Raise your hand if you never had head lice before going to college. Your hand isn’t in the air, is it? Turns out, lice is common. And no question, it’s wildly unsettling for us all. It’s a new world when it comes to prevention and treatment though — more choice, less stigma and less school disruption. Twentieth-century lice care is no more.
Back in 2010 the American Academy of Pediatrics (AAP) updated its recommendations on lice. Basically, schools are no longer encouraged to send children home with lice or keep them away from school. Lice spreads from child to child but it’s certainly nothing like measles. Sending children home from school for a “non-health issue” doesn’t make sense. Further, lice can be living on your child’s head for up to 30 days without hatching (horrifying I know) and can be around for weeks before causing itching the first time around so an urgent send-the-lice-infested-kid-home policy just doesn’t make a lot of sense. Thing is, this changes the game. We all want to get rid of lice on our child’s head immediately, but we’re dependent on all the other families in school doing the same so we don’t get it AGAIN…
In the midst of a lice “crisis,” don’t beat yourself up. This has nothing to do with hygiene. It has more to do with bad luck.
“Head lice are not a health hazard or a sign of poor hygiene and, in contrast to body lice, are not responsible for the spread of any disease.” American Academy of Pediatrics
New 2015 guidelines from the AAP offer some tips for getting your family lice-free as quickly as possible. Lots of over-the-counter (OTC) ways to deal with it. OTC treatments are safe and effective. However, lice are tricky and have been found to have resistance patterns that aren’t entirely understood at this point (the prevalence is unknown)– so rarely a parent needs to switch treatments. That means sometimes we do all the right things and even with the BEST routine and adherence and lice possibly remain. If you suspect you’re not getting rid of lice at home despite great treatment routines, involve your pediatrician. Often ongoing lice is simply that your child is getting re-infested at school or sports. Or they weren’t gone in the first place.
Follow instructions on the bottle — many treatments need to be repeated about 7-10 days after first application.
Sometimes it may be that you need to swap treatments. It’s RARE that you need a prescription treatment. Your child’s clinician can help recommend a transition to prescription medications. The prescription meds are expensive and often unnecessary but one does have the benefit of requiring only a one-time treatment and no combing.
If the thought of chemicals of any kind on your family’s skin is unappealing, manual removal by “wet-combing” or suffocation through hair is acceptable and can sometimes be effective (things like mayonnaise, butter, oils) yet there is no real hard data about effectiveness. It’s important to note that wet-combing should be repeated once a week for at least three weeks if you do this to ensure all lice and nits are removed as you must comb through entire scalp and hair fastidiously.
Discovering lice is clearly in the no-fun parenting category, but it’s also NO BIG DEAL. From experience (x 2) I can say best thing we can do is calm down, head to the drug store, comb away, wash the linens and move on.
What Parents Need To Know
Lice are very common in children between the ages of 3 -12. With the first case, itching may not happen for 4-6 weeks after exposure. You may find lots of lice (don’t freak) as lice can lay up to 10 eggs a day and we often don’t discover lice in the first few days. If your child gets lice know you can deal with it rapidly and it will go away…- Lice don’t jump from person to person! This is a common misconception. They can however crawl and cling very well to hair and are spread most commonly from head-to-head contact. When children discover lice it’s best to restrict head-to-head contact while you get rid of them. Rarely do children share lice via combs/brushes or shared hats and helmets.
- Treatment with OTC shampoos and combing along with some prescription treatments will eradicate lice from your child. Cleaning clothing and bedding and restricting head-to-head contact until lice gone is your best bet. If you feel the lice aren’t going away after diligent treatment, talk with your pediatrician about Rx options.
- If the thought of dealing with lice makes you light-headed, there are lice-removal services available. They’re not cheap (starting around $100 in the Seattle area), but some parents may find the expense well worth the piece of mind of getting rid of lice manually by professionals.
This post was written in partnership with KnowYourOTCs.org. In exchange for our ongoing partnership helping families understand how to use OTC (over-the-counter) meds safely they have made a contribution to Digital Health at Seattle Children’s for our work in innovation. I adore the OTC Safety tagline, “Treat yourself and your family with care all year long.” Follow @KnowYourOTCs #KnowYourOTCs for more info on health and wellness.
Kate Mcfarlane says
Great article!!My daughter had it 2xs . She has really curly hair-so I flat ironed it to make it easier to “comb through” .I ended up killing everything -nits and lice-they are VERY sesitive to temp changes-hot or cold kills them.-It worked the 2nd time too-and decreaed all the stress.If you feel it’s safe to try this -I highly recomend it, plus putting jackets,pillows outside overnight works as well.
Melissa Martineau says
I have to say after reading this article, and others like it, I am disappointed. I wholeheartedly disagree that lice is NO BIG DEAL. It costs families time, energy, and money better utilized other places to eradicate these disgusting pests feeding on our children. Yes, a child should be sent home from school (whether they have had it for two or thirty days) and should not be allowed back into the classroom until treated and approved back by a school nurse (or other authority). We have dealt with it enough at my children’s school that I can say it does affect the kids. Whether they are trying to or not, kids are often in close quarters. On the bus, at the lunch table, backpacks and jackets on hooks and touching, etc. My daughter was horrified the first time she had it, and cried the whole time. To a Mom, that’s a BIG DEAL. We also run on a very tight budget and don’t generally have an extra $100.00 laying around to run to the drug store and buy the treatments at 25 bucks a pop. But when lice happens, our budget gets rearranged. Not to mention the time it takes for me to go through heads of hair strand by strand looking for those nasty louse. Oh, and my favorite part(insert sarcastic tone here) is when the notification comes from the school in the evening that lice was found during that school day in my child’s class. Now our family’s entire evening has been disrupted.
So to say lice in schools is no big deal, untrue. Let’s teach families responsibility and put proper resources in their hands as to how to eradicate it, allowing each child a better (and less itchy) opportunity to learn in their learning environment.
Wendy Sue Swanson, MD, MBE says
Oh my, I think we agree more than it appears!!! I agree this is a HUGE and somewhat disgusting inconvenience and stress.
When I put the context of “no big health risk” I project that against life-threatening and life-ending conditions that I see in pediatrics.
LICE is bad in LIFE. No question.