by Janet Brown
Treating Head Lice
Any parent of young children has had
experience with head lice, or at least knows somebody who has. It is
a very common problem, one that spreads quickly. Head lice can work
themselves through an entire classroom in no time,
Parents want to rid their children of lice
as quickly as possible. Unfortunately, many compounds used to treat
lice contain pesticides like lindane that can be highly toxic to humans.
As health professionals, we have a responsibility to educate ourselves and
our patients about the potential harm associated with these treatments.
Slathering a child's head with toxins that can be absorbed through the
skin, inhaled, or ingested as children put their hands in their mouths, is
questionable from an overall health viewpoint.
Lindane, commonly used in lice treatments,
is ranked by the Agency for Toxic Substances and Disease Registry as one
of the top chemicals of concern (it ranked 33 out of 275). Lindane
is an organochlorine nerve poison. It's a known carcinogen, and
banned in California. Acute symptoms of lindane poisoning include
headache, nausea, vomiting, diarrhea, tremors, weakness and convulsions.
If that isn't enough to deter you, it's also an endocrine disruptor and a
persistent organic pollutant that shows up in breast milk and amniotic
The National Pediculosis Association (NPA)
is a not-for-profit organization with a mission to protect children from
misuse and abuse of potentially harmful lice and scabies pesticidal
treatments. The National Pollution Prevention Roundtable (NPPR)
recently awarded NPA a "Most Valuable Pollution Prevention" award for its
Lindane Usage Reduction Project.
On NPA's website, parents share
heart-wrenching accounts of serious health effects following pesticide use
in treating their children. A common thread among the stories is
lack of education: Most had no idea that the products they used contained
hazardous chemicals. Parents assume that if something is
FDA-approved, it is safe. Unfortunately, it's more complicated than
that. The FDA issued a public health advisory on lindane,
documenting serious side effects and deaths. Lawsuits have been
filed against makers of some pesticide-containing products.
Despite the best screening efforts of
school nurses, childcare providers, and parents, outbreaks of head lice
still do occur. We can't entirely prevent them, but we can get rid
of lice without pesticides. We can reduce the potential for spread
of lice by avoiding the sharing of brushes and combs, dress-up costume
boxes, or naptime blankets, and by checking children regularly.
Do a Google search for "lice removal" and
you'll find many nontoxic nit removal products. One is made of
orange extract, citric acid, yucca and vegetable-based Glycerin.
Another is a 'botanical formula'. It is not possible in this column
to evaluate the various nontoxic products on the market; the NPA is a
valuable resource for this type of information.
One option provided on NPA's website is
cutting the child's hair until it is 1" long. For boys,
particularly, this might be the easiest non-chemical option. Here's
a listing of some other non-toxic options from the National Pediculosis
Top Ten Strategies for Non-Toxic Nit
- Conduct nit and lice removal in a
well-lit area, either with natural sunlight ort a bright lamp.
- Brush the hair to remove tangles with a
regular brush or comb, Clip the hair up that is not being
- Use NPA recommended "LiceMeister comb"
(a stainless steel comb available through the website) to detect lice
- Section by section, go through the hair
meticulously and dip the comb into water or use the LiceMeister comb
cleaning device to remove lice, nits or debris.
- After looking for lice, look through the
same section of hair for nits.
- If you use over-the-counter treatment,
try to avoid all pesticides. If you choose to use a
pesticide-containing product, educate yourself.
- Wash bedding, stuffed animals and combs
and brushes. Vacuuming is best for nit removal.
- Use the LiceMeister comb cleaning device
between the teeth of the comb. Boil before use on different
- Continue to screen for several days to
make sure no nits were missed. Careful screening is crucial in
ensuring that all are removed.
- Should you find more nits, remove them
and continue screening regularly.
Janet Brown is the Partner Coordinator
for Hospitals for a Healthy Environment Program, New York, New York.
Their goals are to reduce the toxicity and volume of health care waste and
to eliminate mercury from the health care practice. Learn more about
the organization at: