WhiteCoat

Ectoparasitosis

lice1

lice2

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This poor girl had the worst case of head lice I have ever seen. This is what the “nits” (eggs) look like, but I actually saw a couple of live adult lice. The poor kid and her mom were frustrated because they couldn’t get the dandruff off of her hair.

nit-picking
After we discharged them, everyone in the ER had itching fits. One person would itch their head, someone else would see them and say “stop it!” Before long everyone was itching their heads. Then everyone had to check each other’s scalps like a bunch of little monkeys to make sure that none of the lice had jumped from the room to a passerby to the nursing station, crawled up someone’s sleeve, and secretly attached to their scalp. A real-life example of the term “nit-picking
(picture credit to http://blog.erck.org/?cat=21)

head-louseHow to treat lice?

Most medications don’t kill the “nits,” they only kill the mature “hatched” lice, which aren’t much bigger than the nits, but are harder to see. The live lice are slow-moving and about the size of a sesame seed. Medications therefore have to be reapplied in seven days to get all of the lice that have hatched since the last treatment. You have to comb through the hair with a fine-toothed comb to remove all of the nits from the hair shafts.
Wash clothes and bedding covers in hot water and vacuum the house and you should be fine.
For a guide from the CDC on treating head lice, click here. A good Wikipedia article on head lice is here.

Now stop itching.

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21 Responses to “Ectoparasitosis”

  1. Carol says:

    Group itching happens in pharmacies too….

  2. Nurse K says:

    Group itching happens at meth houses as well.

  3. Elizabeth says:

    Wasn’t the child complaining of intense itching ?
    I’m scratching just looking at the photos :-)

  4. SeaSpray says:

    Scabies and lice-oh my!

    Oh that would set me to itching every time! I would THOROUGHLY wipe down everything I felt they came in contact with! I felt sorry for them but the psychological itch factor – YIKES!

    One of our nurses got scabies because she was holding a baby for a parent and her shirt had come up and her stomach had gotten exposed.

    While the thought of these critters on our bodies is disconcerting even more so is the mental anguish I have in imagining “ALL” the things that I would think need to be washed, cleaned and sanitized throughout the house (including the pets)and then the thought of reinfecting somehow and having to start all over! (my scalp is itching now! Gee!) :)

  5. Holly76209 says:

    One of the FIRST lessons I learned as a “baby” Social Worker was to never sit on upholstered furniture when doing a home visit. Always sit on a plain chair or stand.

    The VERY first thing I was taught was to NEVER, EVER under any circumstances, EVER let the client get between you and the door.

  6. Rachel says:

    Argh, I’m itching just looking at this. One week in college, I got lice (college kids tutoring little kids, plus the aforementioned upholstered furniture=bad), food poisoning, and a UTI. In the same week. I may have to go shower now. ;)

  7. misspudding says:

    You should’ve followed up your antibiotic-resistance rant post with one about how most of the pesticides used to kill lice are actually becoming ineffective because of resistance.

    “The More You Know”

  8. SeaSpray says:

    Holly, I know exactly what you mean. One of my other hats aside from working at the hospital was working as a Lifeline rep for which part of the job was to go out in the field to install units and to follow-up technical issues etc. I always joked that it was a job that I would pay the hospital to do. :) Our hospital had a contract with Lifeline. I LOVED that job and the people I visited. Most places were clean…but there were a few that I did not dare sit down, drink when they offered a beverage and while I always was pleasant I secretly couldn’t wait to get out. One place I felt like the odor was on my clothing all day! One day I didn’t bring my cell phone and so I had to use the persons phone to call the main headquarters about a technical issue and that is never a fast call. I was dying a thousand deaths because the environment wasn’t exactly wholesome and the phone had so much crud on it that it was unnerving me that it had to go on my ear, near my face and in my hair. Scabies occurred to me that day. I know it was too late but I did shower when I got home that day.

    Our hospital actually had fabric furniture in the waiting room years ago!

    Good idea about keeping exit area open but I didn’t have a choice..I often had to go into the bedrooms, etc.

    Also, often in some of these more challenging places they were nice people that were in serious need of assistance of some sort and couldn’t always afford it and didn’t have anyone to help and they couldn’t. And then some…it was a lifestyle and maybe they could have benefited from some intervention.

  9. Dee says:

    I get the creeps when nurses put 4 or 5 family members in one room with infestations. It takes me a week to feel secure again and stop sucking my thumb. I’d rather treat over the phone.

  10. Anony says:

    omg, did u really had to post that pic? I was taking a bite into my tasty sandwhich dinner and that just totally killed my appetite.

    I refuse to read your blog until that entry with the pic goes onto page two.

  11. Marlaquack says:

    Last year we had a really nasty outbreak of lice at my house. I had a kid who had been very itchy for weeks,but I could not see anything on her head (and I did look). By the time I found it it was bad. I tried 3 different chemical treatments on her. I hated doing it but because she had opened sores on her head, but I had to kill them. None of the over the counter products worked and I spent about $100 on them. As a matter of fact as I was combing out her hair the bugs were crawling around. I’d drip them into a plate with pure bleach or vinegar and they would swim out. The only thing that killed them was dropping them in a candle. Finally I called a friend who told me what to do. I covered their hair in mayonnaise than a plastic bag and left it on for 3 hours. Next I took tea tree oil (which I purchased at Target very important because it’s 1/4 the price of the health food store) and mixed it with shampoo, about 1 tsp of oil to the amount of shampoo for 1 application. I put the mixture on and let it set for 30 minutes than shampooed it off. Lastly I rinsed their hair with warmed vinegar. That killed all the bugs. After the initial treatment I washed their hair with tea tree oil each day for several days and used and electric lice comb with a small metal lice comb. I had to repeat the treatment at about 10 days, but it was much less traumatic (for both of us) the second time.

    I don’t handle bugs well.

  12. Christine says:

    When I worked in Nepal, all the kids in the villages knew they could freak me out by looking at my hair and saying “Zumra cha!” (There is lice!)

    Oddly enough, with all the different homes I slept in, I never once got lice. A colleague of mine who was super paranoid about lice (and always used her own bed linens and pillow when staying anywhere) got a nasty infestation. She had long curly hair and we spent the better part of 2 days killing the lice and combing the nits out. *shudder*

  13. Stick to the natural lice treatments and you cant go wrong

  14. Sam says:

    I have had head live I was about 5/6 I’m now 15, there obivously has been times for a few months were I haven’t had them but they seem to come back, I have tried every lice shampoo on the market and nothing works, I now have a new born baby sister and I’m scared to hold her invade I give them to her which would be unfair as she is a baby, my head is full of scabs at about 1cm diameter there really big, my head is sore very itchy, it’s getting to the point were I’m itching and my scalp bleeds! Please help of u have any adive, and if any one could tell my why my scalp has gone like this please let me know thanks.

    • Sam: i know its a little late but you cant get rid of lice without getting it out of the carpet, clothes, bedding, upholstry etc. You need to not use the chemical treatment they are not good. when all else fails use them. buy a nit comb. soak your head in mayo. Real mayo its disgusting. put a bag over it and sit under a dryer ( or put a hair dryer to it)for a few hours. it will smell be prepared. next rinse with Pure listerine. then mix with pure vinegar. after that shampoo three times with paul mitchell tea tree shampoo. a small bottle will do fine and comb hair with a small tooth comb in shower after. do not condition. once finished take the nit comb and comb out all nits. its going to have to be treated in about another 3 days because the eggs left behind will be treated. remember lice cant jump but its important for you to keep checking yourself. if it looks like a small tear drop and cant be pull off the hair shaft. its a nit. you can also buy a prevet. once you are all clean. its called fairy tale look at it online. its very efficient. also, HAIRSPRAY will be your best friend.

  15. Tim says:

    Sam, It’s great that you are concerned about you little sister. Keep in mind though, that you might have something other than lice. You could have some sort of eczema like Seborrhoeic dermatitis (see image of scratched eczema: http://en.wikipedia.org/wiki/File:Eczema.jpg).
    I would have it checked out by a dermatologist. Any open, bleeding could result in an infection (not good)

  16. Sam says:

    tim thanks for the advice, went to see a dermatologist today and turns out I had 12 open wounds on my head, if it wasn’t for u I could of had serious head problems, he also prescribed me with medecation to stop me itching but I have yet 2 find a cure for these horrible lice!!!!:@

  17. Emery says:

    Sam, read up online as much as you can – I don’t know if pets can harbor them, but your bedding and/or furniture can. Your county public health department should also have information available; good luck!

  18. Sharon H. says:

    Oil kills insects, because they breathe through their exoskeletons and oil closes the openings so they smother.

    Apply any oil to the head and hair, leave for 3 days, then shampoo out. You can wear a shower cap to protect your pillow. :-) And of course wash all bedding & clothing in hottest water.

    No heavy-duty poisons needed.

  19. brandi says:

    well i have had them alot this year. my lil girl goes to school and gets them. only thing that works is manyosse.! i will try the tree oil.
    hope this helps. if you have long hair then use a whole bottle of maynosee and leave in on for 3 to 4 hours. wash everything in hot water!

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