Head Itch What really can help against lice infestation

Although lice are harmless, they are often difficult to eradicate
What's the best way to fight lice? Experts from Charité-Universitätsmedizin Berlin and the Institute for Quality and Efficiency in Health Care (IQWiG) report on why lice even colonize humans and how to get rid of them. The journal dermatologie hautnah in its issue 4/17 deals extensively with the head louse. An expert describes the way of life of the parasites and the best ways to get rid of the lice.

Head lice are relatively persistent parasites that do not disappear after infestation. Treatment is urgently needed, especially to avoid further spread. However, health risks are generally not met by the lice, according to the Institute for Quality and Efficiency in Health Care (IQWiG) on its Patient Information Portal.

Parasites such as fleas and lice were the ideal disease vectors. (Image: fotoliaxrender / fotolia.com)

For the treatment of head lice different means are available, which enable an effective removal of the parasites - many of them do without insect venom, according to the IQWiG. However, care must be taken to ensure proper treatment to ensure successful treatment. Therapeutic options range from mechanical lice comb control to oily products that are designed to stifle parasites, to insect venom. "The treatments differ in their effectiveness as well as in their advantages and disadvantages," reports the IQWiG.

Mechanical elimination with the lice comb
A typical indication of a lice infestation is annoying, persistent head-numbing. Although the parasites do not pose any further health risks, treatment should be provided to prevent transmission. The oldest method is mechanical removal. For this the lice comb is available. With wet hair this is used and with closely spaced tines (maximum distance 0.2 to 0.3 millimeters), the lice can be pulled from the hair. For the elimination of the eggs (Nissen) also special Nissenkämme are available, with still small distances of the tines.

According to the IQWiG, combing with a lice comb or Nissen comb can be made considerably easier by the prior use of a hair conditioner. In addition, when combing each strand should be carefully checked at least twice. Although the Läusekamm contributes in any case to a reduction in the infestation, but a safe elimination of parasites is not guaranteed in this way, reports the IQWiG. A few lice may remain in the hair, so combing is not recommended by professionals as a sole treatment, but only as a supplement.

Agent with silicone and vegetable oils as an alternative to insecticides
Special insecticide-based remedies have been available for decades to ensure safe elimination of head lice infestation, but the use of hard chemicals is reluctant to many parents and they are therefore looking for alternatives. Also, the head lice against the insecticidal-based agents with increased use resistances, which is why the funds "in France, Britain, Denmark and the Czech Republic are now much less effective," reports the IQWiG.

To what extent lice have developed resistance in Germany has not been investigated. As a replacement for the conventional insecticidal agents, products have been developed without poisons such as silicone or vegetable oils. The preparations work by covering the lice and their eggs with a thick layer of oil and thereby suffocating them, according to the IQWiG. The advantage of these remedies is that the lice can not develop any defense mechanisms. However, the specifications for the application are urgently to be observed here. It is used on dry hair to avoid diluting the product.

A special lice comb is important to recognize the small pests in the hair well. (Image: Lars Zahner / fotolia.com)

Repeat treatment required
It is fundamentally important to remember that all lice remedies need to be re-used after seven or eight days as the lice 's eggs can survive treatment, IQWiG reports. The second treatment will ensure that "even the lice that hatched the week after the first application are killed." When used correctly, there is a good chance of getting rid of the head lice by treatment, but none of the products are 100% effective , the IQWiG continues. If necessary, it would require a renewed therapy.

When are children allowed to return to the kindergarten or school??
Until a treatment of the infestation with a therapy 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 one week," explains the IQWiG. Recognized effective therapies include insecticidal-based and silicone-based agents. The Robert Koch Institute (RKI) has also published a list of officially recognized funds. In the pharmacies this can also be given information. While natural home remedies for head lice are also helpful, they are not among the "recognized" treatments and early return to facilities is not possible. (sb, fp)