My kids enjoy complaining about their ailments. In fact, they verge on hypochondriasism... A knee scrape might as well be gangrene, a headache is tantamount to a brain tumor, and a twinge of indigestion necessitates the marriage of this victim with our designated barf bucket. Therefore, when my 7 year-old, Grace began complaining about an itchy head, I figured she had a little dandruff or some dermatitis at play. I checked her head a few times, saw nothing except some white flake-like substance along her crown and over her ears. Then my 9 year-old came home from school scratching like a dog with fleas and I took it more seriously. I got out a bright light and began looking at both girls' heads. More dandruff, I thought. I sat and stared at Grace's head for a while and much to my chagrin, I saw a little critter peek out of her locks. I thought I'd imagined it. Then, another little booger blessed me with his presence and no longer could I blame it on my imagination. Jodie was next, and now that I knew what I was looking for, I saw an adult louse play the peek-a-boo game with me again. My son's short hair made finding the lice easy, one was just hanging out above his ear.

I am panicked. I call my pediatrician's office as if my children have a medical emergency. I wanted to bring them in, to have THEM take care of it immediately. The advice nurse assured me there was no reason to bring them in, with a little knowledge and effort the lice population could be eradicated. Easy for her to say, I thought. I am a complete parasite-phobe. I could barely be in the same room with these licey children. Then, it dawns on me... As much as I try to discourage this behavior, my offspring love being in bed with me. Even better if they are sharing my pillow. I can't begin to entertain that I, a 41 year-old woman, could have head lice. I decided to deal with that possibility later.

Human head lice are called Pediculus Humanus Capitus. If one has head lice, the condition is called pediculosis. They are six-legged insects, about the size of a sesame seed. They are well adapted to attach themselves to human hair with claws. When they're first hatched, they are clear/transparent in color, making them very difficult to see. After their first feeding, they take on a reddish-brown hue and have the ability to camoflauge themselves in the hair by adapting their color to match the host's hair. Unlike fleas, they cannot jump, they crawl, in fact they scurry when they need to hide. They are wingless, therefore unable to fly. They feed only on human blood, not your precious pets, and are unable to live off their host for a significant amount of time: 24 hours tops. Once hatched, a louse lives approximately 30 days during which time the female may lay up to 100 eggs. Males are slightly smaller than females.

There are three stages of the lice life cycle: egg, nymph, and adult.

Eggs are also called nits. A female louse will feed on human blood, then mate and lay her eggs approximately two days later. The eggs are laid very close to the scalp, and the adult secures them to the hair shaft with a very strong cement-like adhesive. Six to nine days later, a tiny nymph emerges. In about a week, after the nymph has molted three times, the nymph matures into an adult capable of feeding on human blood about five times per day. Head lice have retractable mouthparts:  they have two tubes they use to pierce the skin to extract the blood.  When they're not feeding, these mouth parts are retracted back into the head. If she's female, she will lay approximately three to four eggs every day.

Myth- Dirty people get head lice. Fact- Lice prefer clean heads and hair! It's easier for them to hook onto clean hair than dirty hair.

Myth- I will need to fumigate my house since we've had a lice infestation. Fact- Lice can only live for one to two days off the human host. Any eggs/nits that hatch will die very quickly, we're talking about hours here, if they have no human blood.

Myth- I still see nits in the hair, the infestation is still active. Fact- Many of the nits visible in the hair are empty egg casings. Nits lay new eggs very close to the scalp as they require a warm temperature to hatch. If you see a nit more than a few millimeters away from the scalp, chances are it's an empty egg. One can have these empty nit shells without having an active infestation. Live nits are a yellowish-white, hatched nit shells are white and almost translucent.

Myth- Only children get lice. Fact- Adults can get lice, too. They do have some preferences, however. More children are infested with lice than adults, probably for behavioral reasons, i.e. children play in close proximity to one another, especially girls. They seem to prefer female hair as well, potentially because there are more hiding places.

Myth- Lice jump from kid to kid. Fact- Lice cannot jump like fleas. They crawl from head to head. Kids are more like to have this head to head contact, and more likely to share hairbrushes, hats, pillows, etc...

Myth- I can successfully treat my head for lice once. Fact- Regretfully, it takes more than one treatment to eradicate lice. See lice treatment methods below.

Myth- I can get lice from my pets. Fact- Head lice absolutely do not live on animals, they are only able to live on human hair.

Myth- Head lice spread disease. Fact- Head lice are innocuous. They are not harmful and not capable of spreading disease. They only become harmful if a secondary skin infection develops from intense scratching.

Myth- Head lice always cause an itchy scalp. Fact- In some people, head lice cause no itching and scratching. Some people are not affected by the louse's saliva. Some people never experience the itching, and in other it may take up to three months to begin to have an allergic reaction to the saliva.

Myth- There will be lots of lice crawling around the head.  Fact- There are usually only one or two.  In advanced and severe infestations, there may be a dozen at most.

Having never dealt with this before (and somehow knowing I just would at some point or another), I really didn't know what I was looking for in my children's hair. Grace was scratching away, and after numerous head checks I thought she just had dandruff. I saw the white nits, never saw an actual louse, so I figured she just needed a good Head & Shoulders shampoo.

OOPS! All the "dandruff" I was seeing was actually the nits. So, how can you tell the difference? The nits will be glued onto the hair, they are quite difficult to get off, in fact, you need to use your fingernails to slide them off the strands. Dandruff, on the other hand, readily falls off the hair. Generally you can just blow it off, or when you blow it will actually move.

Here are my recommendations for making a definite active lice infestation diagnosis:

For dry hair:

1. Get out a VERY bright light and shine it on the head.
2. Concentrate your search on the top of the head, above the ears, and along the neckline- these are popular lice hangouts.
3. Part the hair into small sections and meticulously search for nits by lifting up smaller subsections. If you find a white speck or flake, attempt to dislodge it. If it's glued on or hard to extract, you probably have a nit.
4. Stop touching your child's head (or your own) and wait patiently and quietly with the light still shining on the head. This is how I first saw the adult lice travelling around my daughter's head.

For wet hair:

1. Get a high quality lice comb- don't bother with plastic, the teeth bend and the little boogers slide right through. Get a sturdy lice metal comb, even a metal flea comb does wonders.
2. Get a white towel or cloth for wiping off the comb and having a background that aids in visualizing what's coming off the head.
3. Wet the hair and place a lot of conditioner on the head. Use at least twice the amount you'd normally use.
4. Again, part the hair into sections and comb like a maniac.
5. Wipe the comb on the cloth and carefully observe what's coming off.  You will see black specks on the comb and on the towel. 

Remember, one must observe a live louse on the head to verify an active infestation.  The presence of nits doesn't guarantee the infestation is current, especially when the nits are a few millimeters down from the scalp.

Forget about Nix. Forget about Rid. They just don't work anymore.

Welcome the new breed of lice called: Superlice. Think Darwinism, survival of the fittest here. Lice are highly adaptive, a true biological success story as parasites go. They've become resistant to the pesticides (pediculicides) we've been using on them for years. The permethrin in Nix and pyrethrin in RID just don't do the job anymore. Not to mention, they are dangerous for pets, and not so great for children, either. They are technically neurotoxins, chemicals that attack the central nervous systems of living beings. Never, ever use these if you have cats in your home. They are deadly for your feline companions!

Okay, so we've established you can't poison these obnoxious insects anymore. So, how do we kill them? Well, aside from blood, they need oxygen to live, so the best treatments involve depriving them of oxygen, that is, smothering them to death. Two such smothering pediculicides have proven to get the job done: Lice MD and Cetaphil Gentle Skin Cleanser. They work, provided you follow these treatment steps thoroughly.

Gather these supplies:

1. 2 or 3 towels. One you will wrap around the child's (or adult's) shoulder to catch the drippy liquid.
2. An 8 oz. plastic dispenser. You can buy one at Sally Beauty Supply for a few bucks.
3. A regular comb or a lice comb. A lice comb is nice since it aids in combing out the Lice MD or the Cetaphil.

Step One: Start with dry hair. Fill the bottle all the way up to the 8 oz. mark if using the Cetaphil. Lice MD comes with a 4 oz. filled bottle. With the Cetaphil, you will begin with 8 oz, I used 6 for my son's very short, buzz cut.

Step Two: Divide hair evenly into four sections and secure with pins, clips or elastic bands. There will be two sections in the front, and two in the back. Lice MD recommends parting the hair every inch or inch and a half, but that's tricky if you're dealing with a lot of hair that likes to keep falling into the procedure, Having it separated into quarters will allow you to see what you are doing.

Step Three: Starting at the front left of the head begin squeezing the liquid onto the scalp making sure the applicator tip is touching the scalp. You will being by applying the lotion from front to back. The first section will take 1 oz. of the Cetaphil or 1/2 oz. of the Lice MD (this is a thick, viscous substance that only takes a small amount). Then you will move to the front right of the head and do the same thing using the same amount of the lotion. Move to the left back of the head, then the right back of the head using the same back and forth motion and you will be half done. You will still have 4 oz. of the Cetaphil or 2 oz. of the Lice MD left.

Step Four: Again, start at the front left of the head, only this time your application will be crisscrossing the first pattern you made applying the liquid across the head, from side to side. Thoroughly saturate all four sections of the head!

Step Five: Massage all 8 oz. of the Cetaphil or 4 oz. of the Lice MD thoroughly into the hair and scalp.

Step Six: For Lice MD: You will need no more liquid if you are using Lice MD. Now, you will wait for 10 minutes before combing.

For Cetaphil: Children with medium or long hair will need 4 more oz. of the lotion applied to the head. Do your best to repeat the steps listed above using the crisscross pattern with the remaining lotion. It's tricky at this point, but the goal is THOROUGH SATURATION.

Step Seven: Wait 10 minutes to start combing out the Lice MD. Wait 2 minutes to start combing out the Cetaphil.

Step Eight: Comb like you've never combed before, my friend. This takes a long, long time. It was a good 45 minutes to comb it out of my daughter's thick hair. About 30 minutes of combing for thinner hair, and 15 minutes for my son's short hair. It's a greasy endeavor with the Lice MD, it's very oily. The Cetaphil will come off in huge blobs, so have that towel ready underneath the seated child or adult.

Step Nine: How long do I comb? Until you see no more lotion coming off the comb. There are no shortcuts here, you're not done until you're done...

After combing you may wash the Lice MD out of the hair. Again, it's greasy stuff and takes a couple of shampoos just to get it all out.

Step ten: You don't need to dry the Lice MD in your hair, but you do need to with the Cetaphil. You must thoroughly dry the Cetaphil lotion in the hair from scalp to ends. This is necessary to completely dry up these lice to the point of them shriveling up! You must make sure they're totally suffocated, blow drying is an intergral part of that process, If the hair feels even slightly damp, you are not done.

After drying, do not wash out the Cetaphil!!! It must remain in the hair a minimum of 8 hours to fully work. I did the treatments at night and had the kids sleep and go to school the next day with it still in, so it was a good 24 hours before it got washed out. The hair will look fine with it, in fact it felt full and thick. Not a bad conditioner, either.

After this first treatment, you're just 1/3 done.  That's right, you have 2 more of these treatments to go. Why?  Because it takes that long to completely annihilate the life cycle.  You've done a good job killing lots of the lice and eggs, but newly hatched lice may still emerge.  It takes 7-10 days for that to happen, so treatment number two must occur exactly 7 days after this initial treatment to prevent these ladies from maturing and reproducing.  And, as I mentioned, the third treatment must come exactly a week after that. 

It's a lot of work, I know, from personal experience I'm fully aware of that fact.  But, if you skimp on this process, you're not going to succeed,  You MUST do these 3 treatments one week apart.  Don't wait for any longer than a week or you'll just be shooting yourself in the foot. 

Armed with almost no information, and scarred by a previous flea infestation, I went CRAZY cleaning. If I could have shrink-wrapped my house in plastic, I would have done so. But, as I previously mentioned, lice don't stand a fighting chance at survival off their human hosts. Thank goodness they're not like fleas that can live for weeks in carpet.

So, what do you need to do around the house to prevent reinfestation?

1. Wash and dry on the hottest settings all bedding.
2. Place all items that can't be washed, like stuffed animals and pillows in a plastic bag or sealed container for 2 weeks. This is even anal, since these guys can't survive very long.
3. Wash all combs and hairbrushes. I threw them in with the bedding so they'd be exposed to the heat. You can also put them in the dishwasher or soak them in isopropyl alcohol for 10 minutes.
4. Get out of the icky licey clothes you were wearing as the person being treated and the person who did the application. Wash them.
5. Don't worry about the carpets. Really, they're not interested in being there nor can they survive.

Important:

Do all three steps above each time you do a lice treatment on the head. So, weekly for these 3 weeks. Some people argue it's not necessary to actually launder the bedding, only to place it in the dryer for at least 10 minutes.

Be patient... May it not be a lousey experience for you.

For more information on treating head lice with Cetaphil, please visit: http://www.nuvoforheadlice.com/

For more information on treating head lice with Lice MD, please visit:  http://www.licemd.com/