Louse combs

Examination of the child’s head at regular intervals using a louse comb allows the diagnosis of louse infestation at an early stage. Early diagnosis makes treatment easier when the small numbers of lice, which first infest the child’s hair, are easily removed, the establishment of a louse population prevented, and the possibility of infesting others is reduced. Accordingly, weekly examinations of children, especially those 4–13 yrs old, carried out by their parents will aid control (15, 28).

Repellents

Essential oils such as rosemary, citronella and piperonal have been tested for repellency to laboratory colonies of body lice (29). Lately, the Hedrin Protect (1,2-octanediol) was introduce to the market. According to the instructions of the manufacturer it should be applied twice a week and repeated after every washing of the hair. We recommend that such a product be used in children who get often infested with lice and in whom the presence of living lice was demonstrated.

Our clinical experience shows that 3-5 drops of concentrated rosemary oil, applied on different sites of the hair (not on the skin and not behind the ears!) and dispersed over the entire scalp with the help of a regular brush, could also give a protection from re-infestation. This procedure should be done every morning before the child goes to the kindergarten or school.

Other preventive measures

Head-to-head contact is by far the major route of transmission for head lice. Studies in Australian schools showed that classroom floors, brushes and hats are not risk factors for pediculosis. Keeping girls’ hair tidy, being well informed on the biology and control of lice and regular examinations are helpful in the prevention of infestations with head lice.

Hats, scarves, hair ribbons, combs, brushes and towels should be for hygienic reasons not be shared among family members. Each person in the family should be examined with his own louse comb. If this is not possible, combs and brushes used by an infested person can be disinfected by soaking them in hot water (55oC) for 5–10 minutes.

Head lice can survive 15-24 hrs away from the host. Therefore, the louse will not leave the head of a person without being sure that it goes to another head. Lice found on the pillows are usually those which were killed or are in the process of dying after a pediculicidal treatment. It should be kept in mind that lice could continue moving for several minutes or even hours even if they are intoxicated (dying, moribund lice). Head louse eggs cannot continue their development at room temperatures, therefore live eggs remaining on the louse comb or brush, can not infest the same or other individuals. Accordingly, clothes, towels, bedding, combs and brushes which came in contact with the infested individual should not be changed. If the treating/treated person feels more comfortable with such steps, then such objects could be left either unused for 4–5 days or washed at 55–60^oC for 30 minutes.

Shaving the head or even a short haircut for prevention or control of lice is not recommended due to the psychological damage the child might experience.