A Family's Lousy Luck

Here's a real head scratcher. Suppose your kid comes home with head lice. Cooties! What are you going to do about it? Head lice are parasites that cling to human hair and scalp and suck blood. Among children, they are as common as, well -- itchy heads. Sources including Contemporary Pediatrics estimate that lice infest as many as 12 million American heads each year, mostly children's.

And lice are tough. People hit them with $100 million worth of lice-killing shampoos and other treatments each year, but the bugs go marching on. Lice aren't like ants to slap off, or like mosquitoes to swat, or even like fleas to pinch. It takes a fight to get rid of them. Here's why:

Lice are tiny and flat, and expertly camouflaged on the human scalp in colors from tan to dark. They have claw-like legs that enable them to hang on despite any number of brushings and regular shampooings. Cleanliness doesn't prevent them. In fact, they prefer a clean scalp.
They glue their eggs, called nits, to strands of hair with super louse cement that defies solvents -- nature's lousy promise of more and more lice.

Parents join the battle against lice with a bewildering arsenal of drugstore and prescription shampoos including Nix and RID that cost around $10 a bottle.

But the shampoo is a pesticide -- something careful parents normally keep away from their children -- and it may not work, anyway. The National Pediculosis (head lice) Association reports 50 calls a day "reporting product treatment failure," meaning the shampoo didn't work, or mom didn't follow directions, or maybe lice are more resistant.

The alternatives range from new-age oils and drowning lice in mayonnaise, to the oldest answer of all -- picking at lice the same way monkeys do.

Whatever works. Bugged parents have to get the lice out for all sorts of good reasons:

1) Lice cause fierce itching and sometimes other health problems, such as skin infections.

2) Itchy kids have trouble paying attention in school. Besides, the school probably won't let your child attend class with a headful of lice or nits.

3) Lice spread. Anyone can have lice. You could have -- scratch, scratch -- lice.

So, you know, this means war.

Margo Swanson, health services coordinator for the Little Rock School District, compares having lice to having a cold. Both are aggravating. Both are difficult to treat. Both spread in crowds.

"There shouldn't be any social stigma to having lice, any more than like having a common cold," she says.
Still, the bugs' most devastating weapon may be the idea that lice are shameful. Lice come with the enduring stigma of poverty, scuzzy living, neglect and dirty hair, even though science insists otherwise.

Science assures it is perfectly possible to be clean and lousy. Lice "happily infest anyone with enough hair and blood to support them," the trade journal Nursing reports. Money, manners and lah-dee-dah social status? -- wasted on a louse.Even Kiplinger's Personal Finance Magazine feels the itch, agreeing: "Those bloodsucking critters ... seem to cling to life and scalp no matter what you do."

Children come down with cooties the worst because they play together and share things the most, in crowded places like schools and day-care centers.

"It's because of the way they interact," says Linda Menditto of the pediculosis association in Newton, Mass. Kids play and even nap in tight groups, swapping blankets and pillows. If lice attach to little girls more than boys, it's probably because girls touch more. The bugs favor white children, probably because lice know their eggs stick best to the round shafts of white kids' hair. Black kids' hair is more oval-shaped. Head lice head for the head because it's such a rich, easy blood source -- dinner just below the skin. They get so spoiled, they can't survive more than a few hours without a person's head to suck.

Nobody knows a whole lot more about lice.
"Head lice are not a reportable disease," Menditto says. That means government health agencies don't collect statistics about lice, so estimates about lice infestations are based on shampoo sales.

"Moreover, lice are not a popular subject for scientific research," Lennie Copeland writes in The Lice-Buster Book: What To Do When Your Child Comes Home With Head Lice (Authentic Pictures, 1995). "Few researchers are willing to raise lice on their own bodies. Rumor has it that most lice researchers are divorced!"

ATTACK!

First and best, do all you can to keep from having lice.
Look at a louse, and you'll see that it can't fly (no wings), and it can't jump (no hopping-type legs). It would as soon stay on the same head where it hatched. Lice spread mainly because people give them easy transportation.

Cooties hitch a ride on combs and hair brushes, hats, stocking caps, scarves, helmets, ribbons, headphones, pillows and sleeping bags. Don't share those things, keep your kids from sharing them at school, and you've already done a lot.

Drugstores brim with bug-killing shampoos, or pediculicides, with label instructions that demand care.

The danger is not the bug shampoo so much as the temptation to use it too much, too often, if it doesn't work the first time, Menditto says.

However, the pediculosis association warns flatly against one ingredient: lindane, or Kwell. Contemporary Pediatrics says pediculicides "are classified as neurotoxic agents." They work by short-circuiting the bugs' nervous systems, but they can affect people, too. Lindane "can cause seizures if used inappropriately."

Ultimately, the cure may be to comb and pick out lice and nits from the hair one by one, until they're all gone.

Lice cleverly run and dodge to frustrate this scheme. Try to have at least two nit-pickers working over an infected head with tweezers or nimble fingernails, like one cop tackling the front door while another cop watches the back.

The secret is a lice comb, a very fine comb that is made to nab the offenders.

"Inexperienced scalp hunters may find it difficult to spot the lice, which move very quickly and often hide close to the neck, hairline or behind the ears," Health News magazine reports from Canada. Nits are easier: a white speck that is stuck to the hair so tightly that you can't scrap it off with your fingernail, is probably a nit.

If you keep your kid combed regularly -- make it a basic habit -- then you'll never have to deal with a large infestation.

And then, clean house.

Recommendations vary widely on how much cleaning is necessary, and whether everyone in the family should lather up with lice shampoo just to be safe. The Lice-Buster Book advises, "a fine alternative is simply to leave the house for a week to 10 days" -- plenty of time for a lingering louse to starve. Menditto downplays cleaning. Heads get lice, she argues, houses don't. "If you spend your primary time delousing your child, rather than doing 30 loads of laundry, you'll be much better off." However, common cleaning measures include: Wash your child's clothes and bedding in hot water, vacuum carpets and furniture, and tightly bag things like stuffed toys for 10 days.

REGROUP

It's because of lice that airline seats have those little napkins draped over the headrests. And kids still play the old game Cootie, assembling little bugs from plastic parts.

When lice spread, everything has to come to a stop, and the entire class in a school has to be checked, sometimes, the whole school. Nationally, almost all school nurses insist on sending lice-infested children home until they are successfully treated. Most nurses won't tolerate even nits, according to The Journal of School Health. And for what it says about lice: "72 percent (of school nurses) did not find treating head lice to be professionally gratifying," the journal adds.

There is no kind word for lice, although everyday language is crawling with them. Thanks to lice, we say louse -- a bum. Lousy -- no good. Loused up -- ruined. Nit-picky -- finding little things wrong. And nitwit -- dumb, just as a head prickling with bugs makes it hard to think.

Intellectualizing too much isn't the way to deal with stubborn lice, anyway. "Do what the monkeys do. Get back to the basics. Take care of your kids.