Head Lice

Head lice is a frustrating problem that many families deal with at some point. Head lice is not dangerous and does not transmit any diseases.  It causes itchy scalp and can be spread by close contact (head to head, sharing hair brushes, hats, etc).  It is not a sign of poor hygiene. Unfortunately, lice have become resistant to many standard treatments, so it can be extremely difficult to get rid of it. There are a few approaches you can take to try to get rid of lice. Be sure to check all members of the family for lice, since it spreads easily in homes.

We recommend the following steps when your child has lice:

• Clean combs, brushes and hair accessories in the dishwasher or get new ones.
• Change child's clothes immediately after treatment. 

• Machine wash all clothing and bedding that have been in contact with infected person(s) in the past 3-4 days. Use hot water and hot dryer. Non-washables can be vacuumed.
• Vacuum everything that hair strands could fall on: rugs, furniture, car seats and car upholstery. 
• Personal things that can't be washed or vacuumed can be tied up in plastic garbage bags for 2 days. Remember to keep bags out of children's reach! 
• The use of environmental products (sprays, etc) is NOT recommended.

There are several treatment options for lice, including home treatments, professional treatments, and prescription medications:

Option 1: Treatment With Over the Counter Lice Medicine.   


Supplies: 

• white vinegar
• stripping shampoo (baby shampoo, Prell, White Rain) 
• NIX brand cream rinse (Permethrin lice treatment) 
• metal lice comb (bought separately). Inomed for example.
• (optional) magnifying reading glasses (helps to see the nits)

Method: 

1. Rinse hair with solution of ½ water and ½ vinegar over a sink, not in the shower or tub. 
2. Use a fine-tooth comb (metal lice comb) and meticulously go through the hair, pulling off the nits. This can be very time-consuming.
3. After this is done, wash hair with the stripping shampoo. Use no conditioners as these may protect the lice from treatment. Rinse and towel dry.
4. Apply NIX brand cream to hair. Leave on the hair for at least 4 hours. The medication could be left on for up to 12 hours (or overnight). May cover head with a shower cap.
5. Rinse hair only with clear water. Do not use vinegar at this point. This may neutralize the NIX.
6. Go through the hair with a comb again and let hair air dry. Do not use conditioners, mousse, or hair spray for awhile. Again, these may help protect the nits and lice from treatments. 
7. Comb through the child's wet hair every 2 days to look for and remove nits. This is critical because any remaining live nits can hatch and start the infection all over again.
   
8. RETREAT the hair with NIX in 7-10 days.

Unfortunately, many families find that this method is not effective at killing all the lice, presumably due to resistance. It still can work as long as you carefully remove all nits and bugs in the week after treatment.

Option 2: Professional Lice Removal
There may be commercial establishments in your area that will check your child (and you, if you want) for lice. Then, if you request, they will remove the lice with a combination of manually removing them, applications of various natural oils shown to kill lice, or high heat. These can be very effective, but also quite expensive (expect to spend about $100 per person).

Option 3: Cetaphil Method
Some people find the approach developed by a dermatologist to be more effective than other home treatments.  Research studies have been done which show it to have a 95% efficacy rate. However, other families have found that this does not work all the time either. You can find out more information here: http://nuvoforheadlice.com/test/

Option 4:  Prescription Medication (Sklice)
Some patients will request a prescription for Sklice, which is considered to have less resistance than the over the counter treatments. However, there is still resistance, and it is best to still use a metal lice comb to remove nits and lice.