How To Treat Head Lice - Veterinarian's View

It all started with a phone call. The school has called my wife in the middle of the day saying that she needs to pick up our daughter immediately. Another child has been scratching her hair so the teacher decided to investigate. Every child had their hair checked that day and there it was - head lice! My daughter was one of the victims.

No problem, I thought. I mean, how bad can this be? I treat parasites every day. Just the other day I dealt with a bad case of ear mites in a very upset Alaskan. Alaskan Malamute that is. You see, I am a Veterinarian and treating parasites is my bread and butter. Sure my patients are furry and four legged. But the etymology of a parasitic infection is the same in any species. Right? Little did I know what I was in for.

I approached the problem with the same attitude as I do with any challenging case. I needed information. I found out that head lice are prolific breeders laying up to 8 eggs a day from when they are only 10 days old, with the eggs hatching a week later. Lice are common throughout the world, including the well-off countries. They spread easiest in places where head to head contact is common (such as kindergartens and primary schools). They also don't discriminate between clean or dirty hair, between neglected children and those well cared for - which dulled somewhat my intense feelings of being a substandard parent. At first glance the challenge presented to me did not seem that great. Head lice are not particularly resilient as far as microscopic critters go. They can not survive for more than about 24 hours outside of the human hair. Their eggs too are laid firmly attached to the hair strands. Therefore no need to exert heroic efforts sterilizing the environment - couches, floor boards, the car etc. - a quick vacuum is all that's needed. Even the bedding and hair accessories only warrant a trip through the washing machine to remove any 'stray' eggs. Oh yes, the eggs! That is precisely where the problem lies. There they were - tiny, white with an orange tinge, teardrop shaped, attached firmly to my child's hair. The eggs can not be washed off and resist all chemical treatments. They are in one word - indestructible. You heard the saying that the cockroaches will be the only ones to survive a nuclear blast? Well, I firmly believe that in that event the cockroaches will have company - those tiny, pesky louse eggs.

It's this hellish resilience of the eggs which makes the treatment such a long, tedious, frustrating experience. A trip to the chemist will bear this out. There are plenty of head lice treatments on the market. They can be roughly divided into two groups - 'natural' and 'chemical'. Notwithstanding the spectacular claims of this product or that, regardless of what you choose, somewhere on the back of the bottle a disclaimer will state in small letters that the substance treats adult lice only and will not affect the eggs. To get the eggs out takes perseverance, bribery and plenty of elbow grease. Our usual treatment routine goes something like this: sit the child down on a low chair in front of TV, bribe liberally with the lollies of their choice, pour a tablespoon or so of your chosen product (we later worked out that a regular hair conditioner works as well as the finest louse treatment) onto the hair and spread it evenly. Then begins the tedious combing procedure. This will test your patience and flexibility as well as practice you answers to the cry of 'Mommy, it hurts!', which you will hear repeatedly. Try to be consistent moving through the hair in an overlapping pattern. Use a metal louse comb rather than plastic. After each passage of the comb through your child's hair, wipe the comb on a tissue and count your trophies. You will soon become expert at discerning adult lice and their eggs in the mixture of hair, conditioner and breakfast serial. Keep going until no new lice/eggs are discovered. Then try a different technique (for example, if until to now you have been brushing over the hair, try brushing from underneath the hair instead) and be amazed at how many parasites you missed the first time. Once no new lice/eggs are recovered, it's time to take a deep breath and go to the shower to wash off the remainder of the conditioner. But don't pat yourself on the back just yet. Tomorrow, when you have to do it all again, you will be surprised at just how many critters you missed the day before. And don't despair if the process continues for a week, many weeks, months... Just remember - ancient people have lived contented lives side by side with skin parasites for millennia. What was that? Did I hear you say 'That's not very encouraging'? Well, I told you I was a Veterinarian, not a kindergarten teacher.

Dr Vadim Chelom B.V.Sc. is a Veterinarian, a writer and an educator. You can read his blog on http://www.doctor-pets.com/

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