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How to Deal with Head Lice

Updated on October 29, 2014

How to Deal with Head Lice

Say the word "lice" and you immediately get the heebie-jeebies.
 It's a natural reaction-after all, the thought of tiny 
critters living in your hair and drinking your blood is not an 
appealing one. Still, head lice is a common childhood issue. 
According to the American Academy of Pediatrics (AAP) there 
are six to 12 million infestations every year, particularly 
with kids ages three to twelve. "The most important thing to 
remember is that a case of head lice is a hassle, but it isn't 
a disease, nor does it cause disease," says Sue Will, a school
 nurse in St. Paul, MN [and president of the National 
Association of School Nurses]. "Try not to get over-anxious. 
Treat it and move on." Here's how to prevent, recognize and 
treat head lice.

How to avoid head lice

If you have children in school or daycare, you've most likely gotten a letter saying a kid has lice and what to do and how to check for it. Now, you may have been filled with that parent indignant righteousness that comes when your child's health is threatened by another child. Before you go trying to find the child understand it's not their fault, or their parents'. Lice happens. Take a breath. It will be OK.

You've probably heard me in the store, or someone like me. "Get that off your head. You don't know who's tried it on before." Bellowing through Walmart like the freak germaphobe I tend to be. It's true. The sight of one of my kids trying on a hat is enough to send me into a fit. Inevitably, I'll be checking the offender's head a week after the incident. And I'll be avoiding that store for a week, too. I'm already labeled "that mom" in three states.

Simply put, you can do everything right and your family could still end up with lice. And of course, head lice have nothing to do with hygiene or income level; anyone can get them. The most common route of transmission is head to head contact, such as two kids bending over the same coloring book. Because lice can't live long off the scalp, it's much harder, but not impossible, for lice to be spread by sharing hats, brushes, hair accessories and combs. Still, it's a good idea not to share these items.

Symptoms and appearance

The main symptom is an itchy head (caused by the louse's saliva when it removes a tiny amount of blood from the scalp), but a person can have head lice and not know it. "The gold standard for diagnosing lice is finding a live one on the head, but they can be very difficult to spot," notes Will. They crawl fast (up to 12 inches or 30 cm per hour - that's fast if you're the size of a sesame seed!) but do not fly or jump. An adult louse can be up to 1/8 inch (3 mm) in size and is pale grey or brown. "Look on the back of the head, in a line from one ear to the other," she suggests. Nits, or louse eggs, do not move. They are oval and tan, yellow or brown. After they hatch, the shell that is left behind is clear or grayish-white. Nits are found about a quarter-inch (one cm) from the scalp. The nits are firmly glued to the hair shaft by the adult louse. Nits are most commonly found around the nape of the neck or behind the ears, although they can be found all over the scalp.


Shampoos and lotions. Medicated shampoos or lotions (known as pediculicides because they contain a pesticide to kill the lice) are the most common treatment. It's very important to follow the treatment directions exactly. Most will require a follow-up application seven to 10 days later.

The most common over-the-counter products contain permethrin (eg Nix and Kwell), which is the treatment of choice recommended by the AAP; or pyrethrin plus piperonyl butoxide (eg RID, A-200, R&C, Pronto and Clear Lice System) which is similar to permethrin, but should not be used by people with allergies to chrysanthemums. Scalp irritation is a common side effect. Some lice have become resistant to some pesticides. If you're pregnant or nursing, consult your doctor before using these products, and they can't be used on kids under age 2. Only treat your kids if they have lice, not as a preventative measure.

Home remedies. Some people have tried home remedies, such as covering the scalp with petroleum jelly, olive oil, mayonnaise or large amounts of conditioner in order to "smother" the lice and nits, or antiseptics like tea tree oil products, but these methods have not been evaluated by medical trials. However, a study published in the journal Pediatrics found that a scalp treatment that involved specific steps with the facial cleanser Cetaphil was effective. Never use gasoline, kerosene, pet shampoos, WD-40 or other dangerous products.

Whatever treatment you choose, you will still need to use a special fine-tooth comb (such as one called the LiceMeister) to comb through wet hair and remove all the nits. Comb every three or four days for two weeks.

Surprisingly, you don't have to go nuts. Head lice only live for a matter of hours off the scalp, and require temperatures warmer than room temperature to hatch. To be on the safe side, wash and dry (at temperatures of 130F/54 C or more) bedding and clothing that has been in contact with the head of the infected person. Vacuum carpets and vehicle or furniture upholstery. Soak hair accessories, combs and brushes in medicated shampoo or rubbing alcohol for an hour, or just throw them out. Pillows and stuffed animals that can't be washed can be bagged in plastic for two weeks. Pets can't get or transmit head lice.

When my girls had lice, I used coconut oil. I slathered their heads and put shower caps on them. They had to wear the caps overnight. In the morning, I used a lice comb and went through every inch of hair they had. Thankfully, it was a summer they decided to cut their hair shoulder and chin length. You have no idea how much easier that is! After combing, I had them shampoo with no water. Then again with water. At night I covered their heads with conditioner and left it on all night with new shower caps. The new shower caps is essential. Seriously, don't use the ones from the night before or you'll be stuck doing this all over again. In the morning, comb, rinse and you're done. And oh so baby soft hair, too.

What other moms did. Sarah Climenhaga of Toronto took a combination approach when her whole family contracted lice. "The baby's hair was so fine we could easily comb out the few lice that she had," says Sarah. "I didn't want to use chemicals, so my four-year-old son and I used a large amount of regular conditioner and let it sit for 30 minutes. It seemed to work, but in the end we both decided to get really short haircuts so we could absolutely know the lice were gone!" Sarah's husband used a lice shampoo. They are all lice free. Barbara Gaudette of Ignace, Ontario used over-the-counter lice shampoo four times (for two outbreaks) on her 11-year-old daughter, combined with thorough combing and housecleaning, without success. Her pharmacist suggested a new non-pesticide lotion product that contains isopropyl myristate (brand name Resultz), which kills lice by dissolving their waxy outer covering, and that did the trick. It's currently available in Canada but not yet in the United States.

Check out kids' books like Yikes-Lice! by Donna Caffey or Scritch Scratch by Miriam Moss to help your children understand too.

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    • RichardCMckeown profile image

      RichardCMckeown 5 years ago

      Thanks for sharing, useful article.

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