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| {{For|the biology of the animal|Head louse}}
| | #REDIRECT[[Pediculosis capitis]] |
| {{Infobox disease
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| | Name = Head lice infestation (pediculosis capitis)
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| | Image = Fig.4.Louse_bites.jpg
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| | Caption = Head lice bites on the nape of the neck
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| | ICD10 = {{ICD10|B|85|0|b|85}}
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| | ICDO =
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| | OMIM =
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| | DiseasesDB = 9725
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| | MedlinePlus = 000840
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| | eMedicineSubj = med
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| | eMedicineTopic = 1769
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| | MeshID = D010373}}
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| __NOTOC__
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| {{CMG}}; {{AE}} {{KS}}
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| ==Overview==
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| '''Head lice infestation'''<ref name="Bolognia" /> (also known as '''pediculosis capitis''', or as "having nits" or "having cooties")<ref name="Bolognia">{{cite book |author=Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. |title=Dermatology: 2-Volume Set |publisher=Mosby |location=St. Louis |year=2007 |pages= |isbn=1-4160-2999-0 |oclc= |doi= }}</ref> the colonization of the hair by the [[head louse]] (''Pediculus humanus capitis''), typically only involves the head or scalp of the human host. Head lice feed on human blood; itching from lice bites is a common symptom of this condition.<ref name="Burgess1995">{{cite journal| author = Burgess IF | title = Human lice and their management| journal = Advances in Parasitology| volume = 36| pages = 271–342| year = 1995| pmid = 7484466 | doi = 10.1016/S0065-308X(08)60493-5| series = Advances in Parasitology| isbn = 9780120317363| first2 = MS| first3 = JW| issue = 6}}</ref> Treatment includes application of [[topical]] insecticides such as a [[pyrethrin]] or [[permethrin]], although a variety of [[herbal remedies]] are also common.<ref name="Burkhart2006">{{cite journal| author = Burkhart CG, Burkhart CN, Burkhart KM| title = An assessment of topical and oral prescription and over-the-counter treatments for head lice| journal = J. Am. Acad. Dermatol.
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| | volume = 38| issue = 6 Pt 1| pages = 979–82|date=June 1998| pmid = 9632008| doi = 10.1016/S0190-9622(98)70163-X| url = http://linkinghub.elsevier.com/retrieve/pii/S0190-9622(98)70163-X}}</ref>
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| Lice infestation in general is known as [[pediculosis]], and occurs in many mammalian and bird species.<ref name="MerckVet">{{cite web | url = http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/71900.htm&word=pediculosis | title = Lice (Pediculosis) | accessdate = 2008-10-08 | year = 2008
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| | work = The Merck Veterinary Manual | publisher = Merck & Co. | location = Whitehouse Station, NJ USA
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| }}</ref> The term pediculosis capitis, or simply "pediculosis", is sometimes used to refer to the specific human pediculosis due to ''P. humanus capitis'' (i.e., head-louse infestation){{Citation needed|date=May 2010}}. Humans are hosts for two other lice as well — the [[body louse]] and the [[crab louse]].
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| Head-lice infestation is widely endemic, especially in children. It is a cause of some concern in public health, although, unlike human [[body lice]], head lice are not carriers of other infectious diseases. It has been suggested that in the past, head lice infection has been a mutualistic beneficial condition which helps to defend against the far more dangerous disease-carrying body louse.<ref name="mutualism">{{cite journal| last =Rozsa | first =Lajos |author2=Apari P. | url =http://www.zoologia.hu/list/Why_infest.pdf | title =Why infest the loved ones – inherent human behaviour indicates former mutualism with head lice| journal =Parasitology | volume = 139| pages =''in press'' | year =2012| doi =10.1017/S0031182012000017| issue =6}} On-line full text available at link</ref>
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| ==Signs and symptoms==
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| The most common symptom of infestation is [[pruritus]] (itching) on the head which normally intensifies 3 to 4 weeks after the initial infestation{{Citation needed|date=May 2010}}. The bite reaction is very mild and it can be rarely seen between the hairs. Bites can be seen, especially in the neck of long-haired individuals when the hair is pushed aside. In rare cases, the itch scratch cycle can lead to secondary infection with [[impetigo]] and [[pyoderma]]{{Citation needed|date=May 2010}}. Swelling of the local [[lymph nodes]] and fever are rare. Head lice are not known to transmit any pathogenic microorganisms.
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| ==Cause==
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| Head lice are generally spread through direct head-to-head contact with an infested person; transmission by sharing bedding or clothing such as headwear is much less common.<ref name=cdc>{{cite web |url=http://www.cdc.gov/lice/head/factsheet.html |title=Head lice fact sheet |author=Division of Parasitic Diseases (DPD), National Center for Zoonotic, Vector-Borne, and Enteric Diseases (ZVED) |date=May 16, 2008 |work=Centers for Disease Control and Prevention website |publisher=Department of Health and Human Services, US Government|location=Atlanta, GA |accessdate=28 May 2010}}</ref> Body lice are spread through direct contact with the body, clothing or other personal items of a person already carrying lice. Pubic lice are most often spread by intimate contact with an infested person. Head lice occur on the head hair, body lice on the clothing, and pubic lice mainly on the hair near the groin. Human lice do not occur on pets or other animals{{Citation needed|date=May 2010}}. Lice do not have wings and cannot jump{{Citation needed|date=May 2010}}.
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| From each egg or "nit" may hatch one nymph that will grow and develop to the adult louse{{Citation needed|date=May 2010}}. Full-grown lice are found to be the size of a sesame seed. Lice feed on blood 1–8 times each day by piercing the skin with their tiny needle-like mouthparts{{Citation needed|date=May 2010}}. Lice cannot burrow into the skin.
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| Head lice and body lice (''[[Pediculus humanus]]'') are similar in appearance, although the head louse is often smaller.<ref name="Bacot1917">{{cite journal | author = Bacot A | title = Contributions to the bionomics of ''Pediculus humanus (vestimenti)'' and ''Pediculus capitis'' | journal = Parasitology | volume = 9 | pages = 228–258 | year = 1917 | doi = 10.1017/S0031182000006065 | issue = 2}}</ref> Pubic lice (''[[Pubic lice|Pthirus pubis]]''), on the other hand, are quite distinctive. They have shorter bodies and pincer-like claws, and are colloquially known as "crabs"{{Citation needed|date=May 2010}}. Head lice are not known to be transmitters of diseases, unlike body lice.
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| ==Diagnosis==
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| [[File:Bugbuster.jpg|right|thumb|Lice comb (Bug Buster) wet combing with conditioner for diagnosis and treatment. Head lice can be seen in foam.]]
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| The condition is diagnosed by the presence of lice or eggs in the hair, which is facilitated by using a magnifying glass or running a comb through the child's hair. In questionable cases, a child can be referred to a health professional. However, the condition is overdiagnosed, with extinct infestations being mistaken for active ones. As a result, lice-killing treatments are more often used on noninfested than infested children.<ref name="Pollack2000">{{cite journal | author = Pollack RJ, Kiszewski AE, Spielman A | title = Overdiagnosis and consequent mismanagement of head louse infestations in North America | journal = The Pediatric Infectious Diseases Journal | volume = 19 | issue = 8 | pages = 689–93 | year = 2000 | pmid = 10959734 | doi=10.1097/00006454-200008000-00003}}</ref> The use of a louse comb is the most effective way to detect living lice.<ref name="Mumcuoglu2001">{{cite journal | author = Mumcuoglu KY, Friger M, Ioffe-Uspensky I, Ben-Ishai F, Miller J | title = Louse comb versus direct visual examination for the diagnosis of head louse infestations | journal = Pediatric dermatology | volume = 18 | issue = 1 | pages = 9–12 | year = 2001 | pmid = 11207962 | url = http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0736-8046&date=2001&volume=18&issue=1&spage=9 | doi = 10.1046/j.1525-1470.2001.018001009.x}}</ref> In cases of children with dirty, long and/or curly/frizzy hair, an alternative method of diagnosis is examination by parting the hair at 2 cm intervals to look for moving lice near the scalp{{Citation needed|date=May 2010}}. With both methods, special attention should be paid to the area near the ears and the nape of the neck. The examiner should examine the scalp for at least 5 minutes{{Citation needed|date=May 2010}}. The use of a magnifying glass to examine the material collected between the teeth of the comb could prevent misdiagnosis.
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| The presence of nits alone, however, is not an accurate indicator of an active head louse infestation. Children with nits on their hair have a 35–40% chance of also being infested with living lice and eggs.<ref name="Mumcuoglu2001"/><ref name="pmid11331679">{{cite journal |author=Williams LK, Reichert A, MacKenzie WR, Hightower AW, Blake PA |title=Lice, nits, and school policy |journal=Pediatrics |volume=107 |issue=5 |pages=1011–5 |year=2001 |pmid=11331679 |doi=10.1542/peds.107.5.1011}}</ref> If lice are detected, the entire family needs to be checked (especially children up to the age of 13 years) with a louse comb, and only those who are infested with living lice should be treated.
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| As long as no living lice are detected, the child should be considered negative for head louse infestation. Accordingly, a child should be treated with a pediculicide ONLY when living lice are detected on his/her hair (not because he/she has louse eggs/nits on the hair and not because the scalp is itchy).<ref name=JDD/>
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| ===Physical Examination===
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| =====Scalp=====
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| <gallery>
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| Image:Pediculosis capitis01.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis02.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis03.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis04.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis07.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis08.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis09.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis10.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis14.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis15.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| </gallery>
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| =====Trunk=====
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| <gallery>
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| Image:Pediculosis capitis05.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis06.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis11.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis12.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis13.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis16.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis17.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis18.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| Image:Pediculosis capitis19.jpg|Pediculosis capitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Permission from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
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| </gallery>
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| ==Prevention==
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| Examination of the child’s head at regular intervals using a louse comb allows the diagnosis of louse infestation at an early stage. Early diagnosis makes treatment easier and reduces the possibility of infesting others. In times and areas when louse infestations are common, weekly examinations of children, especially those 4–15 yrs old, carried out by their parents will aid control. Additional examinations are necessary if the child came in contact with infested individuals, if the child frequently scratches his/her head, or if nits suddenly appear on the child’s hair. Keeping long hair tidy could be helpful in the prevention of infestations with head lice.
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| Clothes, towels, bedding, combs and brushes, which came in contact with the infested individual, can be disinfected either by leaving them outside for at least 2 weeks or by washing them at 60°C(140 degrees F) for 30 minutes.<ref>[http://kidshealth.org/parent/infections/common/head_lice.html Kidshealth.org – Head lice, page-3]</ref> This is because adult lice can survive only one to two days without a blood meal, and are highly dependent on human body warmth.<ref>[http://entnemdept.ufl.edu/creatures/urban/human_lice.htm University of Florida Dept of Entomology Circular 175]</ref> An insecticidal treatment of the house and furniture is not necessary.
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| ==Treatment==
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| {{Main|Treatment of human head lice}}
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| Except for recent studies on [[neem]] seed extract,<ref>{{cite journal|url=http://www.springerlink.com/content/x205175700451226/ |title=Efficacy of a single treatment of head lice with a neem seed extract: an in vivo and in vitro study on nits and motile stages |journal=Parasitology Research |volume = 110 |issue = 1 |pages=277–280 |publisher=[[Springer Science+Business Media]] |date=2012-01-01 |accessdate=2013-12-30 |doi=10.1007/s00436-011-2484-3}}</ref> there is no product or method which assures 100% destruction of the eggs and hatched lice after a single treatment. However, there are a number of treatment modalities that can be employed with varying degrees of success. These methods include chemical treatments, natural products, combs, shaving, hot air,<ref name="Pediatrics">{{cite journal| last =Goates BM et al.| first1 =BM| last2 =Atkin| first2 =JS| last3 =Wilding| first3 =KG| last4 =Birch| first4 =KG| last5 =Cottam| first5 =MR| last6 =Bush| first6 =SE| last7 =Clayton| first7 =DH| title =An Effective Nonchemical Treatment for Head Lice: A Lot of Hot Air| journal =[[Pediatrics (journal)|Pediatrics]] | volume =118 | issue =5 | pages =1962–1970 | publisher =[[American Academy of Pediatrics]] | date =5 November 2006 | url =http://www.zoologia.hu/pediatrics.pdf | accessdate =2010-08-02| doi =10.1542/peds.2005-1847| pmid =17079567 }}</ref> and silicone-based lotions;<ref>{{cite journal|pmc=2652450 |title=The mode of action of dimeticone 4% lotion against head lice, Pediculus capitis |author=Ian F Burgess, Medical Entomology Centre, Insect Research & Development Limited | pmid=19232080 |doi=10.1186/1471-2210-9-3 |volume=9 |year=2009 |journal=BMC Pharmacol. |page=3}}</ref> however all effective treatments require a two-fold process of killing both the adult lice and the eggs. Generally the eggs (nits) need to be manually picked off one by one in order to ensure all live eggs are removed.
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| Lice on the hair and body are usually treated with medicated shampoos or cream rinses. Nit combs can be used to remove lice and nits from the hair. Laundering clothes using high heat can eliminate body lice. Efforts to treat should focus on the hair or body (or clothes), and not on the home environment{{Citation needed|date=May 2010}}.
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| Some lice have become resistant to certain (but not all) insecticides used in commercially available anti-louse products. A physician or pharmacist can prescribe or suggest treatments. Empty eggs of head lice may remain attached to the hair shaft long after the lice have been eliminated{{Citation needed|date=May 2010}}, but rarely are adult lice seen even with an active infestation. Since there is no way to determine whether each egg is alive or dead, chemical treatment (which may not kill the eggs) should be considered only when live (crawling) lice are discovered in order to kill the adults. Instead, nitpicking, which is checking each hair strand for eggs and picking off each egg, should be used to prevent the possibility of an egg hatching resulting in reinfestation.
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| [[Tea tree oil]] is one of the few natural ingredients that have been proven to be effective in laboratory tests,<ref>{{cite journal|url=http://www.springerlink.com/content/d320k5rn36875835/ |title=Activity of tea tree oil and nerolidol alone or in combination against Pediculus capitis (head lice) and its eggs |journal=Parasitology Research |date=January 2012 |volume = 111 |issue = 1 |pages=1985–1992 |publisher=Springer Science+Business Media |date=2012-11-01 |accessdate=2013-12-30 |doi=10.1007/s00436-012-3045-0}}</ref> but The National Pediculosis Association recommends caution when using tea tree oil for the treatment of pregnant women and young children because of safety concerns.<ref name=ped>{{cite journal |author=Eisenhower C, Farrington EA |title=Advancements in the treatment of head lice in pediatrics |journal=J Pediatr Health Care |volume=26 |issue=6 |pages=451–61; quiz 462–4 |year=2012 |pmid=23099312 |doi=10.1016/j.pedhc.2012.05.004 |type=Review}}</ref> Other home remedies such as putting vinegar, isopropyl alcohol, olive oil, mayonnaise, or melted butter under a shower cap have been disproven.<ref>{{cite journal|url=http://www.pediatricnursing.org/article/S0882-5963(04)00139-3/abstract |title=Home Remedies to Control Head Lice: Assessment of Home Remedies to Control the Human Head Louse, Pediculus humanus capitis (Anoplura: Pediculidae) |publisher=Elsevier |journal=[[Pediatric Nursing (journal)]] |date=December 2004 |volume= 19 |issue=6 |pages=393–398 |doi=10.1016/j.pedn.2004.11.002 |accessdate=2013-12-30 |pmid=15637580}}</ref> Similarly, the CDC claims that swimming has no effect on treating lice, and can in fact harm the treatment by commercial products.<ref>http://www.cdc.gov/healthywater/swimming/faq/#get_lice</ref>
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| ==Epidemiology==
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| {{Rquote|right|Reliable data describing the usual incidence of infestation in the general public, in the average school community, or during specific times of the year are lacking.|Janis Hootman, 2002<ref name="Hootman2002">{{cite journal
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| | author = Hootman J
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| | title = Quality improvement projects related to pediculosis management
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| | journal = The Journal of school nursing : the official publication of the National Association of School Nurses
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| | volume = 18
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| | issue = 2
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| | pages = 80–6
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| |date=April 2002
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| | pmid = 12017250
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| | url = http://www.ncbi.nlm.nih.gov/pubmed/12017250
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| | doi = 10.1177/10598405020180020401 }}
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| </ref>}}
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| The number of cases of human louse infestations (or [[pediculosis]]) has increased worldwide since the mid-1960s, reaching hundreds of millions annually.<ref name="Gratz">{{cite journal | author =Norman G. Gratz | title = Human lice: Their prevalence, control and resistance to insecticides. A review 1985–1997 | url = http://whqlibdoc.who.int/hq/1997/WHO_CTD_WHOPES_97.8.pdf | format = PDF | publisher = World Health Organization | location = Geneva, Switzerland | year = 1998 | accessdate = 2008-01-02}}</ref>
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| Despite improvements in medical treatment and prevention of human diseases during the 20th century, head louse infestation remains stubbornly prevalent. In 1997, 80% of American elementary schools reported at least one outbreak of lice.<ref name="ConsumerReports1998">{{cite news | title = A modern scourge: Parents scratch their heads over lice | url = http://web.ebscohost.com/ehost/pdf?vid=7&hid=102&sid=f97918a5-99c7-45da-a365-4324367c3566%40sessionmgr108 | publisher = Consumer Reports | pages = 62–63 | date = February 1998 | accessdate = 2008-10-10}}</ref> Lice infestation during that same period was more prevalent than [[chicken pox]].<ref name="ConsumerReports1998"/>
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| About 6–12 million children between the ages of 3 and 11 are treated annually for head lice in the United States alone.<ref name=cdc/> High levels of louse infestations have also been reported from all over the world including Israel, Denmark, Sweden, U.K., France and Australia.<ref name="JDD">{{cite journal| last =Mumcuoglu | first =Kosta Y. |author2=Barker CS |author3=Burgess IF |author4=Combescot-Lang C |author5=Dagleish RC |author6=Larsen KS |author7=Miller J |author8=Roberts RJ |author9=Taylan-Ozkan A. |displayauthors=9 | title =International Guidelines for Effective Control of Head Louse Infestations | journal =Journal of Drugs in Dermatology | volume =6 | pages =409–14 | year =2007 |pmid=17668538| issue =4 }}</ref><ref name="Burgess2004">{{cite journal | author =Ian Burgess | title = Human Lice and their Control | journal = Annual Review of Entomology | volume = 49 | pages = 457–481 | publisher = Annual Reviews | year = 2004 | url = http://arjournals.annualreviews.org/doi/pdf/10.1146/annurev.ento.49.061802.123253 | doi = 10.1146/annurev.ento.49.061802.123253 | pmid = 14651472}}</ref>
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| The number of children per family, the sharing of beds and closets, hair washing habits, local customs and social contacts, healthcare in a particular area (e.g. school) and socioeconomic status were found to be significant factors in head louse infestation{{Citation needed|date=May 2010}}. Girls are 2–4 times more frequently infested than boys{{Citation needed|date=May 2010}}. Children between 4 and 13 years of age are the most frequently infested group.<ref name="Mumcuoglu1990">{{cite journal | author = Mumcuoglu KY, Miller J, Gofin R, et al. | title = Epidemiological studies on head lice infestation in Israel. I. Parasitological examination of children | journal = International Journal of Dermatology | volume = 29 | issue = 7 | pages = 502–6 |date=September 1990 | url = http://www.blackwell-synergy.com/doi/pdf/10.1111/j.1365-4362.1990.tb04845.x | doi =10.1111/j.1365-4362.1990.tb04845.x | pmid = 2228380}}</ref> In the U.S., African-American children have lower rates of infestation.<ref name=cdc/>
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| The United Kingdom's [[National Health Service]]{{Citation needed|date=May 2010}} and many American health agencies [http://www.nyc.gov/html/doh/html/cd/cdped.shtml][http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=186&PrintPage=1][http://www.worsleyschool.net/science/files/lice/page.html] report that lice "prefer" clean hair because it's easier to attach eggs and to cling to the strands; however, this is often contested.
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| Head lice (''Pediculus humanus capitis'') infestation is most frequent on children aged 3–10 and their families.<ref name="actadermatoven">{{cite journal | author = Nutanson I. et al. | title = Pediculus humanus capitis: an update | journal = Acta Dermatoven | volume = 17 | issue = 4 | pages = 147–59 | year = 2008 | url = http://ibmi.mf.uni-lj.si/acta-apa/acta-apa-08-4/1.pdf}}</ref> Females get head lice twice as often as males,<ref name="actadermatoven"/> and infestation in persons of [[wikt:Afro-Caribbean|Afro-Caribbean]] or other [[black people|black]] descent is rare because of hair consistency.<ref name="actadermatoven"/> But these children may have nits that hatch and the live lice could be transferred by head contact to other children.<ref name="merck_lice">{{cite web | title = Lice (Pediculosis) | last =James GH Dinulos |date=September 2008 | work = The Merck Manual | publisher = Merck & Co., Inc. | url = http://www.merck.com/mmpe/sec10/ch121/ch121e.html | accessdate = 2008-12-27}}</ref>
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| ==See also==
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| *[[Pediculosis]]
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| *[[List of cutaneous conditions]]
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| *[[Head louse]]
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| *[[To a Louse]] (on a lady's bonnet). Perhaps the most widely known cultural reference to pediculosis capitis, occurring in a noted poem by [[Robert Burns]].
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| ==References==
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| {{reflist|2}}
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| ==External links==
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| * [http://well.blogs.nytimes.com/2010/03/24/the-alternative-medicine-cabinet-cetaphil-for-lice/?src=me&ref=health Use of Cetaphil skin cleanser to treat head lice – New York Times]
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| * [http://pediatrics.aappublications.org/cgi/content/full/114/3/e275 Original study in using nontoxic DSP lotion to treat head lice. ''A Simple Treatment for Head Lice: Dry-On, Suffocation-Based Pediculicide'' – Pediatrics]
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| * [http://headlicecenter.com/ In-depth information about Pediculosis capitis and how to treat it]
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| {{Pediculosis, acariasis and other infestations}}
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| {{DEFAULTSORT:Pediculosis Capitis}}
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| [[Category:Parasitic infestations, stings, and bites of the skin]]
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| [[Category:Arthropod infestations]]
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