Head Lice Infestation

Head Lice Infestation

Article
Skin Care
Diseases & Conditions
+1
Contributed byLester Fahrner, MD+1 moreJan 02, 2022

What are the other Names for this Condition? (Also known as/Synonyms)

  • Infestation by Head Lice
  • Pediculosis Capitis
  • Pediculus Capitis Infection

What is Head Lice Infestation? (Definition/Background Information)

  • Head lice are small insects (human blood-sucking parasites) that are found in the hair, eye brows, and eyelashes. They tend to live close to the scalp, so they are not easily visible. The eggs (or nits) of lice stay attached to the hair strands
  • Lice are unable to jump or fly and so are transferred from one individual to another through physical contact, or sharing of bed, comb, clothes, hats, etc. They may affect other regions of the body, such as the pubis, armpits, chest, and seams of infrequently changed and washed clothing
  • Head Lice Infestation is also known as Pediculosis Capitis. Having head lice does not necessarily indicate that the individual has poor personal hygiene
  • Intense itching in the affected areas is the most common symptom of the condition. The constant scratching may make the skin raw and susceptible to secondary bacterial infections
  • Medicated shampoos containing insecticidal compounds are used to treat head lice. With proper treatment, Head Lice Infestation is an entirely manageable condition
  • Environmental control measures and personal hygiene can help treat and control pediculosis affecting other body regions

Who gets Head Lice Infestation? (Age and Sex Distribution)

  • Head Lice Infestations more commonly affects children in the 3-12 year age group
  • Head lice are usually common in school settings, college institutions, and childcare settings, indicating that they affect school children the most
  • Both males and females are prone to get head lice. Also, due to their generally long hair, girls and women are more prone to condition
  • All socioeconomic groups are affected
  • Pediculosis is found worldwide; the condition is observed in both the developed and developing regions of the world

What are the Risk Factors for Head Lice Infestation? (Predisposing Factors)

The following are the risk factors of Infestation by Head Lice:

  • Being in overcrowded places such as schools, correctional facilities, etc.
  • Direct physical contact with infected individuals, or sharing their clothes, beds, combs, towels, and hats/caps
  • Young children, especially pre-school and elementary school age, and their household members and caretakers
  • Girls, and in general the female gender are at high risk for head lice
  • The infection is more common during the summer, warmer months

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Head Lice Infestation? (Etiology)

  • Pediculosis Capitis or Head Louse Infestation is caused by Pediculus humanus var. capitis
  • It feeds on the scalp and spreads through close physical or ‘head-to-head’ contact, shared clothing, hats, combs, and hair brushes
  • The head louse is an ecto-parasite (a parasite that lives outside the body) that sucks human blood

What are the Signs and Symptoms of Head Lice Infestation?

Some common signs and symptoms of Head Lice Infestation include:

  • Severe Itching
  • Small red bumps in the scalp and neck
  • Crawling sensation of bugs in the scalp
  • Nits in the hair that are hard to remove
  • Head lice (and egg clusters) are easily seen on parting the hair to see the scalp, and also at the neck
  • Difficulty in sleeping at night due to itching
  • Foul smell, dull, lustreless hair
  • Abnormal enlargement of the occipital and cervical lymph nodes

How is Head Lice Infestation Diagnosed?

There is no known laboratory test to diagnose Head Lice Infestation. However, the following procedure may be adopted by the physician:

  • Complete evaluation of medical history and thorough physical exam
  • The diagnosis of head lice is reached clinically after observing the insects or nits
  • The eye lashes of young children may be checked carefully with the help of a high-powered magnifying glass

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Head Lice Infestation?

Head Lice Infestations may lead to the following complications:

  • Constant itching and picking of the scalp resulting in secondary bacterial skin infections (bacterial superinfection)
  • Significant sleep disturbance may result in mood changes due to a lack of good sleep
  • Possible social embarrassment of having head lice

How is Head Lice Infestation Treated?

The treatment of Head Lice Infestation includes the use of medications and environmental control measures to maintain cleanliness and hygiene.

  • The first lines of treatment are usually over-the-counter lotions and shampoos containing pyrethrin or 1% permetrhin.  These products continue to kill lice for about a period of 2 weeks after use. The healthcare provider may most likely prescribe a second agent, usually after 7-9 days following the first treatment. There is some evidence of lice becoming resistance to permethrin. In such cases, other anti-lice agents may be tried
  • In addition to treating lice, the nits (which are difficult to detach from hair) and dead lice are removed with special combs (nit combs) that are available over-the-counter. The first nit combing is done at the time of initial treatment, and the second after 7-9 days. It is important to note that nits can survive for up to 4 hours on their removal from the hair/scalp
  • The clothing, towels, and bedding of the patients have to be washed in hot water and dried in a hot dryer for about 20 minutes. The combs and brushes used have to be also washed; the room of the affected individuals must be vacuum cleaned
  • 5% permethrin, benzyl alcohol, malathion cream are some of the other medications used to treat lice
  • Some natural ‘home’ treatment for lice includes the use of cleanser oil, tea tree oil, and olive oil

How can Head Lice Infestation be Prevented?

The following preventive and safety measures can be adopted to reduce the incidence of Pediculosis Capitis, or Infestation by Head Lice. These may include:

  • Avoiding close physical contact with the infected individuals
  • Avoiding sharing of clothes, beds, combs, and hairbrushes of individuals with known infection of pediculosis
  • Educating the people on lice (background, types, spread, etc.), treatment methods, and personal hygiene shall go a long way in preventing the condition and its spread
  • The importance of good hygiene standards of living and sanitary conditions should be stressed
  • Children who have been diagnosed with Head Lice Infestation should report the disorder to their school so that other children in the school may be alerted, monitored, or treated, if necessary
  • Regular screening tests to inspect the children for hair lice could be undertaken, especially in school, college settings, institutions, nursing homes, and summer camps

What is the Prognosis of Head Lice Infestation? (Outcomes/Resolutions)

The prognosis of Head Lice Infestation is excellent with adequate treatment and hygiene measures.

  • With effective treatment, the condition can resolve within 2-3 weeks
  • The treated individuals should avoid all known sources of lice

Additional and Relevant Useful Information for Head Lice Infestation:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/diseases-conditions/infection-center/

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On the Article

Krish Tangella MD, MBA picture
Approved by

Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team
Lester Fahrner, MD picture
Reviewed by

Lester Fahrner, MD

Chief Medical Officer, DoveMed Team

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