Breaking the cycle: School nurse helps families understand head lice problem

Simmerman (Geoff Rands/Democrat-News) [Click to enlarge] [Order this photo]

"I do not like head lice," said Virgie Simmerman, LPN, at the Saline County Circles meeting Tuesday, Dec. 1, "and I will do everything in my power to break the head lice cycle."

Simmerman first explained some terminology about lice. Lice is the plural of louse, which is a small, quick, parasitic insect that cannot jump or fly, and the name for a louse's egg is a nit. Head lice feed off of the blood in the human scalp and can be passed from person to person through direct head-to-head contact or sharing of combs, hats or bedding.

Head lice, Simmerman said, are very contagious.

These lice can live for up to two days without nourishment from consuming blood, she said, and they cannot live on household pets, so if a family experiences an infestation, there's no need to shampoo the family dog. It is also unnecessary to spend a lot of money to rid the home of lice.

Head lice are most commonly found on children between 3 and 12 years old, especially girls, she said, because girls tend to have longer hair.

"Check your children's hair once a week until they go to college," Simmerman said.

There are often not many head lice in an infestation, said Simmerman.

Though many people feel embarrassed by the presence of head lice, said Simmerman, head lice are "not a sign of uncleanliness or poor hygiene."

If a parent notices a child has a constantly itchy scalp, the parent should contact the child's doctor, as well as the nurse at the child's school to see if other children have recently been treated for lice. If the child does have head lice, the parent should contact staff at the school to let them know about the situation.

Treatments for head lice include medicated shampoo, cream rinse and lotion, Simmerman said. Most instances of a head lice treatment failing are caused by parents failing to follow the treatment's directions carefully, she added, such as applying the treatment to dry hair rather than wet hair.

Most treatments contain insecticides, she added, so parents should be careful to follow directions and not reapply the treatment more often than is recommended.

However, she said, the process may be repeated seven to 10 days later to ensure that any nits have hatched and are also killed with the treatment.

Because some medicated scalp treatments contain flammable ingredients, parents should not use a hair dryer on a child's head after applying the treatment.

A cream rinse or shampoo/conditioner combination should not be applied to hair prior to applying lice medication, and hair should remain unwashed for one or two days after using the treatment, said Simmerman. This is because some of the medication is still present and working to kill the lice.

Only one medicated head lice treatment should be used at a time, she said, and the same medication should not be used on a person's scalp more than three times. If three applications have not wiped out the infestation, switch to another medication.

In those 2 and under, no such medicated treatments may be used. In this case, and others, the nits and lice must be removed by hand.

"To remove lice and nits by hand, use a fine-tooth comb on your child's wet, conditioned hair every three to four days for two weeks after the last live louse was seen," instructed Simmerman.

"Hot spots" for head lice on humans include above the ears and the nape of the neck, she said.

Wetting the hair beforehand temporarily immobilizes the lice, she added, and conditioner makes it easier to get a comb through hair.

Simmerman said that when she finds a louse in a student's hair, she sticks it to a piece of tape for two reasons: first, the louse cannot get away, and, second, it makes the louse easily visible for the benefit of the child's parents.

"There are many right ways to do things. It doesn't always have to be my way, ... (its just important) that you're doing something," she said.

However, she mentioned a once-common treatment that parents should never try: kerosene.

When a lice infestation has been discovered, all bed linens and clothing recently worn by anyone affected by the infestation should be washed in 130-degree water and put in the dryer on the hottest setting for at least 20 minutes.

Clothing that is not machine-washable should be dry-cleaned, she said, as should stuffed animals. Alternatively, they can be placed in airtight bags for two weeks.

Simmerman recommended vacuuming carpets and upholstered furniture in both the home and car of a family affected by a head lice infestation.

Hair-care items, such as combs, hair ties and barrettes, should be soaked in rubbing alcohol or medicated shampoo for one hour, washed in hot water or simply thrown away.

There are a few reasons a lice infestation may recur, said Simmerman. There may be some nits left behind, a person may be exposed again to someone else with lice, or the treatment used may simply be ineffective.

"It's about being thorough, very, very thorough, and that takes time, it can take money, and if you don't have money, give your time," she said.

Simmerman has spent 29 years in the nursing field, and has served for the last 15 years as school nurse at Southeast Elementary School, though she gave the presentation on her own time.

She holds monthly presentations on this topic at Southeast Elementary. The next will be held Tuesday, Dec. 15, at 4 p.m.

Contact Geoff Rands at marshallreporter@socket.net