Head lice is the presence of a bug called a
“louse” living on the scalp. It can cause itching ofthe scalp, which is sometimes severe. Outbreaks
Contact with other children who have head lice, or with
of head lice may occur at day-care centers and
their personal items, is the main risk factor. Head lice
schools. The eggs of the louse, called “nits,” are
are a common problem, especially in places like schools
often visible on the hair. Special shampoos are
and day-care centers. Having head lice doesn’t mean
needed to kill the lice and nits. Using a fine-
your child isn’t clean—the lice spread easily from
toothed comb can help remove them from your
child’s hair. Washing and cleaning items likeclothes and hairbrushes may be needed to elimi-
Lice infestations are most common in warm climates and
Most of the time, there is no practical way to avoid head
lice. The personal items of children with head lice, such as
Lice are tiny bugs that live on the human body, where
combs and hats, need to be cleaned. If there are cases of
they feed on blood. Although there are different types of
head lice in the school or community, children should not
lice (body lice, pubic lice), head lice are the main problem
in children. This condition is also called pediculosis capitis.
Head lice are spread from person to person, or from con-
tact with items used by a person with lice (such as brushes,combs, or towels). The lice can live for a few days on
The diagnosis should be confirmed by finding a louse or
objects without being on a person. The lice themselves are
hard to see, but you can see their eggs (called nits) stuckto your child’s hair.
To find lice, the hair is repeatedly combed with a fine-
If nits are seen within one-quarter inch of the scalp, they
Itching of the scalp is the most common symptom. How-
are probably alive. Nits seen farther up on the hair are
ever, many parents find out about the infestation when a
not alive. If the diagnosis is in doubt, the doctor may
note is sent home from school or day care.
Nits (the eggs of the lice) can be seen. They are tiny
Sometimes, especially in outbreaks, nits and lice are
white specks, stuck to the side of a hair. The nits are dif-
ficult to remove from the hair—they won’t just come offeasily, like dandruff. The lice are harder to see—they are
The goal of treatment is to eliminate the lice from your
Itching may lead to scratch marks on the scalp and neck.
child’s hair and from the home environment. Careful atten-
Inflammation may lead to enlarged lymph nodes (glands)
Medications—Several products can be used to help elim-
inate head lice. Many are available at drug stores, without a
Occasionally, infection with bacteria (usually “staph”)
prescription. These are pesticides and should be used as
may be caused by scratching. This results in crusted,
oozing sores (soreness, tenderness) of the scalp, oftenwith visible pus.
One percent permethrin (Nix) is usually effective in kill-
ing lice and nits and is often recommended. Apply thisproduct to your child’s hair and leave it there for 10 min-
utes before rinsing. Another application is often recom-
Although not very common, the main complication is
Your doctor may recommend another product. Other over-
bacterial infection, caused by scratching.
the-counter products include RID, A200, and Kwell,
which also contain pesticides. These medications should
Vacuum all areas of your home carefully, including floors
be used as directed and not overused.
Some patients are hard to cure and need prescription
Wash in hot water all items your child might have come
medications. Malathion (Ovide) is a lotion that is also a
into contact with, including clothes, sheets, and blankets.
pesticide and is sometimes used for difficult cases. Some
Hats, jackets, and other articles need to be washed or
oral medications are sometimes used, such as trimetho-
dry-cleaned as well. Items that cannot be cleaned can
prim-sulfamethoxazole (Bactrim), an antibiotic, or iver-
be placed in a sealed plastic bag for 2 weeks.
Brushes and combs can be treated with lice-killing pro-
! Talk to your doctor before using lice-killing products on
ducts and cleaned in boiling water, but it may be easier
Other over-the-counter products are available, but less is
When can my child go back to school? It is reasonable
to let children return to school or day care after the scalpand hair have been treated with one of the products listed
Combing—A fine-toothed comb can help in removing all
earlier. However, your school board may have a different
nits from the hair. This can be difficult to do, because the
nits produce a substance that makes them stick very closely. An equal mix of vinegar and water may help eliminate thenits, or your doctor may be able to recommend a product. Combing must be done carefully, as it is easy to overlook
Removing nits is usually done for appearance—aftertreatment, any remaining nits are usually dead.
Your child has symptoms of infection (crusty, scaling
rash on the scalp) or a rash on the neck, ears, or else-
Other family members should be checked for lice and live
nits. Family members who sleep with a child who has headlice should probably be treated.
You have difficulty eliminating lice or nits or if the infes-
Careful cleaning of your home is probably a good idea to
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COMPARATIVE EFFICACY AND ACCEPTABILITY OF FIRST- AND SECOND- GENERATION ANTIDEPRESSANTS IN THE ACUTE TREATMENT OF MAJOR DEPRESSION: A MULTIPLE TREATMENTS META-ANALYSIS Andrea Cipriani, Corrado Barbui, Toshiaki Furukawa, Georgia Salanti, Stefan Leucht, Eric Ruhe, Sarah Stockton, Julian Higgins, Guy Goodwin, John Geddes PROTOCOL BACKGROUND Major depressive disorder is the most p
Fisher, Jill A. & Lorna M. Ronald (2008) “Direct-to-Consumer Responsibility: Medical Neoliberalism in Pharmaceutical Advertising and Drug Development.” In S.M. Chambré & M. Goldner (Eds.), Patients, Consumers and Civil Society (Advances in Medical Sociology, Volume 10) (pp. 29-51). Brighton, UK: Emerald Publishing. Definitive version can be accessed here: http://www.emeraldinsight.com