How can I get rid of my child's lice?

How did my child get this? I keep her really clean!

Any child may get lice: rich or poor, short hair or long hair, old or young. It does not mean the child is dirty or bad!

Human lice live only on human hair and scalps. If your child has lice, he got it from another individual with whom he was in close contact. Any circumstance where a child's hair comes close to another child's hair can do it: sleepovers, long bus trips and field trips, etc. Also, sharing combs, brushes, hats, helmets, headbands, scarves, etc. can spread lice.

Regular daily baths and shampoos alone don't get rid of head lice -- so even very clean children can, and do, get head lice. Don't let your child feel self-conscious or ashamed about this very common pediatric problem.

How can I be sure my child has lice or nits?

Lice (tiny, grey-brown wingless insects) and nits (tiny white eggs, the size of a pinhead) are very common in children, but often misdiagnosed. The most common symptom is persistent scratching of an itchy head. Dandruff, dust, dirt, dried hair spray or gel, insects blown into the hair from outside, or eczema can all mimic lice or nits. Look very carefully. Brush your child's hair out vigorously while the child stands with his head over a white piece of cardboard or a white towel; live lice should come out easily.

If you still suspect that your child might have lice lurking in his or her hair, apply about 1 cup of isopropyl (rubbing) alcohol to your child's hair and work it in thoroughly. Then rub your child's hair vigorously with a white towel for about 30 seconds. The alcohol will make the lice "drunk" and cause them to come off the hair.

If you are not sure, let us check your child's hair.

How can I get rid of lice?

The problem isn't getting rid of the live lice -- it's getting rid of the nits.None of the medicines remove nits. They only kill live lice. Most children have only 5-6 live lice on the scalp at a time, which can be combed or picked out easily. Unfortunately, the live lice lay eggs (nits), which are glued firmly to the hair shaft. Children may have dozens of eggs at a time in their hair. After a week, the eggs hatch, the lice mate, and even more eggs are laid. Special "nit killing" shampoos kill live lice and the eggs, and loosen the "glue" that sticks nits to the hair shaft.

To get rid of lice, first treat the hair of everyone in the house over the age of 2 with a special nit shampoo:

  • Read labels carefully: each product has different directions. Many good products are over the counter and do not require a prescription. We recommend trying Rid or Nix (or their generic equivalents) first. If you suspect that the lice are resistant to these products, a prescription product or an herbal product like Hair Clear 1-2-3 is probably a better option. If you have questions about which product is best for you, please contact us.
  • Use an adequate amount of solution: 2 oz for short hair, 4 oz for long hair. Do not use other shampoo, rinse, hairspray, mousse, or other hair products for 24 hours.
  • Everyone should then bathe in the shower or bathtub and put on fresh clothes afterward. Do not rewash hair!
  • Be sure your child isn't infested in the eyebrows and eyelashes. If so, cover the eyebrows and eyelashes with petroleum jelly. Don't use nit shampoo here!
  • Never, ever use gasoline, kerosene, pesticides or motor oil on your child's hair! These home remedies are dangerous and ineffective.

Next, you'll need to pull out or comb out nits from everyone's hair next:

  • Special fine-toothed combs are available to scrape off nits. Fingernails work well too. Go through hair section by section and remove the small white "nits" (lice eggs) glued to the hair shaft, about one third of the way down the hair shaft.
  • Nit removal is easier to do when the hair is damp, right after the shampoo. Next, tackle the bedrooms:

Lice can live up to 3 days on inanimate objects, separated from a person. Go through the rest of the house and car:

  • Most personal articles of clothing and bedding can be disinfected by machine washing in hot water (125 degrees F) for 10 minutes. Allow time between loads for water to reheat to the disinfecting temperature.
  • Place non-washable personal articles or bedding in the dryer on high heat for at least 20 minutes. Alternatively, dry clean them or seal air tight in a plastic bag for a week to disinfect them.
  • If clothing and bedding is not disinfected on the day of head treatment, it should be bagged airtight until it can be done.
  • All towels, sheets, blankets, coats, hats, gloves, mittens, scarves, and clothes need to be disinfected.
  • Fumigation of rooms and use of insecticide sprays on furniture and carpets are not recommended to kill head lice. Thorough vacuuming is sufficient (cushions, mattresses, and under furniture) with proper disposal of the vacuum bag.
  • Combs, brushes, and other personal articles or toys may be disinfected by placing them with laundry in the washing machine, heating in a pan of water on the stove at 150 degrees for 10 minutes or soaking for 1 hour in a 2% Lysol solution. Caution: heating may damage some items.
  • Vehicle upholstery and carpet should be thoroughly vacuumed. Clean car seats.

7-10 days later, repeat all of the above.

Treated persons should be checked for lice and nits daily for 2-3 weeks after treatment.

Treatments don't always kill eggs completely, even when done correctly. Therefore, infested patients should be treated twice.

The interval between treatments should approximate the incubation period for nits (7-10 days) so that the second application will kill any newly hatched parasites.

Should I cut my child's hair short?

We don't usually recommend this for two reasons:

  1. Cutting the hair short doesn't protect against reinfestations. Boys with very short crew cuts can still get lice from sharing baseball caps, etc.
  2. Cutting the child's hair is a very permanent action for a temporary problem. A little girl who has always been proud of her beautiful, long hair may feel like the lice are her fault if her hair is suddenly "chopped off." It can also have kind of a "concentration camp" feel.

If your son has always wanted a buzz cut, fine; this is a good time to do it. Otherwise, don't make a radical change in your child's hairstyle just because of lice.

What if my child is no better after the second treatment?

Sometimes lice can become resistant to the chemicals in the hair treatments. If this is the case, we might need to try a different product. In most instances, the lice in the hair were killed, but the child re- infested himself from something in the house that was harboring lice: a hat, a teddy bear, etc.

Note: Just because a child is still itchy after a treatment doesn't mean that the lice have come back. The chemicals in the hair treatments can dry out and irritate the scalp, which causes itchiness. If your child picks at her dry, irritated scalp, flakes of dandruff can result - which may look like nits at first glance. Look very closely! (In a 2000 study conducted by the Harvard School of Public Health, doctors and parents were asked to submit specimens of lice and nits. When viewed under the microscope, only 59% of the "specimens" were really lice or nits.)