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Lice: What You Need to Know to Prevent the Pests and Their Itch

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Just because you’re an adult doesn’t mean you’re off the hook when it comes to lice.

Unfortunately, although head lice are most common in school-aged children, adults can, and do, still get lice.

But there is a silver lining: lice do not carry disease. So, while they are an annoying and often uncomfortable problem, lice are relatively harmless and can be easily treated.

Types

Lice are parasites that feed on human blood and can be found on your head, body or pubic area. They often cause intense itching in the affected areas. Your pets and other animals don’t play a role in spreading lice that affects humans, and the lice that use you as a host will die within five to seven days if they fall off your body.

Here’s a closer look at the three different types of lice that can infest humans:

  1. Head lice are six-legged insects that cling to the scalp. Each louse is the size of a sesame seed, making them difficult to spot. A female louse can lay up to 10 eggs per day, known as nits, that are firmly attached to hairs near the scalp. Nits can be even harder to detect than the actual insects.
  2. Body lice are much less common than head lice. Body lice most often affects people who aren’t able to regularly bathe or wash their clothes. The insects are similar to head lice, but body lice prefer to lay their eggs in the seams of your clothing or in your bedding. Body lice travel to your skin several times each day to feed on blood.
  3. Pubic lice, commonly referred to as “crabs,” look like tiny crabs when viewed under a microscope. Pubic lice are most commonly found in the pubic area and less commonly may be found on coarse body hair such as chest hair, eyebrows and eyelashes.

Causes

Head lice is most often found in children since it is spread through head-to-head contact or sharing items such as hats, brushes, hair accessories, helmets, and other items worn on or around the head.

“Head lice, while not dangerous, are extremely contagious. Head lice move by crawling; they cannot jump or fly. If one person has head lice and shares a hat with another person, the lice is very likely to travel and spread,” explains Karen Bocchicchio, CRNP, a nurse practitioner at Penn Internal Medicine Woodbury Heights. Unlike head lice, body lice are most often attracted to individuals with poor hygiene. Similar to head lice, body lice are highly contagious and can be spread through contact with an infected person, including by borrowing their clothes or sharing a bed or furniture that is infested.

Pubic lice are most often spread through sexual contact with an infected person. It is important to note that since condoms do not cover the entire pubic area, you can still contract pubic lice from an infected person, even if condoms are used. It’s also possible to catch pubic lice by using the towels, linens, or clothing of people who have pubic lice. If you’re sexually active, have regular check-ups to limit the risk of contracting public lice and other sexually-transmitted infections.

Symptoms

One of the things that makes head lice so difficult to treat is that there are often no immediate symptoms. The first and most common symptom is itching, but that may not appear until weeks after the lice have moved in. Itching from lice is caused by an allergic reaction to the bug bites which can lead to sores or raw skin on the scalp. While uncommon, it is possible for the sores to become infected, making it important to treat the lice and eliminate itching as soon as possible.

“You should call your doctor immediately if your skin becomes red, swollen, or painful, or if the lymph nodes in your neck become tender, as these can all be signs of an infection,” says Karen Bocchicchio.

One of the first signs of pubic lice is also intense itching, which can worsen at night. If you’ve been exposed to pubic lice, you may also notice bluish-gray marks on your thighs and pubic area caused by bites from the louse.

Prevention

While cleanliness may make a difference when it comes to body lice, it is important to note that the most common form of lice – head lice – has nothing to do with cleanliness. In fact, since lice can survive for up to six hours under water, kids who bathe regularly are just as likely to contract head lice as those who bathe less often.

However, there are still some ways in which you can prevent contracting and spreading lice. It is recommended that you:

  • Avoid sharing hats, hair accessories, helmets, combs, brushes, and headphones.
  • Avoid head-to-head contact.
  • Avoid storing personal belongings in shared spaces such as closets, lockers, drawers, and common clothes hooks, especially in public areas such as school and work.
  • Wash your clothes and bedding on a regular basis.

Treatment

Karen Bocchicchio explains that “while lice is not life-threatening, it is important to seek proper treatment since it will not go away on its own. If your child does contract lice, it is important that you notify their school or daycare as soon as possible so that other students can be checked. This can prevent the lice from spreading. You should also be sure to examine all other members of your household and treat them accordingly.”

Most lice treatments can be purchased without a prescription at your local drugstore. All FDA-approved over-the-counter remedies contain pyrethrum -- naturally occurring extracts from the chrysanthemum flower – or permethrin, a synthetic ingredient similar to pyrethrins. While some adults swear by using home remedies such as mayonnaise and vinegar, claiming that these ingredients can smother lice and dissolve the glue that keeps the nits stuck to hair, it is important to note that these tactics have not been scientifically proven.

Some lice may be resistant to over the counter treatments and some individuals may need a stronger, prescription treatment. If you are unable to get rid of the lice on your own after two weeks, talk with your primary care provider to see if they can prescribe a stronger lice treatment. Pregnant women should not use anti-lice shampoo without speaking with their doctor first.

When it comes to lice treatments, you should use only one treatment at a time. Avoid using shampoos and conditioners before applying lice treatments and don’t wash your hair for one to two days after applying the treatment. Additionally, you should not use a hair dryer on your hair after treating it for lice as many of the treatments contain highly flammable ingredients.

While lice cannot survive for long periods off of the human body, it is still recommended that you wash all clothing worn or used within 48 hours before treatment. This includes bedding and stuffed animals.

Still curious about lice? Talk with your primary care provider about how to keep yourself and your family safe from these itchy pests.

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