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Parents urged to take up combs, not shampoos

Experts say only a hands-on approach will solve the stubborn problem of head lice.

Warning to readers: Prepare to itch!

While parents are making their back-to-school preparations _ taking kids to the stores for new clothes, shoes and school supplies _ they should think about making a trip closer to home, say through the strands of their children's hair, where they might just spot some nasty critters hiding out.

In an effort to get a handle on what seems to be a resistant head lice problem, the National Pediculosis Association is calling for a "Back to School All Out Comb Out."

While many schools conduct head checks on a regular basis, the NPA is telling parents that they should keep an eye out for the creepy crawlers and their nits (eggs) before school starts.

That advice is echoed strongly by the Pasco County school system, said Marilyn Koop, registered nurse andsupervisor of health student services. "We need to get parents involved because we need more man power," Koop said. "The school can't do it without the assistance of the parents. They should be regularly checking their children's hair."

An ounce of prevention is worth a pound of pain, said NPA president Deborah Altschuler. Parents who have a handle on the louse situation ahead of time might have a better chance of getting through the school year without having to pull their kids from school until they're parasite free or investing in and exposing their children to shampoos containing what the NPA deems potentially harmful and sometimes ineffective pesticides.

"We know that the chemical approach without thorough nit removal isn't working," said Altschuler, who founded the NPA in 1983 after dealing with resistant lice infestation with her own children. The organization, a non-profit health education agency based in Massachusetts, has a mission to protect children and their families from the misuse and abuse of potentially harmful lice and scabies pesticide treatments.

Over the years, Altschuler has heard all the horror stories: from parents who have severely burned their children using kerosene (an ineffective and obviously dangerous treatment) to those who have improperly and continuously used pesticide shampoos. She decided to look for alternative treatments after her children's pediatrician repeatedly prescribed a shampoo containing lindane. "This stuff is chlorinated benzene," Altschuler said. "I went nuts."

Benzene, a colorless liquid hydrocarbon, is carcinogenic and highly flammable. Shampoos containing lindane can only be obtained with a doctor's prescription and come with a warning to consumers that neurotoxicity _ damage to nerves or nerve tissues _ is a possible side effect. The FDA advises that lindane only be used as a last resort. But even with that restriction it could pose a danger to children who already have been exposed to every over-the-counter pesticide shampoo available, Altschuler said.

The NPA stresses that parents should be on the offensive and willing to roll up their sleeves when it comes to lice and nit removal. "None of this is complicated. This is traditional communicable disease control; sometimes the best defense we have is early detection," said Altschuler, who touts the NPA's Licemeister comb as the best preventive measure. "When the kids shower at night, someone combs their hair. We're just telling them to comb it with an effective tool."

The comb, which can be purchased for $14.95 through the NPA, is a wonderful investment, Koop said. "Response from our parents is that it cuts the combing time and that it's the only comb that was able to get the eggs out."

The Licemeister also comes highly recommended by Lidia Serrano, a former school nurse and owner of Lice Source Services in Plantation. Serrano and her team of nurses see a steady stream of customers willing to pay $85 for a two-hour session to have their children deloused.

"When parents come here, they're usually at their wit's end," said Serrano, who also works with the local schools as well as researchers at the University of Miami and University of Massachusetts who are studying lice resistance.

Serrano said she uses only natural products to kill the bugs before she gets into the nit-picking process. "Parents have to realize that the eggs have to be removed manually; nothing out there is going to kill the eggs. It's time consuming, but it really has to be done," Serrano said.

Koop said she has fielded her share of phone calls from desperate and sometimes angry parents who want the schools to fix the problem. But schools don't get lice, people do, she says.

"It isn't realistic to spray a school with pesticides because, first of all, the sprays are very toxic. We have kids with allergies and asthma who could be at risk," Koop said. "Besides, the building is empty on Friday afternoons until Monday morning, and the experts tell us that lice cannot live off a host, cannot survive without human blood for 24 to 48 hours, so the school is in effect fumigated (every weekend) because the school is empty."

"Kids with a continuous head lice problem are staying infested, not getting reinfested," Altschuler said. "Their parents aren't getting all the nits out. It just makes sense _ if you want to get rid of the chickens you better be stomping on the eggs.

Koop said she is relying on education to tackle the lice problem in Pasco schools. Last year, she met with a committee to set procedure and give parents the latest information in an easy-to-read brochure that includes helpful hints from the NPA as well as advice to parents to consider natural solutions such as HairClean 1,2,3 _ which can be found in some health food stores.

School nurses also will be heading into the classrooms to educate children about the life cycle of lice and how to prevent infestation.

"It's really very much a head-to-head situation," Koop said. "We're advising students to keep their heads apart and not share combs, brushes or hats, so children will understand it and hopefully be careful of their contact. It's just like telling them to cover their mouths when they cough when they have a cold."

10 steps to help keep head lice and their eggs out of your child's hair

1. Watch for signs of head lice, such as frequent head scratching. Anyone can get head lice, mainly by head-to-head contact, but also from sharing hats, brushes and headrests. Lice do not jump or fly.

2. Check all family members for lice and nits (lice eggs) at least once a week. Only those infested should be treated. Lice are reddish-brown wingless insects (about the size of a sesame seed); nits are grayish-white, always oval shaped and are glued at an angle to the side of the hair shaft.

3. Be sure not to confuse nits with hair debris such as bright white irregularly-shaped clumps of dandruff stuck to the hair shaft or elongated segments of dandruff encircling the hair shaft and easily dislodged. Lice treatment is not appropriate for hair debris.

4. Consult your pharmacist or physician before applying or using lice treatment pesticides when the person involved is pregnant or nursing, has allergies, asthma, epilepsy or pre-existing medical conditions or has lice or nits in the eyebrows or eyelashes. Never use pesticide on or near the eyes.

5. Remember, most lice-killing products are pesticides. If you choose to purchase an over-the-counter treatment, follow the directions carefully and use with caution. The NPA strongly discourages prescription treatments containing lindane. Based on increasing reports of head lice resistance on a national level, the NPA advises parents to discontinue their use at the earliest sign of treatment failure. Manual removal is the best alternative whenever possible and especially when treatment products have failed.

6. Follow package directions carefully. Use the product over the sink, not in the tub or shower. Always keep the eyes covered.

7. Remove all nits. This assures total lice treatment. Separate hair in sections and remove all attached nits with the NPA's Licemeister comb, baby safety scissors or your fingernails.

8. Wash bedding and recently worn clothing in hot water and dry in hot dryer. Combs and brushes may be soaked in hot water (not boiling) for 10 minutes.

9. Avoid lice sprays. Vacuuming is the safest and best way to remove lice or fallen hairs with attached nits from upholstered furniture, rugs, stuffed animals and car seats.

10. Notify your child's school, camp, child care provider and neighborhood parents. Check for lice on a regular basis. This is the best way to protect your family and community.

Source: The National Pediculous Association. To contact the National Pediculosis Association, write P.O. Box 610189, Newton, MA 02461. Call (781) 449-NITS, ext. 101, fax (781) 449-8129, or access their Web site at