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Lice in Japan? Tackle the problem head on.

By on August 9, 2018

Head lice, or to be more precise, Pediculosis Humanus Capitis can strike at any time.  The likelihood of head lice is higher in the warm months.

This infestation of the scalp hair occurs mainly in school children and occasionally in adults. Sometimes it affects the eyelashes too. It is caught by direct contact by children playing together and in normal contact between children and their parents. It may also spread by shared caps, hair brushes, and combs. The diagnosis is usually obvious as one can see the eggs (‘nits’) attached to the hairs close to the scalp especially at the back of the head, and the live mature lice which then move. The infestation may also cause an itchy rash at the back of the neck.

When treating a child with head lice, other members of the family and the other children at the school with whom sufferer may have been in contact should be examined and treated if necessary, otherwise re-infestation may occur. Treatment involves applying a chemical to kill the lice and their eggs and physical removal of the nits with a fine-toothed comb.

In Japan, the only treatment for head lice one can obtain over-the-counter is called Sumithrin, available as a powder or shampoo. The generic name is phenothrin (permethrin is similar). The manufacturer recommends applying it to the scalp, then washing off the powder after an hour, or the shampoo after five minutes, and repeating, the treatment four times at three day intervals. Some hospitals’ pharmacies in Japan may prepare extemporaneously other chemicals for the treatment of lice.

The problem with using powder or shampoo-based treatments is that they may not be as effective as lotions or liquids, and resistance of the lice and nits to phenothrin may exist. That is probably the reason why four applications of Sumithrin are recommended, which is rather inconvenient, as opposed to just two applications a week apart which are used with other treatments.

If a course of treatment with Sumithrin fails, another chemical, in a lotion or liquid form, should be tried. This usually means it needs to be obtained from overseas, or via the Internet. The common alternatives are called Carbaryl and Malathion. They are applied to the scalp, allowed to dry for 12 hours or overnight, and then washed off. All these chemicals are smelly and should be used in a well-ventilated bathroom. It is kinder to the applying fingers to use plastic gloves!

An alternative, which does not involve using strong chemicals is the ‘wet combing method’. By this means the lice are mechanically removed by combing wet hair meticulously (probably for at least 30 minutes each time!) at four-day intervals for a minimum of two weeks. Hair conditioner may be used to facilitate the process.

There is no need for children to be kept away from school until they are pronounced cured as this is not effective in preventing spread. The lice do not live for long away from the human body and there is no risk of spread to or from pets. Hot washing of sheets and pillow cases is usually all that is needed in the way of household disinfestation. Thus, whatever you do to treat the condition it is rather troublesome, but in my experience it is always possible to get rid of the lice one way or another.

This advice is offered as a general guideline. As with any medical situation, consult your own medical practitioner for your child’s specific needs.

 

About Dr. Gabriel Symonds

Dr. Gabriel Symonds was the director of the Tokyo British Clinic. The clinic closed down in May 2014 after serving the expatriate community for 20+ years. Dr. Symonds has retired and the Tokyo British Clinic is now closed. Dr Symonds will continue to live in Tokyo and may be contacted by e-mail over any questions concerning medical records or related matters: symonds@tokyobritishclinic.com He will be available from another address for: smoking cessation psychotherapy/counselling circumcision information Tel: (03) 5458-6099 www.tokyobritishclinic.com