Don’t Be a Lousy Exterminator: The Art of Lice Kill.

School is back in session and your little ones are back to swapping germs and bugs with a veritable petri-dish of fellow elementary schoolers. Yet, besides the common colds and flu’s, there are other much more icky things that can hitch a ride home with your child!

Lice are vampire like parasites who feast on blood five times a day while making nests in the scalp and replicating after a good meal. They are spread by close personal contact or through sharing objects like brushes, hats, combs, clothes, or bedding.

They can live without a meal for ten days, but their egg-babies “nits” can survive up to three weeks! As hatched adults they are the size of a sesame seed. You can find them often thriving in their most common scalp spots, behind the ears, back of the scalp and neck. Subsequently, their presence causes itching and scratching followed by scabs and inflammation.

Dandruff can often be mistaken for nits, but nits adhere to hairs more tightly and adults can be seen as copper colored flecks on the scalp.

OTC Treatments

There are multiple OTC pediculocides (lice killers) that can be used on the scalp, typically with initial dose and then again one week later. If post 12-hours after treatment, lice are not dead and they are still active, the medicine may not be working. In this circumstance, see your healthcare provider for a different type of treatment. Otherwise, the scalp should be rechecked with a nit comb every 2-3 days, for 2-3 weeks post treatment.

Of OTC brands, Permethrin 1% cream like Nix is the most popular and it should be applied for 10 minutes to clean, dry hair. Pyrethins like Rid and Triple X are also available. All of these kill adult lice but do not destroy the eggs, which is why a second treatment is recommended 9-10 days after the initial.

OTC Alternative Therapy Treatments

There are some OTC remedies that do not carry much weight in the medical community, but may show minor benefiting in thwarting the louse. Dilute white vinegar rinses are said to debond the nit from the shaft to help make nit removal easier. Thick topical substances like Vaseline or mayonnaise are also thought to be helpful by suffocating the nit and making the hair shaft too slick to stick to.

RX Treatments

For severe cases or those that are resistant to OTC treatments, a visit to your pediatric, family practice, or dermatologic clinician will be needed.

A stronger version of Permethrin is available RX, which is a 5% cream and is advised to use overnight. Other topicals such as Benzoyl Alcohol lotion and Sklice (Ivermectin lotion) are available to kill adult parasites, while  Ovide (Malathion Lotion) and Natroba (Spinosad cream) are the only two which can kill lice and nits (Ovide partially). In a shampoo form, Lindane is available, but no longer recommended due to its toxicity/adverse effect profile.

Lice infestations are common in schools, but by advising your child not to share hairclips, combs, or hats and sometimes separating hats & scarves from coat rooms, outbreaks can be prevented. Additionaly, remember to wash clothing/bedding used 2-3 days before treatment in hot water (zip lock bag for non-washables x 2 weeks), vacuum floors/furniture, and soak combs/brushes in hot soapy water for 10 minutes.

Keep your school nurse in the loop, as he/she may be very helpful in containing cases. Having a lice infestation is a lousy affair, but it can be treated successfully with proper extermination techniques!

*The information provided above or in any blogs on this site is for educational purposes only. It does not replace advice or necessary examination and diagnosis from your healthcare clinician. Please see your healthcare provider for any and all concerns with changes in your health or treatment of disease.*

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