Head lice are parasites that live on the scalp and cause an itchy scalp. This parasite is commonly found in preschool and school age children, namely children aged 3-11 years. The medical term for the disease caused by head lice is  Pediculosis capitis .

A person can get head lice due to contact with the head of another person who has head lice. This is different from the assumption in the community that head lice appear as a result of poor hygiene of the hair and scalp, or as a result of being infected by animals.

Head lice are generally harmless parasites to humans. However, untreated head lice can cause discomfort and irritation to the sufferer as a result of scratching the itchy scalp.

Causes of Head Lice

In medical terms, head lice are known as Pediculus humanus capitis . Adult head lice are generally the size of a sesame seed and brown or gray in color. The parasite can survive for up to 30 days on the human scalp, but usually dies within 12–24 hours of shedding from the hair.

Head lice are most often transmitted through direct contact with the sufferer's head. Without direct contact, head lice cannot move from one head to another. This is because head lice cannot fly or jump.

Although unable to fly or jump, head lice can crawl quickly. This allows head lice to move from the sufferer's head to another person's head through things used on the head, such as hats, scarves, combs, hair clips, pillows, towels, and  headphones .

Contagion can also happen indirectly if someone keeps those things in the same place as things belonging to the sufferer. For example, putting clothes in the same closet as the sufferer, or when hanging hats and scarves on the same hook as the sufferer's belongings.

Symptoms of Head Lice

Symptoms of head lice are  itching on the scalp , which can spread to the neck and ears. This itchiness arises as a result of the human skin's reaction to tick saliva. In addition to itching, sufferers can also feel a tickling sensation of something crawling on the scalp.

When should you go to the doctor?

Hair lice are parasites that can be overcome with a comb, as well as a special liquid or shampoo that kills lice sold over the counter. If you have done self-treatment at home but the head lice have not disappeared, consult a  doctor immediately .

Diagnosis of Head Lice

Doctors can detect head lice by asking about symptoms and examining the patient's hair to see if there are lice or lice eggs. If the lice cannot be seen directly, the doctor will use a serit comb, which is a special comb that can catch hair lice and lice eggs.

Here are the steps in using a comb:

  • Comb the patient's hair using a normal comb first, to untangle the tangles
  • Comb the patient's hair with a comb slowly from the scalp to the ends of the hair
  • Ensure that the entire hair area is combed evenly

After that, the doctor will check if there are lice or lice eggs stuck in the comb on each comb. If the tick cannot be seen clearly, the doctor will use a magnifying glass.

If the diagnosis still cannot be established, the doctor will perform an examination using a Woods lamp . Woods lamp is a device that can emit ultraviolet light and is commonly used to detect various disorders on the skin, such as bacterial and fungal infections, as well as vitiligo .

In this procedure, the doctor will light the Woods lamp and shine it on the patient's scalp at a distance of 10-12 cm in a dark room. Hair lice and lice eggs will be seen shining under the light of the lamp.

Hair Lice Treatment

As mentioned above, one way to get rid of head lice is to comb wet hair with a comb. Combing is done every 3-4 days, at least for 2 weeks, to ensure that there are no more lice in the hair. This therapy can also be combined with the use of lice exterminating shampoo.

Another handling step that can be done is the use of shampoo that contains permethrin . This shampoo is sold over the counter and can be bought without a doctor's prescription. The use of shampoo can be done independently at home, with the following steps:

  • Remove clothing before using shampoo for head lice.
  • Do not use conditioner or shampoo with conditioner before applying the lice shampoo.
  • Use hair lice medicine according to the instructions on the medicine package.
  • Use the shampoo all over the scalp and hair, when the hair is half dry. For sufferers with long hair, use 2 bottles of head lice shampoo if necessary.
  • Rinse hair after 10 minutes.
  • Do not wash your hair for 2 days afterwards.
  • Use a comb to remove dead fleas.
  • If necessary, cut the hair short to facilitate treatment.

If the movement of head lice is still felt, do not repeat the head lice shampoo treatment directly. Keep in mind, head lice shampoo cannot  kill lice eggs . Therefore, the use of this shampoo needs to be repeated 7-10 days after the first treatment, in order to eradicate newly hatched lice.

To get rid of lice and their eggs, the best way to do it is to use a comb while the hair is still wet. Comb the hair daily with a comb for 2–3 weeks, to make sure all lice and lice eggs are gone.

Not only on the head, the items used should also be cleaned of lice. The following are examples of items that need to be cleaned from fleas and how to clean them:

  • Wash clothes, sheets, and pillowcases in hot water, then dry in the sun
  • Soak the comb, band, and hair clips in hot water for 5–10 minutes
  • Cleaning floors, carpets, chairs, and sofas with a vacuum cleaner
  • Put items that cannot be washed into a tightly closed bag, then store them for 2 weeks

It is important to remember, do not use insecticide sprays, as they will be dangerous if inhaled or absorbed into the skin. In addition, always read the rules of use of the drugs used, to prevent the abuse of drugs.

If the head lice still do not go away with the treatment above, consult a doctor. Doctors can give other types of lice exterminating liquid, such as malathion  ivermectin , or  spinosad . In addition, the doctor can also give  cotrimoxazole to drink  which can be used as a way to get rid of head lice .

Complications of Head Lice

Head lice that are not treated well will cause itchiness on the scalp that makes the sufferer scratch their head continuously. Itching will be felt more at night, because ticks are more active in dark conditions. This condition can cause sufferers to experience sleep disturbances .

Other complications from head lice that sufferers can experience are:

  • Rash and scalp damage
  • Anemia due to infection
  • Bacterial infection of the skin ( impetigo )
  • Stress

Prevention of Head Lice

There are several steps that can be taken to prevent the appearance of head lice. This preventive measure should also be done by people who have been affected by head lice, so that head lice do not come back. Some of the efforts that can be made are:

  • Avoiding contact with other people's heads when doing activities together
  • Do not share the use of personal items, such as clothes, hats, towels, and pillows
  • Do not lie on a sofa, carpet, or bed that has just been used by the sufferer, unless it has been cleaned with a vacuum cleaner .
  • Wash the victim's clothes with hot water, then dry them in the hot sun
  • Wash the items used by the sufferer, either using warm water or with the  dry-clean method
  • Put the patient's belongings that cannot be washed into a bag and close it tightly for 2 weeks
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