September 14, 2012

Head Lice--An Icky Fact of Childhood, and What Parents Can Do

As autumn approaches, one of this season’s greetings is familiar to parents with younger school-age children: head lice. It’s one of the top five disorders for school-age children.

The little critters live on the scalp and feed on blood. Their eggs, or “nits,” attach to hair, most commonly on children ages 3 to 12. Their presence is completely democratic—anyone can be affected regardless of socio-economic status.

Lice don’t cause illness, but most people think they’re gross, and they’re annoying—there’s a lot of itching. Scratching an itch can break the skin and invite infection.

Lice can jump from one kid’s head to another nearby. That starts anew the egg-laying- itching cycle. An active lice infestation often prompts schools to send a child home to avoid spreading the creepy joy.

Lice must be removed and/or treated in some way. The insects jump and are elusive, but the nits attach firmly to strands of hair. A nit attached to the hair at scalp level is probably alive and must be treated or removed or it will hatch. If the nit has grown away from the scalp, the louse probably has hatched.

According to the Centers for Disease Control and Prevention (CDC), all members of a household where someone has head lice should be checked for the presence of an active infestation and treated if necessary. That involves removing lice and nits with a fine-toothed comb, and following up with medicine called “pediculicides.”

Combing can be tedious, but sometimes it’s sufficient to stop an infestation. Most often, though, a pediculicide is necessary. Some are available over the counter, others only by prescription. The first application kills active lice and must be repeated if all the lice don’t die. Additional treatment may be needed in seven to nine days to kill lice that have hatched from remaining nits.

Lice can develop resistance to certain chemicals, so if one pediculicide doesn’t work another might. If your child has lice, consult your pediatrician or the school nurse about the best treatments. The CDC site also provides guidance.

Because previous treatments haven’t worked or to avoid chemicals, some people try home remedies such as vinegar, isopropyl alcohol, mayonnaise and petroleum jelly. They seldom work.

Here are some lice-removal tips provided by the CDC:


  • Before applying treatment, remove clothing that can become wet or stained.

  • Apply pediculicide according to the instructions contained in the box or printed on the label. If the infested person has hair longer than shoulder length, a second bottle might be necessary. Pay special attention to instructions on the label or in the box regarding how long the medication should be left on the hair and how it should be washed out.

  • If a few live lice are still found 8 to 12 hours after treatment, but are moving more slowly than before, do not re-treat. The medicine may take longer to kill all the lice. Comb dead and any remaining live lice out of the hair using a fine-toothed nit comb. They’re often found in lice medicine packages, but many flea combs made for cats and dogs are also effective.

  • After each treatment, checking the hair and combing with a nit comb to remove nits and lice every couple of day might decrease the chance of self-reinfestation. Continue to check for two to three weeks to be sure all lice and nits are gone.

  • If you’re using the prescription drug malathion, re-treatment is recommended after seven to nine days ONLY if crawling bugs are found.

  • Do not use a combination shampoo/conditioner, or conditioner before using lice medicine. Do not wash the hair for a day or two after the lice medicine is removed.


Head lice can’t survive long if they cannot feed on someone’s scalp. So you needn’t spend a lot of time or money on housecleaning activities after treatment. To avoid re-infestation by lice that have fallen off the hair or crawled onto clothing or furniture:

1. Machine wash and dry clothing, bed linens and other items that the infested person wore or used during the two days before treatment using the hot water (130°F) laundry cycle and the high heat drying cycle. Clothing and items that are not washable can be dry-cleaned
OR
sealed in a plastic bag and stored for two weeks.
2. Soak combs and brushes in hot water (at least 130°F) for 5 to 10 minutes.
3. Vacuum the floor and furniture, particularly where the infested person sat or lay even though the risk of getting infested by a louse that has fallen onto a rug or carpet or furniture is very small.
4. Do not use fumigant sprays; they can be toxic if inhaled or absorbed through the skin.

Some common treatments can cause skin or eye irritation. Call the poison center if a child swallows lice shampoo or medicine or if someone splashes these products into the eyes. The 24-hour number is (800) 222-1222.

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