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.

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.

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.

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.

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 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.

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%).

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.

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.