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Head Louse – Symptoms, Causes and Treatment

The head louse is a small insect that lives on the human scalp and feeds on blood. Head lice infestations are very common, especially among school-age children.

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Things worth knowing about "Head Louse"

The head louse is a small insect that lives on the human scalp and feeds on blood. Head lice infestations are very common, especially among school-age children.

What Is a Head Louse?

The head louse (Pediculus humanus capitis) is a wingless, blood-sucking insect that lives exclusively on the human scalp. Head lice are among the most common parasitic conditions in childhood and occur worldwide. They are approximately 2–4 mm in length, grayish-brown in color, and visible to the naked eye. Their eggs, known as nits, are firmly attached to hair shafts and are most commonly found near the neck and behind the ears.

Causes and Transmission

Head lice are transmitted almost exclusively through direct head-to-head contact. Transmission via objects such as combs, hats, or towels is possible but uncommon. Head lice cannot fly or jump – they simply crawl from one strand of hair to another.

Close physical contact (e.g., in schools or daycare centers)
Sharing combs or hairbrushes
Sleepovers with affected individuals

Symptoms

The primary symptom of a head lice infestation is intense itching of the scalp, caused by the saliva that lice inject while feeding. Additional signs include:

Itching especially behind the ears and at the nape of the neck
Visible lice or nits in the hair
Redness or small sores from scratching
In rare cases: swollen lymph nodes in the neck

Diagnosis

Diagnosis of a head lice infestation is made by careful visual inspection of the hair. A fine-toothed lice comb (nit comb) is particularly useful. Live lice or nits found close to the scalp (less than 1 cm from the root) confirm an active infestation. Nits found further from the root may already be dead.

Treatment

Pharmacological Treatment

Several pediculicides (anti-lice products) are available for treatment:

Permethrin: A synthetic insecticide that paralyzes the nervous system of lice. Widely used and well tolerated.
Dimethicone: A silicone oil that kills lice and nits by suffocation. No known resistance issues.
Pyrethrum extracts: Natural insecticidal compounds derived from the chrysanthemum plant.

Mechanical Treatment

Combing with a nit comb, ideally combined with a conditioner or special gel, physically removes lice and nits. This method is particularly suitable for young children or those who prefer to avoid chemical treatments.

General Measures

Check close contacts (family members, classmates) and treat if necessary
Wash clothing, bed linen, and towels at a minimum of 60 degrees Celsius
Clean and disinfect combs and hairbrushes
Notify the school or daycare center of the infestation (mandatory in many countries)

Prevention

Complete prevention is difficult, as head lice infestations are not related to poor hygiene. However, the following measures can reduce the risk:

Regularly checking hair, especially after school trips or sleepovers
Tying or braiding long hair
Not sharing personal hair care items

References

Robert Koch Institute (RKI): Information Sheet on Head Lice. Berlin, 2023. Available at: https://www.rki.de
Centers for Disease Control and Prevention (CDC): Head Lice – Diagnosis and Treatment. Atlanta, 2023. Available at: https://www.cdc.gov
World Health Organization (WHO): Ectoparasites – Pediculosis. Geneva, 2021. Available at: https://www.who.int

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