Head-scratching condition may be on the rise

LACONIA — Breanna Neal, owner of Polished and Proper Barbershop and Shave Parlor on Main Street, said her shop has seen more cases of head lice in the past six weeks than in the last seven years – eight since mid-January, compared to three between 2013 and 2020.  

One customer was age 15.  The rest were in elementary or preschool.

“We’re taught in (barber) school how to check,” said Neal. “We’re always looking for lumps, bumps, moles and critters” – and anything moving on scalps, or tiny, greyish tear drop-shaped eggs clinging to hair follicles.  “We all have the same human reaction.  If anyone talks about head lice, your head starts to itch.”

Each year, an estimated 6 to 12 million American children ages three to 11 experience head lice, an infestation of parasites that live in hair and feed on human blood, but cause no known medical complications other than extreme itchiness, typically on the head, back of the neck, or behind the ears, according to the Centers for Disease Control and the American Academy of Pediatrics.  They’re officially declared a nuisance. They mainly cause discomfort and embarrassment.  

Lakes Region school districts who responded for this story – Laconia, Gilford, Winnisquam and Franklin – are not reporting above-average numbers so far this year. “We’re not seeing a spike on our end,” said Laconia School Superintendent Steve Tucker.  Gilford school nurses have seen none, said the district's superintendent. Local barbers and stylists who seldom cut children’s hair say they have not encountered any.

But Christine Cherry, who runs head lice treatment clinics in Chichester, Nashua, Plaistow and Portland Maine affiliated with Lice Clinics of America, said her New Hampshire locations have seen a 35 percent uptick in business over this time last year.

And she believes cases go un-reported because of the cultural stigma around head lice. “Not everyone wants to talk about it,” she said. State and local health departments don't require reporting.

Contrary to popular notions, head lice are not related to a lack of personal hygiene or unclean homes, according to the New Hampshire Department of Health and Human Services’ Bureau of Infectious Disease Control.  They can, however, be spread easily through shared clothing and bedding.

“Especially elementary school kids, they’re taught at that age to share,” said Neal at Polished and Proper. “They’ll say ‘Try on my hat’ or ‘I forgot my coat.”

Although people are usually grateful to learn the cause of their symptoms, the specter of head lice sparks panic.

“People get a little mad, too,” said Diana Merriam, a nurse at Franklin High School.  “This is something people get more worried about” than they should. “It doesn’t transmit disease. It has nothing to do with the cleanliness of your house or your head.”  The worst side effect is skin irritation or inflection at the site of scratching.

NH schools, which follow New Hampshire School Board Association guidelines, do not conduct routine screenings for head lice or necessarily send infected children home; they notify parents if a student complains of itchiness and head lice are found.  

“They’re trying to make the child feel as comfortable as possible while keeping other safe,” said Adele Chertoff, assistant to the Winnisquam Regional School District superintendent.

Paul Smith Elementary School in Franklin sees roughly two to three cases a month, and Franklin High School has found none yet this school year. “We don’t have a no-nit policy, but we do send them home if we see live lice,” Merriam said.

Head-to-head contact through sports, playdates and slumber parties provides the most direct transmission of head lice, according the CDC. Head lice are not a local or a winter-time epidemic, but they can be a crisis in families, especially when kids trade hats, pillows, combs, brushes or coats – or share them with parents. Plastic or metal head phones or helmets don't spread them. 

During winter, parents should check their children’s scalps and comb through their hair once or twice a month, Neal said. “You’re looking for nits, little white things that don’t come off hair easily, or something moving quickly on the scalp.”

“If you blow on it and it moves away, it’s dry scalp or dandruff,” said Cherry. The best way to screen for them is to use a lice comb, and the most effective ones are sold online, she said. Put conditioner on the hair, then comb through it while looking under direct light or sunlight for tear-drop shapes attached to the hair shaft.  Then wipe the hair off with a paper towel to remove the eggs.

Treatments vary, depending on who you consult.  School nurses recommend de-lousing shampoos available at drug store pharmacy counters that contain varying concentrations of permethrin, a chemical that attacks the central nervous system of lice and ticks. They also advise contacting a primary care provider if prescription-strength medication is needed.

Cherry, who treats stubborn or repeat cases, prefers a less-toxic oil called Lice MD.  Based on the life cycle of head lice “you really need to do three or four treatments over two weeks and do a lot of combing.”  She treats customers who aren’t successful at home with a device that uses no harsh chemicals and dehydrates both the lice and their eggs.

When barbers encounter a head with lice or eggs (also called nits), all tools and towels are disinfected, the hair cut is stopped midstream – ideally at a point that will make the customer presentable - and the hair is swept up, put in plastic bags, sealed and disposed of.  “It’s not like we’re in freeze, fight or flight. We know what to do,” Neal said.

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Roberta Baker can be reached by email at Roberta@laconiadailysun.com