Back to School? Back to Head Lice Season

Fall months are prime time for head lice. Here's how to spot them and get rid of them.

Medically Reviewed by Hansa D. Bhargava, MD on July 15, 2012
3 min read

Fourth grade had barely started when I got a call one early September day from the school nurse. "Your son has lice," she said. "Come pick him up right away."

All I could think was, "Those dirty creatures on my child -- in my house?"

In fact, dirt has nothing to do with lice, says Paradi Mirmirani, MD, a dermatologist at the Kaiser Permanente Vallejo Medical Center in California. "It's really not an issue of cleanliness. It's an infestation that's related to close contact, which we have in schools." Mirmirani's three kids picked up lice at their school a couple of years ago.

Kids are particularly easy targets for lice, thanks to the size of their hair shaft. "Lice are more easily able to cling to hair that's finer and thinner in diameter," Mirmirani says. Plus, children are big on sharing -- hats, towels, you name it. That's probably why there are 6 million to 12 million cases of lice in children each year.

The telltale sign of lice is itching, especially behind the ears, on the scalp, and at the nape of the neck. Itching is a reaction to the lice's saliva, which they inject while feasting on blood from under the skin.

When you look closely at your child's head under a bright light, you'll spot light brown, sesame seed-sized bugs darting around. Those are the lice. Or, you may just see their eggs, called nits, clinging to the hair shaft close to the scalp. Most kids have only about 10 live lice on their head at any given time, but their scalp can be home to several hundred eggs.

What's a parent to do? Two things -- treat your child and clean house. An over-the-counter medicated shampoo or rinse with permethrin (brands include Nix and Rid) usually wipes out lice pretty effectively. The FDA also recently approved a comb-free lice shampoo, Sklice (ivermectin). Sometimes, the first treatment doesn't kill all of the lice, and you'll need to apply a second treatment seven to 10 days later.

Meanwhile, wash all the sheets, towels, clothing, combs, and brushes your child recently touched in hot water (at least 130 degrees Fahrenheit), and vacuum carpets and furniture. Check everyone else in the house.

Don't like the idea of treating your child with chemicals? You may have heard about trying to suffocate the bugs with olive oil, mayonnaise, or petroleum jelly. But no evidence proves this works, maybe because lice are pretty hardy creatures. Studies show they can survive several hours of smothering natural remedies.

With most lice treatments, you'll also need to go through your child's hair with a fine-toothed comb to get rid of nits, and reapply the treatment in about a week to kill any newly hatched eggs.

Not in a nit-picking mood? Call a lice removal company -- such as Hair Whisperers in Los Angeles or The Texas Lice Squad -- and they'll come pick the little critters out of your child's hair for you. They'll also show you how to prevent future outbreaks.

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