Head Lice

How to examine household members for head lice:

All persons in the household should be examined for the presence of lice or nits.  A thorough head check should take 15 minutes or more and must be done in good light.  This is done by parting the hair in small sections with a comb looking for small tear shaped specks that vary in color from whitish to brown. These specks are the nits or lice eggs and are stuck to the hair shaft and cannot be easily removed.  These are usually seen about ¼ to ½ inch from the scalp. 

The louse is a small flat, wingless, grayish-brown insect with stubby antennas and six legs.  They are most commonly found behind the ears and at the nape of the neck, although they may be found anywhere on the head.  The louse can be seen with the naked eye.  If any family members are found to have lice or nits they should also be treated with the anti-lice shampoo.

Treatment Plan for Parents and Guardians:

1.  Thoroughly screen all household members and inform any of the child’s close contacts regarding exposure, that includes friends, overnight guests, relatives, sports team (especially those teams sharing helmets and caps) and all other possible outside contacts.

2.  Use a safe lice-killing treatment that is effective such as Nix ®, Rid ®, A-200 ® or Pronto ® which are available over the counter without a prescription. Several non-prescription shampoos are on the market to eliminate lice and their nits (eggs).  They are available at your local drugstore.  There are also other shampoos available by prescription.  You will need to contact your family physician for a prescription.  Prescription anti-lice medication is the least effective and the most toxic treatment.

Lice-killing treatments may not be 100% effective in killing nits and lice.  Nits often survive, hatch, and reinfest the child and others.  The remaining nits will hatch within seven days.  Therefore, a second treatment may be necessary.  Read and follow the label directions.  Pay particular attention to the amount of time recommended for the lice-killing treatment to be left on the hair and scalp.  The lice-killing treatment should not be used on a regular basis or as a preventative measure.

Itching may occur after treatment due to scalp irritation.

Consult a health care provider if the child or family members are pregnant, nursing, under two years of age, have open wounds on their scalp or neck, have known allergies or if eyebrows and eyelashes are infested.  These precautions apply to the persons administering treatment as well as those receiving the treatment.

3.  After treatment and shampoo, remove all the nits and any remaining lice on the hair by:

4.  Separating the child’s hair into small sections.

5.  Starting at the top of the head next to the scalp, lift one inch of hair up and out and comb the entire length of the hair strand.

6.  Repeating all sections until thoroughly combed, remembering the bangs.

7.  Using a comb that is specifically designed for removing nits. 

8.  Regular use of shampoo and conditioner daily for two weeks followed by fine tooth combing of wet hair makes it easier to eliminate lice.  A strong effort to comb out all the nits is very important to assure that the child will not reinfest him or herself.

Note: This is a very time consuming procedure.  Depending on the length of your child’s hair this process may take several hours over several days.

Nits and lice that are removed from the head should be placed in a sealed plastic bag for the outside trash.  Do not drop them on the floor.

The most important effort is the daily shampoo, conditioner and wet combing technique described above.

Care of the Home Environment:

• Assure that the child’s personal belongings are machine washed in hot soapy water and dried on high heat for 20 minutes (include hats, caps, bed linens and clothing).
• Combs and brushes should be soaked in hot soapy water.
• Articles that cannot be washed in hot water may be dry cleaned such as dolls and stuffed animals OR the articles may be seal in plastic bag for 14 days.
• Environmental lice sprays are generally not effective and NOT recommended.
• Pets DO NOT carry human head lice; therefore, spraying pets is unnecessary since head lice need human blood to survive.
• Screen your child daily after an infestation for 2 weeks then weekly throughout the entire school year.

Alternative Head Lice Treatments:
Natural and Non-toxic (Two week process)
This works by applying an agent to suffocate crawling lice. Consider the use of Crisco (easy to remove), Vaseline (difficult to remove), and real mayonnaise (NOT lite or low fat) applications.  Completely saturate the hair with whichever product you choose and it should remain on the hair for a minimum of two hours (a shower cap may be helpful).  The lice can be removed by the use of regular shampoo and conditioner then fine tooth combing while the hair remains wet.

Efforts to comb out nits or eggs attached to the hair shaft with a nit comb will reduce the risk of treatment failure.

Shampoo the hair daily with regular shampoo followed by conditioner for two weeks. Comb the hair with the nit comb to remove nits and lice.

Cutting long hair makes this process easier.

To avoid reinfestation, instruct all family members to avoid borrowing personal items such as combs, brushes, hats, towels or clothing from each other or from friends.  It is best for everyone to use only their own personal articles both at home and at school.

Head lice can be eliminated in your home if they are detected, treated and controlled early.