The No-Panic Parent’s Guide to Managing Lice

Just hearing the word “lice” can make anybody’s head suddenly feel itchy and send a parent into a tailspin of horrified panic. Head lice is a common problem for many school age kids and their families, affecting 6 to 12 million people annually. They can be found just about anywhere - schools, daycare, and homes - and they are not picky when it comes to any one group of people. Lice are equally happy living in clean hair as much as dirty hair and personal hygiene has nothing to do with getting head lice.

As a parent, it can be quite horrifying to get that call or email from school telling you your kid has lice. While lice are contagious and can be very annoying, they pose very little health risk and have not been shown to spread disease. So before you decontaminate your entire household and turn your world upside down, dive in to this practical guide on how to deal with those pesky bugs.

Head lice are tiny parasitic insects that infect the skin and scalp areas. The louse (singular form of lice) lives off small amounts of blood from the scalp. Lice lay their eggs, also known as “nits”, very close to the scalp along the hair shaft.

The key to managing lice is understanding their life cycle. Head lice can live up to 28 days and they develop in 3 phases: the nit or egg, the nymph, and the adult louse:

• Nits (eggs) are typically pearly white or grey, oval-shaped, and usually found stuck to the hair shaft close to the scalp. They typically hatch in 6 to 9 days.
• Nymphs are typically greyish-white and look like a small version of the adult. They become adults within 7 days of hatching.
• Adult louse are usually beige in color and the size of a sesame seed. They can lay up to 10 eggs per day.

Lice do not fly or jump - they crawl. The most common way to get lice is through prolonged head-to-head contact. While lice can be spread through the sharing of brushes, hats, pillows, and furniture, the risk of catching lice this way is very, very low.

The most common symptom of lice is an itchy scalp or rash caused by the skin’s reaction to lice saliva. However, sometimes it takes up to 4 to 6 weeks to develop a reaction, which means many people can have lice but experience no symptoms. The easiest way to know if your child or family member has lice is to sit them down in a well-lit spot and and comb through their hair looking for live lice or nits. Be aware that lice can be fast moving and tend to shy away from light. Nits, on the other hand, are often found stuck to the hair and within 1 inch of the scalp.

Most of the time, lice can be treated at home. There are a few instances in which an office visit is a good idea, including concerns about lice in a newborn, or if the skin on the scalp looks infected - red, swollen, or with drainage.

The first line of treatment for most adults and kids over the age of 2 months old is an over-the-counter treatments using 1% permethrin or pyethrins. It is important to note that most medications kill lice but do not kill nits. Successful treatments require medication followed by careful combing of the hair to remove lice and nits. One approach to lice and nit removal is called the Wet-Comb Method.

With a little conditioner or combing gel (usually included in most over-the-counter treatment kits), you make start the process of banishing those pesky lice! Following these simple steps to get the job done:

Step 1: Generously apply conditioner or combing gel to the scalp and full length of your child’s dry hair.

Step 2: Untangle the hair with a brush or wide-toothed comb

Step 3: Using a fine-toothed head lice comb (available at most pharmacies), carefully comb along the scalp through to the ends of the hair.

Step 4: Wipe the comb after each stroke on a white paper towel and check carefully for nits or lice

Step 5: Comb each section at least 5 times.

Step 6: Wash the hair as normal when finished.

Repeat the wet-comb method every 2-3 days until the person is nit- and lice-free for at least 10 days.

While you may be tempted to throw out every stuffed animal, wash your entire wardrobe, and do away with your furniture, I encourage you to pause and take a more practical approach. The truth is, lice generally don’t survive more than 1-2 days away from the host and nits can only survive up to a week. By following these practical tips for frequently used household items, you can keep it from spreading and save yourself a lot of hassle:

• Machine wash and dry clothes and bed linens used within 1-2 days of treatment.
• Soak brushes and combs in hot water (not boiling) for 10 minutes.
• Avoid excessive household cleaning or use of pesticides and sprays. It is reasonable to do limited vacuuming of areas where the person may have recently sat including furniture and carpets.
• Clothing or items that can’t be washed can be sealed up in a bag for 2 weeks.

While many schools and camps follow a “no-nit” policy and will often send kids home with any signs of nits or lice, the American Association of Pediatrics and the Centers for Disease Control have recently recommended that children should not be restricted from school for lice or nits. It is reasonable to allow a child to finish the school day, go home and be treated, and return to school.

If you have any questions about caring for your family amid a lice breakout, don’t panic! Talk to your child’s provider today or connect with our Virtual Medical Team via our app.