ClinicalCommunity Pharmacy

Getting ahead of lice

While several health concerns come to the forefront as students head back to their classrooms, head lice seems to top the list at most pharmacies

Head lice are tan to grayishwhite, 6-legged, wingless insects typically measuring 2 mm to 3 mm in length, or about the size of a sesame seed. Because lice crawl and do not jump, head-to-head contact is the primary route of transmission. Once on the scalp, lice attach eggs to the base of hair shafts a few millimeters from the scalp surface.

Once laid, eggs hatch within 9 to 12 days, and the resulting nymph matures into an adult louse over the subsequent 9 to 12 days, for a full reproductive cycle of approximately 3 weeks’ duration. Typical signs of head lice are usually itchiness on the scalp, around the ears and the back of the neck. However, some people may experience no symptoms at all.

Because lice eggs are located on hair shafts approximately 4 mm from the scalp, it is often easier to identify eggs by searching at the back of the hairline, where they are most visible. Research suggests that wetting hair before combing improves diagnostic reliability.

There are several methods that can be recommended for managing a head lice infestation. Pharmacy teams should help customers choose the most appropriate product for their child because not all treatments will be
suitable for everyone. Understanding a person’s preference, medical and drug history, the product’s active ingredient, how the active ingredient works, how the product should be used and if anything has been tried previously will allow pharmacists and pharmacy staff to recommend and help parents choose the right head lice product.

Mechanical removal involves systematically combing the whole head of wet hair with a detection comb to remove the lice. The comb must be cleaned after each pass through the hair to remove lice and eggs, which is best done by wiping it on clean white paper or cloth.

The process must be repeated every few days for two weeks. Products containing dimeticone or isopropyl myristate kill the lice through physical action. Dimeticone coats the surfaces of head lice and suffocates them, while isopropyl myristate dehydrates head lice by dissolving their external wax coating.

The advantages of these products are that they are easy to apply, they have few side-effects, are odourless or have only a faint perfume, and the head lice are unlikely to become resistant to them.

Instructions must be followed exactly otherwise the treatment won’t work. Some of these products don’t kill louse eggs either, so it is vital that the treatment is repeated after a week to kill any lice that have hatched since the first application.

Many parents are looking for allnatural remedies, so it would be wise for pharmacies to stock up on both traditional and alternative choices. It’s also important to alert parents to this topic, as they need to be inspecting their children for ticks and lice and so whilst stocking up on head lice products, education shouldn’t be missed.

Make sure head lice products are prominently displayed, along with educational brochures. Remind parents that their children should not share hats and also point out places where lice can be contracted.

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