Pediatric Conditions and Treatment Head Lice: Stop the Spread and Get Rid of it For Good

Head lice are tiny, wingless insects that live on the human scalp and feed on blood, like vampires! Anyone can get them, regardless of how clean their hair is.

Lice spread through direct head-to-head contact. This is the most common way for them to move from one person to another. While they can also spread through shared items like combs, brushes, hats, and even pillows and bedding, these methods are less common. Lice don't jump or fly, but they can crawl quickly across hair, making head-to-head contact a key risk factor.

What are the signs of head lice?

The most common sign of head lice is extreme itching. This happens because humans have an allergic reaction to the lice's saliva. However, itching may take several weeks to develop after an initial infestation. You should also look for:

• Tiny white dots (nits) attached to the hair shaft: Nits are the lice eggs, which appear as small, oval-shaped objects.
• Live creepy crawlies: These small, gray-brown insects move quickly and are usually found near the scalp.

The gift of lice causes kids to scratch, a lot, but doing so can cause sores on the scalp, and even bleeding. That's why it's important to nip the nits in the bud.

How can I be absolutely sure my child has head lice?

Take these steps to check for lice:

• Use a fine-toothed comb: Gently comb through your child's hair, section by section, over a white paper towel or sheet.
• Look for live lice and nits: Inspect the comb after each stroke for any signs of lice or nits. You need to find live lice for a definitive diagnosis because nits alone might just mean a past infestation.
• Check behind the ears and at the nape of the neck: Lice love to hide in these areas.

If you find lice or nits, don't panic! Head lice are easily treatable. There are several different types of over-the-counter (OTC) lice treatments available at most drugstores-and some home remedies that some believe work.

The gift of lice causes kids to scratch, a lot, but doing so can cause sores on the scalp, and even bleeding. That's why it's important to nip the nits in the bud.

There are a couple of things you can try that pediatricians have seen success with:

1. Over-the-counter and prescription lice medications and products

• Lice shampoos: These shampoos typically contain pyrethrins or permethrin, which kill lice and nits. Follow the instructions carefully and repeat the treatment as directed. Don't skip any steps, even if the lice "seem" gone. Keep in mind that lice can be stubborn and sometimes resist these products, so if they don't work, consider prescription options.
• Lice lotions: Ask your doctor to prescribe ivermectin (Sklice) or spinosad (Natroba), which are effective prescription options.
• Cream rinses: Often called the "Nuvo Method," look for Cetaphil Gentle Skin Cleanser as another option you can apply to the hair, comb out the excess cleanser and nits with a metal lice comb, then blow the hair dry with the cleanser applied. Generally, you leave it on overnight and wash it out in the morning. Because this cleanser is not made for hair, it has a drying effect that can suffocate lice. Note that this method is not FDA-approved for lice treatment, though some families say it works.
• Comb out the leftovers: Remove any remaining lice or nits after you've done all treatments. Follow-up combing about a week later helps ensure all lice are gone.

2. Home lice remedies - hey, can't hurt to try!

• Mayo: Gross is right. While no science backs this up, some people believe that covering the hair with mayonnaise for 8-12 hours can suffocate the lice.
• Essential oils: Some people believe essential oils, such as tea tree oil or lavender oil, have insecticidal properties. However, research on their effectiveness is limited, so use with caution.
• Vinegar: Diluting vinegar with water and applying it to the hair can help loosen the nits from the hair shaft. Just watch the eyes-it stings.

Note from your friendly neighborhood pediatrician: we highly recommend you try the proven medications first.

Ok, but I never want this, ever. How do you prevent head lice?

While head lice are common, there are things you can do to help prevent them:

• Make it a teachable moment: Tell your children what head lice are and how they spread. Help them understand how to avoid head-to-head contact.
• Avoid sharing personal items: Encourage your child to avoid sharing combs, brushes, hats, and scarves.
• Do regular lice checks: Checking your child's scalp periodically can help catch an infestation early.
• Vacuum regularly as a precaution: Focus on areas where your child rests their head.
• Wash bedding and clothing in hot water and dry on high heat: Do this if you have heard rumors of any infestation in schools, daycare settings, or other places you attend. Lice cannot survive for more than 48 hours off the human scalp.

My child has head lice. How can I prevent them from being bullied?

Here are ideas:

• Be calm and supportive: Head lice are common and easily treatable. Keep reminding yourself and your child that. Also, reiterate that it can happen to anyone.
• Talk to your child about head lice: Explain that it's not their fault and that you will help them get rid of the lice.
• Keep a positive attitude: Your child will feed off your energy, so stay positive and reassuring, even if you feel stressed and grossed out.
• Don't shame your child: Head lice are not a sign of poor hygiene, and it's important to avoid making your child feel embarrassed or ashamed.
• Communicate with your child's school: Many schools have policies for dealing with head lice, and it's important to be aware of them. Your child's school nurse should warn parents if an infestation has been reported without releasing your child's name.

Head lice infestations are a common part of childhood, but they don't have to be a major source of stress. By understanding how head lice spread, how to treat them effectively, and how to prevent their return, you can confidently manage this situation and keep your family louse-free. Remember, you are not alone, and with the right tools and a bit of patience, you can conquer head lice!