With school now in full swing, you want to be sure your youngsters don’t come home with head lice.
But while these tiny, scalp-loving pests can cause plenty of
irritation, itchiness, and concern, experts say that a lice infestation
isn’t a cause for panic.
Of all the critters that commonly feed off of humans,
“head lice are the least significant,” says Richard Pollack, Ph.D., a
public health entomologist and a senior environmental public health
officer at Harvard University. “Yet they have bubbled up forcibly to the
top of what everyone fears.”
That may be partly because
misconceptions abound about lice—about how they behave, where they’re
spread, and how they’re best treated. Here, we asked experts to weigh in
on four widespread beliefs and the truth behind them.
Myth: Lice Prefer Dirty Hair
The truth:
Contrary to popular opinion, having lice doesn’t signify poor hygiene.
In fact, lice are just as apt to make a home in freshly shampooed hair
as they are in locks that could use a washing.
“They don’t care at
all,” says Dawn H. Gouge, Ph.D., a public health entomologist at the
University of Arizona. “They love warm little noggins.”
Myth: Kids Pick Up Lice Mainly at School
The truth:
Although lice can be transmitted at school, kids can also “catch” them
in a number of other places, including sleepovers, playgrounds, sporting
activities, and camp.
And according to Gouge, the idea that
school is the primary place for lice infestation has led many schools to
implement “no nit” policies. These require children to be sent home
from school or kept out of school if nits (lice eggs) are discovered on
their scalps. In a new Consumer Reports nationally representative survey
of 2,016 U.S. adults, we asked Americans whether their child had ever
been sent home or asked to stay home from school because he or she had
lice. Fifty-two percent of those with children in their household who’d
dealt with a lice infestation in the previous five years said yes.
But
such policies have several flaws, according to the Centers for Disease
Control and Prevention. It’s easy to mistake dandruff or debris for nits
in hair. Plus, nits don’t move and, in fact, are affixed to hair shafts
with a cementlike substance that makes it unlikely they can be
transferred from one person to another. And there’s no evidence that
banning kids with nits from the classroom is useful. The National
Association of School Nurses notes that classroom or schoolwide nit
checks aren’t effective at preventing incidences of lice in schools.
Keeping
kids with nits (or lice) out of school has “absolutely no benefit to
anybody,” Gouge says. And the American Academy of Pediatrics (AAP) has
proclaimed that “no-nit policies are unjust and should be abandoned.”
The cost of missed school far outweighs any risks of head lice,
according to the CDC and the NASN.
Myth: Lice Spread by Jumping or Flying
The truth: Lice, which are wingless, don’t jump or fly. They don’t hop from place to place, either.
They
can crawl, however, and very quickly, because their legs are very well
adapted for crawling. And once they crawl onto a child’s head, they tend
to hang on tightly, thanks to the hooklike claws they have at the end
of their legs.
So how do they get from head to head? By crawling from one head to another, via direct head-to-head contact between two people.
Though
it’s theoretically possible to pick up a louse from a public place,
such as a movie theater seat, it would be highly unlikely. That’s
because lice live on human heads, and they need to feed every 4 to 6
hours. Adults can survive only for about a day if they fall off. (They
don’t live on pets, either—only people.)
In fact, it’s pretty
unlikely that lice will be transmitted from person to person without
direct head-to-head contact, Gouge says.
Even the sharing of helmets, clothes,
pillows, and hairbrushes probably rarely leads to lice transmission,
according to the CDC. The risk is greater, however, when these types of
items are used by more than one child in quick succession, Gouge says.
And if someone in your household does have lice, it’s a good idea to
launder their bedding and clothes and to clean hair-care items as a precaution, according to the AAP.
Myth: Pesticide Must Be Used to Kill Them
The truth: Several
pesticide-based treatments are available, either over the counter or by
prescription. But these may not always be the best choice.
Sometimes
called “super lice,” many of the pests in the U.S. and other parts of
the world have developed resistance to over-the-counter lice treatments
that contain certain pesticides, notably permethrin and pyrethrins. In a
2016 study on this topic, scientists found that 98 percent of the lice
they evaluated—collected from 138 sites in 48 states—had a gene mutation
indicating possible pesticide resistance. The researchers say that
while the mutation doesn’t guarantee that an OTC lice product with
permethrin or pyrethrins will fail, it does reduce the chances treatment
will succeed.
Prescription lice treatments may be more effective
but can be expensive. For instance, according to drug pricing website
GoodRx, Sklice, a prescription treatment that contains the pesticide
ivermectin, can cost $350 or more for a tube, and it might not be
covered by insurance. And some pesticide products carry risks, such as
malathion (Ovide and generic)—it’s flammable, and it can cause stinging
and burns. CR’s experts recommend against using products containing the active ingredients malathion and lindane.
Note
that some prescription pesticide treatments should be used on children
only of certain ages, may need to be used more than once, and are
applied for varying lengths of time, so it’s important to read
directions carefully.
And there are effective alternatives to
pesticide-based products. Consumer Reports’ scientists have long
advocated the use of wet-combing: coating your child’s head with
conditioner or oil and combing out lice and nits with a fine-tooth metal
nit comb. The AAP also recommends this method for parents who prefer
not to use one of the available lice pesticides, or whose children are
too young for them.
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