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The problem of the control of head lice has always been dominated by two factors, the
need to maintain such a concentration of insecticide that the young louse was killed either
before or just after hatching, and the removal of the nit from the hair. The louse cements
its nit to the hair with a substance which is more resistant than the hair itself, thus chemicals
which would dissolve the cement would either be depilatories or harmful to the skin or
both. For this reason the only treatment for heavy infestation was at one time the complete
cropping of the hair. In the early 1920's the necessity for this was removed by the invention
of a special metal comb (Sacker) with extremely fine teeth, triangular in section, which
removes nits from wet hair.
Since the war much research has gone into the development of chemical preparations
based on modern insecticides, such as D.D.T. and B.H.C., which would be lethal not only
to the louse, but also to the hatching nymph. Within the last few years Imperial Chemical
Industries, Limited have produced a preparation of gamma B.H.C. in the form of a cream
hair shampoo known as Lorexane No. 3, packaged in small tubes containing enough for
eight shampoos, which is quite attractive in use. This preparation has been given extensive
field trials, notably in Salford, the success of which have been widely reported upon in the
medical press.
In London a trial in division 2 began in the spring term, 1959. The trial was not concerned
with the efficacy of Lorexane as a parasiticide but with the feasibility of extending
the established principle of helping parents to keep their children clean themselves. Instead
of the issue of the traditional advice card, with its offer of cleansing station facilities,
parents were to be encouraged to clean their children themselves by the issue of a tube of
Lorexane No. 3 shampoo, with instructions for its use.
The Divisional Medical Officer reported in December, 1959:
... The general opinion of the school health visitors is that the shampoo is reaching
and being used by the other members of the family as well as the child in whom infestation
was found and numerous instances have been quoted showing that the availability
of the shampoo has been welcomed by families and the individual members are eager
to use it. Success in reducing infestation and re-infestation has been reported in families
in which previously little progress had been made. Nevertheless, there are parents who
make little or no effort to cleanse their children and home visits continue to be necessary
in these cases.'
Accordingly it was decided that, with effect from 1 January, 1960, the trial of the issue
of Lorexane for use at home would be extended to the whole of the County of London.
A problem raised by the introduction of the shampoo is the re-education of the families
who have been encouraged over past years into the habit of making voluntary bathing
centre attendances. Health visitors have now to re-educate these families into the alternative
habit of asking for a tube of Lorexane instead.