Head Lice: A Panic-Free Guide

Lice.

Feeling itchy yet?

That response, along with an “eewww” is pretty typical, even just thinking about lice. And finding it on your child’s head? It’s enough to send even calmer parents into a tizzy. Hopefully the following information can help you and your household stay sane when confronted with an infestation.

Stay calm

1) Lice don’t carry disease.

They’ll make one’s scalp feel itchy, and scratching can lead to some scabs. Too much scratching anywhere can lead to secondary infections (bacteria on the outside getting “under” the skin and growing there). But the lice themselves don’t cause serious health problems.

2) Any human can get lice.

I know, that may not initially seem especially reassuring, but it should be. If your child gets infected, it’s not because they’re dirty, or because you haven’t kept the house clean enough. People of all social groups, economic statuses, and ethnicities can get lice.

3) Lice don’t jump, hop, or fly.

It takes prolonged, head-to-head contact to spread lice—think sharing a bed. Occasionally, lice can be transmitted from sharing headwear (hats and caps, scarves, and ribbons, and occasionally combs, hairbands, and barrettes), so “Don’t share what’s on your hair” is probably a good rule to teach our kids. But walking past someone or even sitting in the next desk for a school day will not spread lice.

4) Lice can be treated.

And finally, there are treatments, and they do work. So, you’re not stuck with lice forever.

Diagnosis

Diagnosing the lice is the first step. People will typically have lots of itching, especially behind the ears or along the hairline on the back of the neck. Look in these locations for small crawling bugs (about the size of a sesame seed), and for lice eggs (called “nits”) which are yellow to white casings adhered tightly to the shaft of a hair. The nits, too, are small—about the size of a knot in a thread. They need the warmth that comes from being close to the scalp (within a quarter of an inch) to survive, but they are adhered so tightly to the hairs, that empty and dead casings can be found farther along the hair shafts.

Treatment

Over-the-counter medication

If you do find lice, the first line of treatment is an over-the-counter medication. These generally do a good job of killing the live lice when the instructions that come with the medication are followed carefully. Conditioners and conditioning shampoos can interfere with the medication, so be sure not to use these just before a treatment. And, because the medications don’t work well on lice eggs (called “nits”), you’ll need to repeat the treatment in seven to ten days; it’s a different length of time for each medication, so again, be sure to follow the instructions.

Combing

Ever heard the term “nit picking”? The phrase comes from the tedious process of carefully combing through hair to remove the nits (egg casings) from a person with lice. Fortunately, this process is not required, as we can have much greater success using appropriately-timed medications. “No-nit” policies at schools and daycares are out too: children should not miss or be excluded from school because of head lice.

Cleaning

Extensive house cleaning is NOT necessary. Again, remember that lice don’t happen because our households or children aren’t clean.

• Clothing and bedding that has touched the individual’s head in the past two days should be washed using the hot water washing cycle (over 130°F) and the high-heat drying cycle. Dry cleaning kills lice too.
• You may want to treat stuffed animals as well. If these can’t be washed, storing them in plastic bags for a period of time (so that the lice don’t have access to humans) is an option. Since lice can’t survive without a human for more than one to two days, starving them for that length of time should be sufficient. For extra insurance, two weeks in a plastic bag (to make sure any eggs have hatched, and those adults can’t feed either) is more than enough.
• General household cleaning (vacuuming carpets and fabric-covered furniture) is plenty, to pick up lice that have fallen off the head of an infested person. “Fumigating” with insecticide sprays or fogs, either individually or professionally, is NOT necessary and will expose your household members to toxins.

Other household members

Check other household members for lice as well. Everyone who has it in any household in which your child spends significant time should be treated simultaneously. But pets do NOT need to be treated, since the lice only live on humans.

If following the above recommendations with the appropriate timing of any repeat treatments fails to resolve the infestation, then you’ll want to reach out to Pediatrics Northwest. There are prescription medications that can be used if over-the-counter medications fail.