Never mind an axe-wielding maniac: It may be “super lice” that await your child at sleepaway camp this summer.
According to experts in publications such as The Journal of Medical Entomology in 2014, the modern louse has grown resistant to traditional treatments, giving it “super” status.
A University of Massachusetts study tracked a gene connected with resistance in samples of lice gathered from across North America and found 99.6 per cent of head lice in the U.S. and 97.1 in Canada have the gene sequence connected with resistance.
Public health authorities in B.C. don’t bother tracking lice infestations because they are not considered a disease threat.
But front-line workers, such as pharmacists who dispense the remedies, say numbers of lice complaints are increasing.
“It’s going up,” said Priti Bhathella, owner of Elements Compounding Pharmacy in Saanich. “It’s going up because of the resistance.”
Bhathella said older, insecticide-based pyrethrins and permethrins that attack the nervous systems of the creatures are no longer working effectively.
But newer treatments are working well. One that Bhathella said has impressed her works by dissolving the waxy coating on the exterior of a louse or juvenile nymph. Once the protective coating is gone, the louse dies quickly.
Bhathella said lice-treatment products range in price from $20 to $40.
These treatments are often in a shampoo that is applied twice. The first gets rid of any existing infestation and the second, usually in seven to 10 days, kills off any newcomers hatched from viable eggs left behind after the first treatment.
If, however, an infestation flares up again in less than a week, the treatment likely isn’t working and a return to the pharmacist is advised.
Beware, however: Giving yourself another treatment too soon could result in an unsafe exposure to chemicals.
“The key thing is to get the treatment to work properly the first time so the patients don’t get frustrated,” said Bhathella.
She also said it’s important to get a positive diagnosis from a doctor or nurse to ensure any itch or spot is, in fact, the result of a louse infestation. That can help avoid overexposure to insect-killing shampoos.
“You always want to make sure you have an actual infestation and not just treat willy nilly,” said Bhathella.
Dr. Dee Hoyano, medical health officer with Island Health, said it’s important to remember that an infestation should not be a source of shame.
Head lice have nothing to do with personal hygiene or economic status. People inadvertently come into contact with one or more of the creatures and an infestation takes off.
Lice are most common in children because kids will wrestle and share hats or clothing.
But Hoyano also said head lice are not a health hazard. Lice do not transmit diseases in the way ticks can spread lyme disease, for example.
Lice can, however, lead to itchiness. Bites tend to be concentrated close to the hair line, on the back of the neck or behind the ears.
Some people may itch more than others, depending on reactions to the bite. Excessive scratching may lead to an infection through a break in the skin.
But any infection is a secondary result, and not spread by lice.
Hoyano and Bhathella said nobody, especially a child, should become ostracized or stigmatized because of head lice. There’s no reason to start a child’s treatment by anything drastic, such as shaving his or her head.
“The big myth is [that lice are] related to poor hygiene or not bathing enough, which has been shown to really not be the case,” said Hoyano. “It tends to be in younger children more, because they are more likely to be in close contact with each other.
“It’s definitely a nuisance and definitely should be treated,” she added.
“But it’s not a reason to go stigmatizing a child or excluding them from school or any other activity.”
Tips for treating and avoiding head lice
• Don’t swap clothes, especially hats. While quick moving, lice don’t jump from person to person like fleas. They can only spread through contact, direct or indirect.
• Purchase a fine-toothed nit comb. This can help remove the eggs and the adult lice. Use comb once with dry hair and then wet, using an inexpensive hair conditioner to make it easier to comb.
• Ask a professional such as a doctor or nurse to make the diagnosis.
• Wash clothes, bedding, sheets and pillow cases. Dry the bedding on high for 20 to 30 minutes to kill eggs, nymphs or lice.
• Vacuum the house. This is more for peace of mind than anything else, since lice and eggs can’t live for much more than a day off the live host.
• Repeat in 10 days to two weeks. Just a few eggs can result in another infestation, so keep on top of it.
Head louse lives its entire life on human scalp
The head louse, Pediculus humanus capitis, has been with humans since ancient times.
Lice even appear in the Bible, with Moses and Aaron inflicting them upon Egypt after the plague of frogs failed to persuade the Pharaoh to let the Jews go. Exodus 8:17 says: “All the dust of the land became lice throughout all the land of Egypt.”
But despite that long and storied relationship, public health officials in B.C. don’t track their infestations and only one specimen exists in the collection of the Royal B.C. Museum.
“I’ve never even seen one myself,” said Claudia Copley, entomology collections manager at the Royal B.C. Museum.
Copley also said she is unsure whether the head louse would even count as part of the natural history of B.C. and be considered worthy of preservation.
The sesame-seed-sized creature’s natural habitat is the human scalp, where it lives its entire life. It’s a different animal from the pubic louse, Pthirus pubis, which lives mostly in the human crotch but can infest other densely haired parts of the body, such as the eyebrows.
The head louse undergoes three nymph stages before it has moulted and metamorphosed into a fully grown adult.
Nymphs and adults feed entirely on blood. They bite the skin and their saliva contains an anti-coagulant that allows blood to flow. It’s the saliva that causes the itching reaction.
Lice reproduce sexually and a female will lay eggs on the hair, sticking them there with a hard glue. That’s one reason why washing alone makes them difficult to combat.
In six to nine days, the eggs hatch, the first juvenile nymph stage appears and the life cycle is on.
— Richard Watts
