Learning and development

Common parasites

Head lice are most common in children aged three to 11 years, although they can affect anyone, including adults. They are easily spread through close head-to-head contact and tend to be more common at primary school because of the way young children play and learn. While a head lice infestation is often a minor inconvenience, if left untreated, it can lead to complications, such as an itchy rash at the back of the neck and behind the ears, loss of sleep and skin infections (caused by excessive scratching). 

Research carried out in February at the Medical Entomology Centre, Insect Research & Development Limited, Cambridge, found that within any school community, some children are regularly infested because their parents/guardians don’t treat the infestation, or they try but are unsuccessful and don’t seek help. 

According to the UK Health Security Agency’s advice to schools on managing specific infectious diseases (updated in February), sending letters and notifications to parents or carers doesn’t reduce the risk of transmission and may provoke anxiety. 

Instead, it says schools should “encourage parents and carers to give regular head checks and provide good hair care to help identify and treat head lice early”. Raising local awareness of head lice detection and treatment through pharmacies may be an effective way of keeping infestations under control.

“Some pharmacies have promotional digital display screens, which are a great asset for marketing head lice products, along with display banners and aisle fins that can be used within the store,” says Lucy Willars from the Hedrin head lice brand.

The NHS website recommends wet combing to remove head lice and nits. According to Community Hygiene Concern (CHC), the success of wet combing depends on the choice of the comb and method being used. 

CHC’s ‘Bug Busting’ kit involves using a specially designed comb with normal shampoo and conditioner. The NHS website says it usually takes about 10 minutes to comb short hair, and 20 to 30 minutes for long, frizzy or curly hair. Lubricating the hair with a conditioner or a medicated product containing dimeticone makes the procedure easier, particularly for curly hair. 

If wet combing fails to work, parents should then use medicated treatments. 

Current NICE guidance recommends that a physical insecticide, such as dimeticone, should be the first-line treatment before using a chemical pesticide. However, wet combing or using products containing dimeticone are the recommended first-line treatments for pregnant or breastfeeding women, young children aged between six months and two years and people with asthma or eczema.

“It’s imperative for pharmacies to have head lice treatments available in different forms, such as rinses, mousse, liquids, shampoos and sprays, in addition to head lice combs,” says Chan.

Threadworms are another common childhood infestation, especially in children under 10 years. These tiny worms are found in stools and look like small pieces of thread. They usually come out at night and spread easily from person to person. Threadworms don’t always cause symptoms, but can cause itching of the anus or vagina, which may disturb sleep. The infestations can usually be treated with a single dose of mebendazole from a pharmacy. 

“If parents feel embarrassed about discussing certain health issues, such as head lice or threadworms, they can go into the private consultation room,” says Fortune. “Using leaflets, promotional materials and posters in the pharmacy can help to raise awareness of these common conditions. Some medicines can be costly, so it’s helpful for pharmacies to find out which conditions are covered by any local NHS ailments schemes.”

General health advice

According to research by Oxford Brookes University, the University of Birmingham and the Oxford Health NHS Foundation Trust, the number of school nurses has fallen by 35 per cent in the last five years to about 2,000. 

As well as managing minor ailments and injuries, school nurses often deal with public health issues, such as immunisation, sexual health, managing chronic conditions and mental health support.

The Asthma + Lung UK charity says that every year, there’s a spike in asthma attacks in children across the UK when they return to school after the summer. 

This may partly be due to the rise in colds and other respiratory infections, but it may also be due to allergies or stress and excitement. “Community pharmacists are ideally placed to deal with all types of medication enquiries,” says Fortune.

“Children with asthma often develop worse coughs and colds. When they go back to school, it’s important to make sure that they and their parents can use their inhalers properly, and that they have been prescribed preventer inhalers.”

Chan adds that sleep should be a priority for children going back to school, and this is something that pharmacists may be able to advise on. 

“Holidays usually mean later bedtimes, so getting children back to a regular routine is beneficial,” he says. “Restricting the use of phones, TVs, tablets or computers one hour prior to bedtime will also help, alongside warm milky drinks.”

Views from the p3pharmacy panel