Effective treatments for head lice

Head lice is a parasitic infestation common in children. Proper management is essential to treat lice in a safe, convenient, cost-effective, and efficacious manner. School lice policies are often antiquated and can stigmatize the child and family. Evidence-based care guidelines may significantly help families minimize the stress of lice.

No-Nit Policies in Schools: Time for Change

No-nit policies that exist in many schools throughout the United States were established years ago based on fear and misinformation, rather than scientific evidence. Children who are found to have live lice are no more infectious on the day of diagnosis than they had been prior to the discovery. Transmission of head lice requires close personal contact, which is not common in the school setting. To date, no scientific literature exists to support the exclusion of children from school due to head lice infestation. Therefore, there is a need to develop updated school policies using research-based evidence to determine the best method of treating infestations while allowing children to remain in school.

Demystifying pediculosis: school nurses taking the lead

The treatment of Pediculosis capitis, or head lice, is fraught with misinformation, myths, and mismanagement. Common myths include the need to exclude children from school, the need to remove all visible nits ("no-nit" policies), the need for massive environmental cleaning, that head lice live for long periods of time, and that schools are a common location for lice transmission. Head lice are a common childhood nuisance, causing embarrassment and emotional trauma in both children and families. This article explores and challenges the commonly held beliefs about the identification, management, and treatment of Pediculosis by presenting current recommended evidence-based practice. It also challenges pediatric nurses, and school nurses in particular, in alignment with the National Association of School Nurses (NASN) Position Statement on Pediculosis Management in the School Setting, to act as change agents for reasonable and effective school policies and practices.

Shared vulnerability: a theory of caring for children with persistent head lice

Head lice infestation is a worldwide phenomenon that affects persons of all ages. For reasons that are not entirely clear, a number of children experience persistent head lice infestations lasting weeks, months, or years. Little is known about the impact of caring for children with persistent head lice on parents/caregivers. The purpose of this grounded theory study is to explore how parents and caregivers manage caring for children with persistent head lice. Data were obtained through participant observation and in-depth interviews with a purposive sample of 20 parents/caregivers of school-age children with persistent head lice. The researcher identified a 4-stage process of shared vulnerability used by parents/caregivers to manage caregiver strain associated with caring for children with persistent head lice. The four stages included (a) being ostracized, (b) losing integrity of the self, (c) struggling with persistence, and (d) managing strain.

Home remedies to control head lice: assessment of home remedies to control the human head louse, Pediculus humanus capitis (Anoplura: Pediculidae)

As the frequency and level of pediculicide resistance increases throughout the world, the need for novel solutions to control pediculosis has intensified. The development and registration of new pesticides has become so costly that many chemical companies are unwilling to pursue it and health-care providers now face a serious lack of new commercial pediculicides. Many infested people resort to using "home-remedy" approaches that have not been scientifically tested. In this article, we examined the potential value of six purportedly effective "home remedies" (vinegar, isopropyl alcohol, olive oil, mayonnaise, melted butter, and petroleum jelly) to treat head louse infestations and the likelihood of drowning lice by water submersion. Results indicated that only the application of petroleum jelly caused significant louse mortality but no treatment prevented lice from laying eggs. Most home remedy products did little to kill eggs, despite prolonged exposure. Petroleum jelly caused the greatest egg mortality, allowing only 6% to hatch. It was extremely difficult to drown lice, despite extended periods (i.e., 8 hr) of water submersion, suggesting that killing lice by depriving them of oxygen is inefficient. None of the home remedy products we surveyed was an effective means of louse control. This suggests that when treatment failure occurs, an increased amount of time and effort should be focused on alternative chemical pediculicides and/or manual louse removal (i.e., combing) rather than using any of these products.

A population-based approach to pediculosis management

Pediculosis is a population-based problem that is a priority concern for many communities. Public health nurses in a county health department collaborated with epidemiologists, nursing students, and faculty to design and implement an effective population-based pediculosis management project. The focus of the project was the development of pediculosis treatment and prevention guidelines based on recognized best practices that were acceptable to both epidemiologists and practicing public health nurses. Public health nurses disseminated these guidelines to community providers and reinforced their use through consultation and educational sessions. Two critical changes occurred as a result of the project. First, community providers significantly changed their recommendations for the treatment of pediculosis after nursing intervention. Second, public health nurses increased their population-based practice skills, continued to use those skills to address pediculosis, and extended those skills to additional population-based initiatives.

Scabies and lice: review of the clinical features and management principles

Health care providers frequently encounter human infestations of scabies and lice. When a person is identified as having either of these infestations, he/she should be treated. More importantly, their close contacts should be examined and treated if needed. It is vital for dermatology nurses to understand the epidemiology, transmission, symptoms, distribution, diagnosis, complications, and treatment for scabies and lice infestations.

Head lice: changing the expensive chemotherapy culture

The revulsion prompted by the discovery of head lice on a child's head, and the money spent by the NHS each year on supplying licensed medicines for head lice, is disproportionate to the medical impact that lice have on their hosts. This article discusses the evidence available on the effectiveness of the commonest parasiticidal preparations, and argues the case for a more rational, simpler and cost-effective response to this common problem.

Head louse infection: a health promotion activity

Head lice are the most common human ectoparasite. Although an infectious disease, louse infection rarely cause physical problems other than an itchy scalp. Social stigma surrounding infection induces feelings of shame, anger and embarrassment for families. Preventative health education and promotion via screening can effectively reduce the incidences of lice infection. The Mosaic Model of Treatment is recommended as the most up-to-date treatment regime, suitable for use on all children.

Pediculosis in a school population

This nonexperimental, retrospective study of elementary, middle school, and high school children (a) determined the prevalence of pediculosis, (b) identified populations susceptible to head lice infestation, and (c) examined the role of the school nurse in pediculosis management. The findings showed the highest prevalence of pediculosis was among younger school-age children, and girls were 3 times more likely to be infested than boys. Hispanic children had the highest rate of infestation, followed by Caucasian children. African American children showed a 15% infestation rate, a finding not supported by other studies. The role of the school nurse in pediculosis management was restricted by time and budgetary constraints. Findings of this study support the need for a standardized data collection system for pediculosis in all school districts.

Head lice for A & E nurses

Accident and emergency nurses are in an excellent position to offer skill and advice on the treatment of head lice, from health education to diagnosis and cure to contact tracing. This paper offers guidance on how to detect lice and how to treat infestation. There are a number of treatment options available, including pharmacological and physical treatments. Choosing the most appropriate option can be difficult due to reports of 'Super Nits' resistant to insecticides and lack of data to support the use of alternative methods such as 'wet combing' and aromatherapy treatments. However, nurses do need to be aware of how lice move between people, so they can take an active role in health education and make sure that patients affected by head lice are managed properly.

Factors contributing to the overuse of chemical pesticides in children with persistent head lice

A growing number of head lice cases, for reasons that are not entirely clear, are repetitive or enduring. Despite the emerging phenomena, there has been little in the literature to guide school nurses in their day-to-day struggle with families experiencing head lice infestations that persist despite repeated treatment attempts. Children with persistent head lice are at increased risk of overexposure to chemical pesticides from multiple-treatment sources. In addition, school absences for persistent head lice infestations place children at risk educationally.

Skin problems and parasites in children: 3--Head lice

Head lice are common in children, occur occasionally in women and are rare in men. All social classes are affected. Treatment should be reserved for genuine cases of infestation, i.e. where live lice are seen. More research is needed into methods of treating head lice. The school nurse has an important role in educating children, parents and school staff.

School nurses' perceptions of and experiences with head lice

Researchers examined school nurses' perceptions of head lice, perceived self-efficacy in dealing with head lice, and personal experience in reducing head lice problems. Survey data from a two-wave mailing from 382 school nurses found most nurses supported a "no-nit" rule of forced absenteeism of any child with nits in their hair (60%). They perceived OTC treatments for head lice as very effective in killing adult lice (66%), and 9% perceived them as not effective. Nurses had a high efficacy expectation regarding their ability to control head lice (63%), and they had high outcome expectations regarding the results of their work with students and families of students (66%). Most nurses received their information about head lice from professional journals (76%) and professional conferences/conventions (62%).

Some lousy questions for home health nurses

Pediculosis continues to be a widespread problem for both the public and health care professionals, including home health nurses. Dealing with this problem is complicated by a number of factors, including questions concerning the efficacy and safety of the medications used and the level of knowledge of about this condition. Because pediculosis often is considered more as an embarrassing annoyance than a serious threat, it has a relatively low priority on the list of contemporary health care concerns. This article addresses several practical questions concerning the character and treatment of pediculosis that are of special concern to home health nurses.

A guide to nurse prescribing of insecticides and anthelmintics

Several drug preparations are available to the nurse prescriber to treat parasitic infestations, most commonly head lice, scabies and threadworms. It is vital that the nurse has a thorough knowledge of the types of preparations available, together with an understanding of the non-pharmacological interventions to eradicate infestation. Many people may be treated without the intervention of a doctor, but the nurse prescriber should ensure that those who are affected receive appropriate referral to their GP if there are special circumstances, secondary infestation or a suspected infestation by roundworms.

From eradication to resistance: five continuing concerns about pediculosis

A school nurse, serving in the capacity of infection control officer, is responsible for managing head lice infestations. The nurse's concerns on the student and parent levels include dispelling misconceptions about lice, screening, motivating correct treatment, and providing follow-up. The nurse's responsibility to the community as a whole also involves putting into practice policies that prevent the spread of infestations without promoting pediculicide resistance.

Pediculosis prevention and control strategies of community health and school nurses: a descriptive study

Pediculus humanus capitis (pediculosis capitis) affects several million school children in the United States every year and is more prevalent among children than all other childhood communicable diseases combined. Traditional treatment of pediculosis involves the direct application of pesticides to the scalp of infested individuals. Yet, a single-treatment, 100% ovicidal pediculicide has not been developed. Head lice can be easily detected by an educated screener. The National Pediculosis Association (NPA) recommends regular screenings to control lice outbreaks in school settings. Screening is utilized as a prevention strategy to facilitate early detection and minimize exposure to potentially toxic chemicals. Nurses working with children in the country's schools are in key positions to develop, initiate, and incorporate prevention and control strategies into their child healthcare agenda. An NPA national survey identified specific lice management strategies used by community health nurses (CHNs) and school nurses working in school systems. The purpose of this article is to report the prevention and control strategies used by the nurses. Results of this national survey indicated significant variation in management strategies. A national standardized approach toward prevention and control is not being utilized.

Dispelling the common myths about pediculosis

Pediculosis, the condition of being infested by head lice, is a major community health problem in the United States. Head lice, the most common species in humans, occupy considerable amounts of time and energy both within schools and the medical community. The condition creates school and family disturbances and personal embarrassment--consequences far exceeding its medical effects. Because parents are often embarrassed when they are informed about a head lice infestation, they often do not approach the subject with their health care providers. Pediatric nurse practitioners (PNPs) need to incorporate education relating the diagnosis and management of pediculosis in the well child visit. PNPs can dispel the common myths that have existed for so long to help open communication with parents and children to promote safe and proper treatment. Early detection is vital in preventing epidemics.

Nursing management of patients with scabies and lice

Ectoparasites have afflicted mankind since antiquity and continue to be responsible for much human suffering. The infested patient is in need of prompt, effective treatment from a compassionate, knowledgeable nurse. The nurse who understands how these creatures are transmitted and how they can be efficiently eradicated can help the patient become free of the misery of infestation and the dangers of secondary disease.

[Study of nursing problems involving care of the hair and scalp in hospitalized patients]

A autora procurou identificar os tipos e os problemas de enfermagem referentes ao cabelo e couro cabeludo, apresentados por pacientes internados em clínicas médicas e cirúrgicas gerais de um hospital governamental de ensino. Identificou 4 classes de problemas: estado de limpeza, lesões, infestações e penteação. Cada classe foi subdividida em graus os quais foram denominados tipos de problemas. A proporção de problemas por paciente encontrada foi 0,80 e a proporção de pacientes com problemas foi 58%. Foram também estudadas algumas condições que podem intervir no cuidado ao cabelo e ao couro cabeludo e foram obtidas informações sobre hábitos e costumes apresentados pelos pacientes.