Lice

Because lice can spread easily, it’s important to treat them quickly once a diagnosis is made. Treatment for lice will depend on your child’s age, his or her tolerance for specific medications and the extent of the infestation.

How are lice in children treated?

The simplest approach to treatment is removing nits and lice with a fine-toothed comb. However, this method needs to be done thoroughly and on a daily basis for many days in order to work properly. To be sure that all the lice are gone, you need to comb daily until you haven’t seen any live lice or nits for ten to 14 days.

The American Academy of Pediatrics (AAP) doesn’t recommend combing alone as a treatment. In most cases, over-the-counter (OTC) or prescription shampoos need to be used prior to combing.

While OTC and prescription shampoos generally work well, no product has been clinically proven to be 100 percent safe or effective against lice infestations.

Over-the-counter products

Medicated shampoos that contain ingredients such as permethrin (Nix) or pyrethrin (Rid) are the primary method of treating lice infestations.

Shampoos that contain pesticides may be harmful to young children and should only be used if absolutely necessary and under a doctor’s supervision 

Removing nits

• After using a medicated shampoo, you will need to remove nits and lice from your child’s hair with a fine-toothed comb, preferably one with long metal tines. To be sure all the lice are gone, continue to check and comb the hair for 10 days to two weeks after the last louse is seen. This is the recommended method of treatment for children under age 2.

• It’s not uncommon to find live lice on your child’s head between eight and 12 hours after treatment. If the lice are moving slower than before, it’s not necessary to re-treat. This just means that the medication is taking a little longer to kill the lice. Continue to comb dead and remaining live lice out of your child’s hair, as well as the nits.

  
Prescription medications  

If lice are still active eight to 12 hours after rinsing your child’s hair with an OTC lice shampoo, the medicine may not be working. In this case, your child’s doctor may prescribe shampoos that contain different ingredients, such as:

• Ovide (malathion) is a prescription lotion that is applied to dry hair and left on overnight. It works as a pesticide by killing live lice and as an ovicidal by killing lice eggs.

• Ulesfia, a medicated lotion that contains the ingredient benzyl alcohol, is safe for children 6 months of age and older. Ulesfia kills live lice but unlike Ovide, it doesn’t kill lice eggs. This means you will need to comb out the nits and repeat the treatment about a week later.

When applying lice shampoo, follow the instructions on the box carefully. Here are important things to remember:

• Do not use a combination shampoo/conditioner or a cream rinse before using lice shampoo. 

• Do not re-wash your child’s hair for one to two days after treatment with a lice shampoo. 

• Wait 7-10 days before applying a second lice shampoo treatment.

Cleaning the house

Here are some easy ways to get rid of lice and nits around your home:

• Make sure every family member is checked for lice and receives any necessary treatment.

• Wash bedding and clothing in hot water (around 130 degrees in temperature), and dry in a hot dryer for at least 20 minutes.

• Dry-clean any clothing, bedding, stuffed animals or linens that aren’t machine -washable and store them in a sealed plastic bag for two weeks.

• Soak combs and hairbrushes in hot water for at least 10 minutes.

• Vacuum all carpeting, curtains and fabric-covered furniture to remove lice and attached nits.

It’s not necessary to use environmental sprays in your home to get rid of lice. These sprays contain pesticides, which can be very dangerous. 

Prevention

How can I prevent my child from getting lice?

Although it’s difficult to prevent your child from the spread of head lice, you can take the following precautions:

• Teach your children never to share combs, brushes, hats, pillows or hair ties.

• Watch for signs of head itchiness (scratching the scalp).

• If your child does get lice, start treatment right away to prevent the infestation from getting worse and spreading to the rest of your family—and let the school know in case the source of the problem is the classroom. If other children aren’t treated, your child could get it again.