Treating Head Lice

What are head lice?

Head lice are tiny bugs the size of a sesame seed. Young lice, or nymphs, are clear, but as they feed on blood they become a reddish-brown to black color. Usually head lice do not cause health problems, but they can be annoying. Getting head lice does not mean a person is dirty, but rather that they have been near someone with head lice.

How do you get head lice?

While head lice do not fly or jump, they can move quickly. Head lice travel from person to person after close contact. Sharing of hats, brushes, combs, or pillows can easily spread head lice from one person to the next. Close head-to-head contact, such as when children are playing together, can also spread head lice.

How do I know if my child has head lice?

Children with head lice may complain of their head itching. Some children may also have red bumps on their scalp. If you look closely you may see the live lice, but not always. Seeing nits, or lice eggs, is often the only way to tell your child has lice. The tiny yellowish-white oval nits are attached to the hair shaft and may be confused with dandruff. Unlike dandruff, nits are not flaky or easily removed from the hair. Nits may be found throughout the hair, but are most often seen at the back of the head, just above the neck, or behind the ears.

How do you treat head lice?

Once you know your child has head lice, you should begin treatment. Use of over-the-counter (OTC) lice products containing permethrin 1% (Nix) or pyrethrins (RID, A-200, others) is the first step. When using these products the directions should be carefully followed. In addition to use of these OTC lice products, you may also want to remove the nits. The hair should be checked in one inch sections. A finetooth lice comb can be used to comb out remaining live lice and nits. Not doing proper nit removal can cause OTC lice products not to work as well.

Experts also recommend a second treatment with OTC lice products nine days after the first treatment, to kill remaining lice or lice that have just hatched. If after two treatments you still see live lice, you should call your child's prescriber. There are prescription lice treatments your child's prescriber may want you to try.

Don't use unproven remedies like mayonnaise, petrolatum jelly (Vaseline), olive oil, butter, Cetaphil (Nuvo lotion), or tea tree oil. Also, don't use dangerous chemicals such as rubbing alcohol, kerosene, gasoline, or paint thinners.

Once I've treated my child, how do I keep them lice free?

Be sure to machine wash clothes, bedding, and towels used by your child within the previous two days. Use hot water (130 degrees F) and/or dry them in a hot dryer (for at least 20 minutes). Items that can't be washed or placed in the dryer can be vacuumed or put in a sealed plastic bag for two weeks. Soak combs and brushes in hot water (at least 130 degrees F for 5 to 10 minutes). Going overboard with house cleaning is not necessary. Also, the use of lice sprays on furniture is not recommended. Carefully check your child's hair (and their brothers' and sisters' hair too!) for several weeks after treatment. Then continue to check their hair every now and again. The sooner you know your child has lice, the easier it is to treat it and keep it from spreading.

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