02.03 Pediculosis Capitis

Hi there! In this lesson we are going to talk about Pediculosis Capitis - or head lice!

So I´m just going to warn you now that your skin is going to be crawling by the end of this lesson. Mine already is from prepping the lesson so get ready to join me.

Head lice is a very common problem for school-age kids. The bugs infest the hair and scalp and then lay their eggs. Then it's all transmitted to other people through contact - usually through personal items like toys, hats, coats, hair brushes. So the first picture here is of the lice bug. The second is of a nit or egg attached to the hair follicle.

The primary complaint or noticeable symptom is just itching. When looking closely at the hair you may be able to see movement from the bugs, but usually what people find are the little white eggs attached to pieces of hair. There´s no fancy test or diagnosis here just visual detection of bugs or nits.

If you suspect lice or are a school nurse checking the heads of kids then make sure you wear gloves!

So what do we do if someone has lice. Most medications can be gotten over the counter now and the most commonly used is Permethrin 1%. It requires 2 applications- the second one being 7-10 days after the first.

So if we can treat it - why is it so common! Honestly guys, I get a message once a week from my kids school about lice. This is because it takes serious vigilance to get rid of these determined little bugs. There is some evidence that the bugs are becoming resistant to the medications so in order to really make sure they are gone parents have to manually remove the eggs after killing the bugs with the medications. The eggs can really hang onto the hair follicles so parents need to use a fine tooth comb daily until the eggs are definitely, 100% gone. So that's how you get it out of the head of 1 kid.

Then you have to try and get the eggs and bugs off all hats and scarves and coats that are piled up in a classroom. Obviously, we can’t just spray the whole room with pesticide so all the linens and clothes need to be washed in hot water. Hair care devices need to be soaked in boiling water for 10 minutes. And anything that can’t be washed needs to be sealed in a ziplock, sealed tight bag for 2 weeks! So you can see it's not actually an overnight solution.

Kids and parents can get really embarrassed by this diagnosis - so it's important to tell people that head lice can happen to anyone and it’s not at all associated with cleanliness or socioeconomic status.

Your priority nursing concepts for the patient with pediculosis capitis are infection control and tissue/skin integrity

That's it guys! Head lice is a super straight forward diagnosis. Your key learning points for this lesson are to First, know that it's a common parasite in school age kids that is usually spread through contact with infected personal items. Second, remember that it is treated with medications like permethrin 1%, but that it can be really tough to get rid of, so meds need to be followed by manual removal. Third, educate kids to try and prevent any bullying and embarrassment.

That’s it for our lesson on pediculosis capitis.. Make sure you check out all the resources attached to this lesson. Now, go out and be your best self today. Happy Nursing!