What to do if your child has head lice....

01/05/2010 12:00 PM

11/18/2010 11:35 AM

Head lice infestations are exceedingly common, affecting 6-12 million children in the United States per year.  Having a child with head lice creates a lot of anxiety for parents; however, it is neither a health hazard nor a sign of poor hygiene.   

Head lice are diagnosed by finding live lice in the hair or nits (lice eggs) on the hair shaft near the scalp.  Live lice are difficult to find because they are fast movers.  To inspect you child’s hair, sit in a well-lit area and comb through small sections of hair beginning at the nape of the neck.  Nits are tiny, oval, and white.  They are adherent to the hair shaft by a glue-like substance, unlike dandruff which is easily removed. 

If your child has lice, the treatment involves multiple steps.  The first part is to kill the live lice with a lotion/ shampoo/ or rinse.  Currently, Permethrin 1% (Nix) is the recommended first-line treatment for head lice.  Malathion is a prescription lotion available for the treatment of head lice; however, it should be reserved for resistant cases because of its high alcohol content.  Although these agents are highly effective at killing lice, there are currently no products on the market that are 100% effective for destroying the nits.  Lice eggs hatch in 10-14 days, so it is likely that the treatment will need to be repeated in 7-10 days.   

This brings me to the second tier of treating lice- “nit picking” or combing through your child’s hair and picking the nits from the hair shaft on a daily basis until the head lice are gone. 

Finally, you should wash all of your child’s recently worn clothing and bedding in hot water and vacuum carpet and upholstered furniture.  Any items such as stuffed animals that cannot be washed should be placed in plastic bags for two weeks to insure that the lice have died before returning the items to the bed.   

If your child has lice that have not responded to treatment, you should take him to see his healthcare provider. 

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