Head Lice

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     Nothing quite strikes fear and panic into the hearts of parents as much as the words “head lice”. Yet, it is almost impossible to get your child from preschool to high school without encountering these little beasts.

     Every time one of my children had head lice, my own head started to itch. I never had lice, but I treated myself just the same. The worst case we had was when the coach of the girls softball team insisted the players all wear the batting helmet without a cap on underneath. Sure enough, the whole team got infected.

     If you see your child itching his head – especially at the nape of the neck and behind the ears, look closely near his scalp. The egg casings (nits) are white or grey, oval or bullet-shaped and attached firmly to the side of the hair shaft. Dandruff brushes off easily. Nits don’t brush off. You may see actual lice crawling on the child’s hair (Eeek!), but most of the time you won’t.  The experts say that seeing nits doesn’t make the diagnosis of head lice – that you have to see live lice - but if your child is itching and you see nits, you’ve got lice.

     After the immediate panic, parents need to get into the right frame of mind. Head lice have become resistant to most forms of therapy over the years, so, you need to abandon the feeling that you MUST get rid of the lice RIGHT NOW! Know that, even though it is going to take a while and a fair amount of work, the lice will be gone soon. All you have to do is to keep up the attack. Getting rid of head lice involves two basic principles: Make the head a “not-so-nice-place-to-live” for the lice and then keep removing the eggs and lice until they’re gone. The first involves using medications that can be purchased without a prescription such as Nix or Rid. They are placed on wet hair after shampooing (don’t use conditioner), left on for a time and then rinsed off with water. Be sure to follow the printed directions. Next, use a good, metal nit comb (the free plastic ones in the lotion packages are worth what you pay for them) and get to work combing the wet hair. Wash the pillow cases in hot water and wash or change out the hats but don’t try to fumigate the rest of the house and don’t buy anti-lice furniture sprays. There is little evidence that lice live longer than 48 hours off of the scalp, so I’ve never understood why you would “put pillows and stuffed animals in a bag for two weeks". Lice can’t fly or jump, although they could fall off onto a stuffed animal, but any louse that leaves a nice, warm, bloody scalp to get on a piece of nylon probably wasn’t going to live very long anyway.

     Forget mayonnaise, olive oil, petroleum jelly and hot-air drying. A straightening iron could fry a few of the critters and makes the hair easier to comb, so it might help, but the main thing is to comb daily after treatment. The nits hatch after a week, so repeat the medicine treatment once each week followed by daily combing until the lice go.
     There are medications that your doctor can prescribe: malathion (Ovide) for children 24 months and older; benzyl alcohol (Ulesfia) and invermectin (Sklice) both of which can be used on infants down to 6 months and spinosad (Natroba). Be sure to find out what these medications will cost and whether your insurance will cover them.
      There are also oral medications which can be used. Speak with your child’s caregiver about them.

     Nits that are alive are usually closer than an inch from the scalp. If the nit is further than an inch from the scalp, it is empty or dead.