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Head Lice


Main > Common Problems > Head Lice Treatments

Head Lice Treatments





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Head lice infestations are a common problem in infants and children, even in those who practice good hygiene and frequent hair washing. Lice only infect humans and they are spread by direct contact with someone who is already infected or by use of their belongings (such as hats, brushes or combs).

The most common symptom of children infected with head lice is itching, although some children do not complain if they have a light infestation.

Adult lice are reddish-brown and 1/16 of an inch long. They move very fast and are most commonly seen at the back of the neck and behind the ears. Lice can only survive for two to three days when off of the human body. Nits are eggs from the adult lice and are whitish and are firmly attached to hairs. The eggs hatch in 6-10 days and it then takes another two to three weeks for the lice to mature and be able to reproduce.

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Although many schools and day care centers have no nit policies, just because you have nits doesn't mean that you will have a lice infestation. Even after nits hatch, the casing can stay on the hair for a long time and it is hard to tell the difference between a nit with a live louse embryo in it, which can be infectious, and an empty one. Nits are more likely to contain a live embryo if they are close to the scalp.

So what do you do if you see nits? First, do a thorough check of your child's hair and scalp to look for live lice. If you don't see any, then you may be able to just try and remove the nits on a regular basis and continue to look for live lice. Since most of the anti-lice medications are not ovicidal, meaning they don't kill the eggs, treating a child with just nits may not be necessary.


Anti - Head Lice Shampoos

If you find lice or nits on your child, use an anti - lice shampoo, such as Nix or Rid, and follow the package directions carefully. In general, you should apply it to washed and dried hair and apply the shampoo until the hair and scalp is saturated and thoroughly wet. Leave the shampoo on for ten minutes and then rinse it out. Consider using a second shampoo treatment in 7-10 days to kill newly hatched lice.

A prescription shampoo, Ovide (malathion), may be needed for resistant lice. It is lathered into dry hair and left on overnight. It should not be used in newborns or infants, and be careful, because it is flammable!


Removing Nits

To assure total lice treatment it is necessary to remove all of the nits in your child's hair. You can use the plastic comb that came with your antilice shampoo, or for better results, consider buying a fine toothed metal comb (such as the LiceMeister 888-542-3634 to order).

Use a regular comb or brush and hair clips to remove tangles and separate your child's hair into sections. Now use your lice comb and go through each section of hair from the scalp to the end of the hair, removing all of the lice and their nits (lice eggs). After finishing each section, search again for any lice that you may have missed and remove them.

It is important that you now check your child's hair every night until all of the lice and nits have been removed. Sit your child in the bathtub and comb their hair out with a regular comb. Check the scalp thoroughly and remove all lice (alive or dead) that you find. Next, use your lice comb again and go through each section of hair until all nits have been removed.

For lice in eyelashes, apply Vaseline to the eyelashes twice a day for a week to kill them.


Cleaning the House

Lice can live for up to three days off of the human body, so it is important to follow these steps to prevent reinfestation:
  • Wash all bedding and recently worn clothing in hot water (>120º) and dry in a hot dryer.
  • Soak combs/brushes in hot water for 10 minutes.
  • Vacuum to remove all lice and hairs with attached nits from furniture, rugs, stuffed animals and car seats. Place items that can not be washed or vacuumed into plastic bags for three weeks.
  • Change your child's sheets and pillowcases every night for a week and wash in hot water.

Alternative Treatments

There has been much talk about newer therapies for treating resistant lice such as applying full fat mayonnaise, olive oil, Dippity-Do brand styling gel, or Hair Clear 1-2-3 to the hair overnight. This is supposed to suffocate or smother the lice, and while this is probably safe to do, it is messy and probably unnecessary if your are persistent in manually removing lice and nits. To remove vaseline from hair, consider using baby powder and a liquid grease-cutting detergent.

See the site www.headlice.org for more info.

Some physicians are using oral therapies to deal with resistant lice, including the drug ivermetim (a one time dose) and the antibiotic Bactrim (3 day course).


Treatment Failures

While there is much evidence that lice are becoming resistant to the effects of anti - lice shampoos, the most common reasons for treatments to not work is failure to remove all of the nits. Another common reason is that your child is continuing to be exposed to someone with lice, either at school or daycare. Make sure that all childcare personal know to do lice checks on all children to prevent reinfestation.

After treatment, if you continue to see nits, but no live lice, then that may not really be a treatment failure. Nits, even when empty, can stay attached to the hair for a long time. Continue checking your child's hair and scalp daily to remove nits until they are all gone.


Important Reminders

  • Be patient. This is a frustrating problem.
  • Check your children for lice regularly and teach them to not share combs, brushes or hats.
  • Avoid using lice sprays, pesticides, gasoline or other non-approved products on your child. These can be deadly!
  • Call your pediatrician if your child's lice infestation has not resolved in 1-2 weeks or if his scalp has a rash that is infected with pus or honey colored scabs.



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Important disclaimer: The information on keepkidshealthy.com is for educational purposes only and should not be considered to be medical advice. It is not meant to replace the advice of the physician who cares for your child. All medical advice and information should be considered to be incomplete without a physical exam, which is not possible without a visit to your doctor.