Head Lice Treatments

The most common symptom of children infected with head lice is itching, although some children do not complain if they have a light infestation. Frequent itching can lead to the develop of crusty sores on the child's scalp, which can be a sign of a secondary infection.

Adult lice are gray or reddish-brown and 1/16 of an inch long or about the size of a sesame seed. They move very fast and are most commonly seen at the back of the neck and behind the ears. They move by scurrying, but do not hop or fly.

Lice can only survive for one to three days when off of the human body. They survive by biting and feeding on human blood.

Nits are eggs from the adult lice and are whitish and are firmly attached to hairs. A female louse can lay about 6-10 eggs a day or about 100 eggs over her lifetime of 3-4 weeks. The eggs hatch in 6-14 days and it then takes another one to two weeks for the lice to mature and be able to reproduce and lay more eggs. In untreated children, this cycle will repeat itself about every 3 weeks.

For light infestations or if you don't want to use an anti-lice shampoo, you could try to manually remove the live lice and nits. The National Pediculosis Association recommends that 'manual removal is the safe alternative and necessary component to any head lice treatment regimen.'

You can also use an anti - lice shampoo, such as Nix (1% permethrin) or Rid (pyrethrins plus piperonyl butoxide), and follow the package directions carefully. Keep in mind that the American Academy of Pediatrics recommends that Nix is 'the recommended treatment of choice for head lice.'

In general, you should apply it to washed and dried hair (Nix) or wet, unwashed hair (Rid) 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, since these shampoos aren't good at killing nits.

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! Unlike most OTC anti-lice shampoos, Ovide has high ovicidal activity and so is more likely to kill the nits too.

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 suffocate and kill them.

• 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. You might consider placing items that can not be washed or vacuumed into plastic bags for three weeks, but this probably isn't necessary in most cases.
• Change your child's sheets and pillowcases every night for a week and wash in hot water.
• Since lice don't survive long off a person's head, you usually don't need to use pesticidal sprays on carpets, furniture, etc.

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). Elimite (1% permethrin), a stronger, prescription version of the medication in Nix is also sometimes used for resistant or hard to treat cases of head lice infestations.

Resistant lice may also be suspected because an incorrect diagnosis has been made. A recent study showed that only about 30% of the samples submitted actually included a viable nit or louse. The other samples included empty nits, dandruff, hair casts, etc. So the first step in finding out if your child has a treatment failure is to visit your doctor for an evaluation. This may decrease unnecessary treatments and missed school days.

• Be patient. This is a frustrating problem.
• Check your children for lice regularly and teach them to not share combs, brushes or hats.
• Unlike other infestations, like pinworms and scabies, you usually don't have to treat every one in the house unless you find live lice on them.
• 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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