How to identify head lice and the best way to get rid of them
Advice from our GP on how to treat head lice and on the best approach to tackle anxiety.
Q. My daughter's head is itchy lately. I think she may have head lice. How can I be sure, and if she has them, what is the best way to treat them?
Dr Nina replies: Lice are small wingless parasites about the size of a sesame seed when fully grown. They vary in colour from pale cream to grey-brown and cannot jump or fly, but use their legs to cling tightly to the hair shaft and to move quite quickly from hair to hair.
They are very contagious among close contact. Schoolchildren sharing secrets or working closely together can facilitate the lice crawling from head to head. They also travel easily among close family contacts this way.
Once lice arrive on someone's head, they settle close to the scalp. The most common areas to see them are behind the ears and at the nape of the neck. The female louse lays eggs, which hatch about seven to 10 days later. The lice feed by sucking small amounts of blood from the host's scalp and become fully-grown in about six to 10 days when more eggs can be laid and the process continues. The shells left behind after the eggs hatch are referred to as nits and these grow out along the hair shaft.
Live louse and eggs can be hard to see because they tend to be very close to the scalp. If infestation has been there a while, the nits may be more easily seen as they grow out along the hair shaft.
An itching head may be a sign of head lice but it doesn't always occur. The best way to diagnose lice is by detection combing. This is best done on wet hair but can be done on dry hair also. The teeth on these combs should be no more than 0.3mm apart in order to trap the lice.
Apply a large amount of conditioner to the hair, and comb through with a normal brush or comb. When the hair is tangle free, start combing through small sections of the hair from the scalp to the end of hair shafts, and check the comb after each segment to look for louse or eggs. Rinse out the conditioner and repeat the combing on the hair again. If you find lice, then your child will require further treatment.
There are a number of treatments available. You can also treat a person using wet combing. The above method needs to be repeated on days five, nine and 13 in order to ensure there are no viable eggs.
For many years, chemical insecticides were used to kill lice and eggs. The lice are now resistant to many of these. More recently, non-chemical methods are becoming more popular - these include dimethicone and cyclomethicone treatments. These work by suffocating the louse and loosening the eggs so resistance is less likely. These solutions are applied to the hair and left for minutes to hours. Hair is then fine-combed and washed.
Newer non-chemical devices include electric or vacuum combs. These zap or suction lice while combing takes place and are said to eliminate them without the need for chemicals or solutions.
Lice can only live for about two days off the human head and cannot pass from or to pets, so extreme cleaning methods are not necessary.
Finally, itching can persist for a few weeks after the hair has been treated and does not necessarily mean the nits are still present.
It is important to check and treat all household members as failure to do so may allow lice to survive and reinfest.
Q. I have been diagnosed with anxiety. My GP has prescribed medication but I’m really keen to explore other methods of treatment or help. Have you any advice about where I should start?
Dr Nina replies: Anxiety disorders are very common, affecting up to one-in-eight people. Seeking help is the first step on the road to recovery and your GP is a good place to start. Medication can help in some cases, but it isn’t always required and certainly shouldn’t be the only treatment.
Counselling or talk therapy is probably one of the best places to start. Your GP may recommend practitioners in your area. Other good places to search are the websites psihq.ie (Psychological Society of Ireland) or iacp.ie (the Irish Association of Counsellors and Psychotherapists).
Regular exercise has been clinically proven to reduce stress levels and help anxiety. Yoga and Tai Chi are particularly good at reducing stress levels. Eating well will also help. Avoid alcohol, excess sugar and too much caffeine.
Disrupted sleep can be a symptom of anxiety, so focus on your night routine. Have a proper wind-down time and keep your room cool, dark and quiet.
Practice mindfulness — join a group or course. If you prefer to do these things alone, downloading an app such as Headspace may be helpful.
Bibliotherapy or reading therapy can be very effective. There are some excellent self-help books available also — you can get many of these in your local library.
It is important to let friends and family know how you feel. Their potential support shouldn’t be underestimated. Humans, at core, are pack animals. Anxiety often makes us withdraw from social interaction, however, loneliness and isolation can lead to worsening mood and depression.
Asking for help isn’t a sign of weakness, it’s a sign of strength.
Health & Living