Pediatrician Molly O'Shea, who writes for Patch and has her own practice, in Troy, has seen her share of head lice cases. Here are her suggestions to parents:
Little else strikes fear and grossness in a parent that the yellow note in his child's backpack indicating her schoolmate has head lice. Just thinking about it makes your head itch! The thought of little bugs crawling around on your scalp, sucking your blood, laying eggs and generally causing a nuisance is disgusting. Here is the truth about head lice and how to treat it.
Head lice is not caused by lack of cleanliness. In fact, lice like clean hair best and especially hair adorned with gels and sprays and sweet-smelling conditioners. So, don't be grossed out that some "dirty" kid brought this scourge upon you - just the opposite.
Facts about lice
- Pets can't carry lice.
- Lice can't fly, they can only crawl and cannot jump more than an inch or two at most.
- Lice eggs are called nits and hatch nine days after being laid.
- Lice mature in 10 days and can live about 25 days total.
- Each female louse lays about 80 eggs in her lifetime.
- An adult louse can survive off the host for two days.
- Prepubertal kids get lice pretty easily.
- Adults are much less susceptible.
- Lice do not carry diseases.
- Getting lice is not due to bad hygiene.
- Only items in contact with the hair itself need to be cleaned (no need to vacuum the whole house for example). Hats, hair brushes, hair clips and bedding definitely need to be cleaned, but stuffed friends only need to be quarantined for a few days because lice can't live off a person for longer than that.
Be sure it's really lice
Not all white stuff near the scalp is lice related. Making a correct diagnosis is important. If you don't see live lice you can't be sure it is head lice.
If you suspect your child has lice, comb her hair while it is wet and look for the actual bugs. If you find even one, you have an active infestation. Sometimes dandruff, cradle cap or just poorly rinsed shampoo can cake on the scalp in areas and flake off resembling nits. Be sure you have the real thing before you go through the hassle of treating it.
If need be, take your child to the doctor to be sure.
How to treat it
Using an over-the-counter medicated shampoo is a good way to kill the lice, but be sure to use it correctly! Rid and Nix are the most common, but recently the FDA approved a nonpesticide containing a product, Ulesfia, that is safe and effective for children 6 months and older.
When you pick up your medicated shampoo, apply it to dry hair (not washed hair as the package suggests). When you wash the hair, the lice can sometimes ball up and protect themselves and the medicated shampoo won't do what it needs to. Instead, apply it to dry hair, everywhere, careful to get every hair near the scalp covered. Leave the shampoo on for the time recommended and wash it out.
An inexpensive alternative: Cetaphil
There is an inexpensive and very effective treatment available that has been tested and studied well. Here's how it works: Buy over the counter Cetaphil cleanser (also known as Nuvo lotion). Mix and rub 12 ounces of it onto a dry scalp and hair for 30 minutes, then comb it out as much of the goo as possible, use a hair dryer to fully dry the hair, then shampoo eight to 24 hours later. Repeat in one week.
When combing out the hair, combing down toward the scalp (as opposed to the usual way you would comb your hair from scalp to ends) is much more effective at removing nits.
In two applications, one week apart, 99 percent of kids were free of lice. This method works by suffocating the lice with the goo and then the goo traps the bugs and nits and makes it even easier to get them out.
Sounds simple, doesn't it?! And cheap, too: The Cetaphil only costs about $10 as opposed to other products that don't have the success rate this does. The other thing about this method that makes it so appealing is that the need to comb out the hair painstakingly every day for the intervening week is gone.
The prescription product Ulesfia works similarly, but at $44 per bottle it seems a big expense. For this product, you only have to use it for 10 minutes, and then comb it out. Repeat in one week. So it's a little faster but more expensive and requires a prescription.
Comb, clean, be vigilant
Combing the hair thoroughly to remove all nits and lice is essential regardless of whether you use a medicated cream or the Cetaphil lotion. Using the proverbial fine-toothed comb (I think metal ones are far superior to the plastic ones), meticulously comb through the hair, making sure you get every single hair between the tines of the comb at one point.
High heat: Put all hair brushes, combs, hair accessories, hats, etc. either through the dishwasher or the laundry on high heat to kill any lice that remain.
Comb, web, comb: Comb out the hair thoroughly every day for the next week. You will undoubtedly miss some nits (the lice eggs) so to ensure they don't hatch and lay new eggs, wet the hair and comb it out every day for the next week.
Repeat shampoo: Reapply the medicated shampoo or the Cetaphil lotion a week later to kill any hatchlings and comb out for another few days.
Laundry: Lice don't live long off the scalp. No need to do laundry every day for this week or two. Just do the bedding on day one and any other day that you find live lice. There's some debate about whether you really need to bag up stuffed toys, hats that can't be washed, etc. It seems that since the lice can't live long off a human head to feed on, these items won't harbor live lice for long.
Natural remedies like mayonnaise, tea tree oil and other products have not been shown to be any more effective than just combing the wet hair.
No need to spray: Spraying your furniture or house with lice killing spray is not necessary because lice don't survive off the scalp. Pets can't get or carry lice either.
Don't overreact: Don't treat your whole family just because one child has lice. You can't prevent lice infestation. Just comb your infested child's hair well, wash the hair accessories, combs, brushes and hats and stay on the lookout for lice.