorations and hats with somebody who has them, or even being near someone who has lice.

The early symptoms of head lice are little red bumps appearing on the scalp, neck, shoulders and behind the ears. A scratchy head is also a symptom, as well as little white eggs found within the hair and scalp.

There are many ways to treat head lice. The EPA recommends a multi-faceted Integrated Pest Management (IPM) approach. IPM is a smart, sensible and sustainable approach to pest control. Smart because IPM creates a safer environment by managing pests and reducing human exposure to pests and pesticides. Sensible since practical strategies are used to reduce sources of food, water and shelter for pests. Sustainable because the emphasis is on prevention that makes it an advantageous approach.

The first step is identification – determine whether the problem is with lice or some other pest. Second, focus on sanitation by washing and drying (on high heat) all of your belongings that may have been exposed to kill all the lice and their eggs. Third, monitor for remaining lice and their eggs by frequently checking the scalp and combing the hair with a nit comb.

And please, forget the old home remedy of turning your children’s heads into salad by slathering them with mayonnaise, lime, garlic lotion, or olive oil to kill the lice. These little critters are not easily suffocated. These remedies, along with dishwashing detergent, however, may be useful in softening up the nits to make it easier for the nit combs to remove them.

Pesticidal head lice shampoo may be a necessary treatment.

Pesticidal head lice shampoo may be a necessary treatment.

Finally, the use of pesticidal head lice shampoos may be necessary. The bad news is that today’s lice are tougher to kill than they were 20 years ago when I had to treat my daughter’s head lice. This is because some have developed resistance to permethrin and pyrethrum, the active ingredients in many of the over-the-counter lice products. Read the National Institute of Health publication on resistance in head lice to the over-the-counter pediculocides and the blog on persistent and possibly resistant head lice.

Learn more about head lice management from the BioIntegral Resource Center’s IPM manual and the National Pediculosis Association.

If you continue to be infested with live lice after treatment, discontinue use of the products and consult with your pediatrician. If you are diligent and comb out the nits on a daily basis (such as every night during bath time) you should be able to remove most of the nits.

There are ways to reduce your exposure to head lice. Tell your children not to share combs, brushes, hats or clothing with anyone. Vacuum frequently. Finally, wash and dry (on high heat) any clothing they may have shared.

These tips can help you better enjoy the summer camp season!

About the Author: About the Author: Marcia is with EPA’s Center of Expertise for School IPM in Dallas, Texas. She holds a PhD in Environmental Management from Montclair State University along with degrees in Biology, Environmental Design, Landscape Architecture, and Instruction and Curriculum. Marcia was formerly with the EPA Region 2 Pesticides Program and has been a professor of Earth and Environmental Studies, Geology, and Oceanography at several universities.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

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Persistent and Possibly Resistant Head Lice

By Marcia Anderson

Another interesting case has crossed my desk: “Our second grade daughter contracted head lice when her best friend came to sleep over last fall. First we bought a lice elimination product, and began to treat her scalp.  We followed the directions, thought we had them licked, and then they reappeared the following month.   Next we tried another and an “electronic robi comb.” Three months later we still have lice. Now my youngest son has them.  There are prescription only products that contain Malathion  and another with Lindane that my pediatrician will prescribe that will perhaps work. Why do the over the counter products not work and should I put such harsh chemical pesticides on my children’s head?”

Before you resort to Malathion, know that some lice have a genetic mutation that leaves them immune to Malathion, however it is the inactive ingredient in the product, isopropyl alcohol, that seems to kill the lice. The lice products may contain pyrethrum, permethrin,  Lindane or Malathion as active ingredients; these are all pesticides that are meant to have residual properties that are potent enough to kill the lice that do not hatch for a few days.  Most pediatricians will not prescribe Malathion  or Lindane for treating children under six-years-old (as per directions on the label).  Lindane has been banned in the US for many agricultural purposes and also by the state of California and 17 European countries. I would think twice before I applied this to my own child’s head. Malathion was invented for pest control on agricultural crops and has been banned for indoor use as an insecticide. I would also think twice about using this pesticide on my child’s head.

Today’s lice are tougher and their exoskeletons are thicker than they used to be 20 years ago, when I too, had to treat my own children with head lice. I conducted some internet research and found that the lice of today hatch and mature on different schedules then they used to. This complicates established treatment directions. The lice seem to have also developed some resistance to the active ingredients, permethrin and pyrethrum. And forget turning your children’s heads into salad by slathering them with mayonnaise, lime garlic lotion or olive oil, as the little critters cannot be easily suffocated. (Journal of Pediatric Nursing)

Look for a product with isopropyl alcohol as a main ingredient and remember that it will take multiple treatment of lice products, to catch the next generation of lice as they hatch. If you are diligent and comb out the nits on a daily basis (such as every night during bath-time) you should be able to remove most of the nits between treatments.  In the mean time, wash and dry on high heat all hats, jackets, bed linens and stuffed animals.

About the Author: Marcia is the bed bug and vector management specialist for the Pesticides Program in Edison. She has a BS in Biology from Monmouth, second degree in Environmental Design-Landscape Architecture from Rutgers, Masters in Instruction and Curriculum from Kean, and is a PhD in Environmental Management candidate from Montclair – specializing in Integrated Pest Management and Environmental Communications. Prior to EPA, and concurrently, she has been a professor of Earth and Environmental Studies, Geology and Oceanography at Kean University for 14 years.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.