A question of health: How to tackle the horrors of head lice?

Creepy-crawly cure

Creepy-crawly cure

My child was infected with head lice on and off all of last term, and I want to find a solution before next term begins. From talking to parents at my children's school, it seems that everyone has the same problem, no matter what they put on their children's hair. I have been using chemical solutions and wet combs, but I am worried about using these too frequently. Wet combing does not seem to get rid of the pests. Friends have mentioned neem oil, but I have never heard of this before.

Head lice among children in schools has reached epidemic proportions. There is no simple solution to the problem – if there were, everyone would be using it and there wouldn't be a continuing epidemic. One of the problems is that head lice have become resistant to the commonly used chemical solutions. There is also the worry that toxic insecticides may be absorbed into the body. There is only a limited amount of evidence on the subject. Studies have shown that the various chemical solutions are all better than no treatment at all, but they have a less than 100 per cent success rate. My own recommendation, based on my experience both as a GP and with my own children (I hope they are not reading this) is that "bug-busting" is the most effective way of getting rid of head lice. But it requires dedication and hard work. Every three days you have to wet the child's hair with ordinary conditioner. Thoroughly comb the wet hair with a very fine nit comb, all the way down to the roots. If there are any live insects present, they will be removed by this combing and you will see them in the sink. Don't worry about removing the tiny grey blobs on the hairs. If you remove live insects every three days, you prevent these insects from laying new eggs. Within a couple of weeks, the life cycle of the head lice will have been disrupted, and you should be free of the infestation. This does not mean that your child won't bring home new head lice at the beginning of next term, so you will have to be vigilant and start the whole process again if a new infestation occurs. Neem oil is pressed from the seed of the neem tree, which grows in eastern India and Burma. It is a traditional treatment, but I don't know of any scientific evidence that it works.

Discomfort eating

For the past couple of months I have been experiencing a strange symptom. On my first drink or bite of almost anything I experience a very sharp pain in both sides of my jaw. Apple juice causes the worst pain. I tried an experiment – I put a little plastic bag over my tongue and then drank the dreaded apple juice. This worked, but obviously I cannot live with a bag on my tongue.

This sounds like a problem with your salivary glands. When your tongue is exposed to food, particularly acidic food, the glands in front of the ear and under the jaw secrete saliva into the mouth. The saliva helps to digest the food. I suspect your pain is being caused by the release of saliva into the tiny channels that deliver the saliva to the inside of the mouth. If these channels are blocked, or even partially blocked, they will become painful as soon as they are exposed to a rapid flow of saliva. People who develop tiny stones in their salivary ducts can have symptoms similar to yours. I suggest you consult a specialist in oral medicine. You could be referred by either your GP or your dentist. In Liverpool, where you live, there are oral medicine specialists at the Liverpool University Dental Hospital.

Growing pains

I am quite short for my age, and I was wondering if there are any drugs I can take, or anything else I can do, to increase my height?

There is only one drug that can increase a child's height – human growth hormone. This drug is naturally produced by the pituitary gland, but can also be given by injection. Children who do not have enough growth hormone are much shorter than other children of a similar age, and the rate at which they grow is greatly reduced. Most children who are shorter than average have enough human growth hormone to grow normally. They are short for genetic reasons – they are the children of short parents. A doctor can check your height and compare it to that of other children of your age. If you are much shorter than expected you should see a growth specialist, who can do tests to see if there is any medical reason for this. It is important to do this before you stop growing, because once the bones reach their final length it is impossible to stimulate them to grow any longer.

Send your questions and comments to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182 or e-mail health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions