Head Lice: Harmless but difficult to get rid of
Head lice are relatively stubborn parasites that do not go away on their own after an infestation. Treatment is urgently needed, especially to avoid further spread. However, lice do not generally pose any health risks, reports the Institute for Quality and Efficiency in Health Care (IQWiG) on its patient information portal.
There are various means available to treat head lice that enable the parasites to be effectively removed - many do not require insecticide, according to the IQWiG. However, correct application must be ensured to ensure successful treatment. The possibilities of therapy range from mechanical control by means of a lice comb, to products containing oil that are intended to suffocate the parasites, to insect poison. "The treatments differ in their effectiveness as in their advantages and disadvantages," reports the IQWiG.
Mechanical elimination with the lice comb
A typical indication of a lice infestation is the annoying, persistent head itch. Although the parasites pose no further health risks, treatment should be undertaken to avoid transmission. The oldest method is mechanical elimination. The lice comb is available for this. This is used when the hair is wet and the lice can be pulled from the hair with the tines standing close together (maximum distance 0.2 to 0.3 millimeters). Special nit combs are also available to remove the eggs (nits), with the tines still spaced apart. According to the IQWiG, combing with a lice or nit comb can be made significantly easier by using a hair conditioner beforehand. In addition, each section should be carefully checked at least twice when combing. Although the lice comb helps to reduce the infestation in any case, the IQWiG reports that the parasites cannot be safely removed in this way. A few lice may remain in the hair, which is why combing out is not recommended as a single treatment, but only as a supplement.
Agent with silicone and vegetable oils as an alternative to insecticides
Special insecticide-based agents have been available for decades to ensure that head lice infestation can be safely removed, although many parents are reluctant to use harsh chemicals and are therefore looking for alternatives. The head lice also develop resistance to the insecticide-based agents when used more, which is why the agents “have become much less effective in France, Great Britain, Denmark and the Czech Republic,” reports the IQWiG. The extent to which lice have developed resistance in Germany has not yet been investigated. Products without poisons, such as those with silicone or vegetable oils, have been developed to replace conventional insecticide products. The preparations work by covering the lice and their eggs with a thick layer of oil and thereby suffocating, so the IQWiG. The advantage of these agents is that the lice cannot develop any defense mechanisms. However, the guidelines for use must be observed here. It is used on dry hair to avoid thinning the agents.
Repeat treatment required
It is fundamentally important to take into account that all anti-head lice remedies have to be used again after seven or eight days, since the eggs of the lice can survive treatment, reports the IQWiG. The second treatment ensures "that the lice that hatch in the week after the first application are also killed." When used correctly, chances are good to get rid of the head lice through the treatment, but none of the products work 100 percent , the IQWiG continues. If necessary, a new therapy would be necessary.
When are children allowed to go back to daycare or school?
Until the infestation is treated with a therapy that is recognized as effective, the affected children may not go to kindergarten or school, the IQWiG continues. However, they can go back to the facilities after the first treatment. "It is therefore not necessary to wait for the second treatment after a week," explains the IQWiG. Effective therapies are recognized as insecticide-based and silicone-based. The Robert Koch Institute (RKI) has also published a list of officially recognized funds. Information can also be provided in the pharmacies. Natural home remedies for head lice also offer help, but they are not among the "recognized" treatment methods and an early return to the facilities is not possible here. (fp)