Head Lice? Oh No!

by Katie Porterfield
September 15, 2011

What are head lice?
The announcement often comes in the form of a note sent home with your child from school—a member of your child’s class has head lice. Or perhaps the note reveals that it’s your child whose head is crawling with tiny, wingless insects. Just the thought of it is enough to make a parent cringe. Head lice is the second most common condition in school children (the common cold tops the list), affecting 1 in every 10 children. It takes just one child with head lice to transmit the creepy, crawly critters to the entire class.

Three millimeters long (the size of a sesame seed) and brown, tan, or gray in color, head lice spread through head-to-head contact or through sharing lice-infested personal items such as hats, towels, brushes, hair ties, or pillows. While ridding your child’s scalp of pesky lice and their eggs (known as nits) can be quite a nuisance, the important thing to remember is lice are completely harmless and do not pose any health hazard to children. In addition, they aren’t a sign of poor hygiene or an unclean living environment.

What are the symptoms of head lice?
Children with head lice often experience itching behind the ears or on the back of the neck. Itching can start right away or weeks after the initial infestation. Once itching begins, it can continue long after the lice are gone. Eczema, dandruff, or an allergic reaction to hair products can also cause itching, so the only clear sign of head lice is the insects (or nits) themselves.

The American Academy of Pediatrics (AAP) provides steps for identifying head lice and nits:

• Seat your child in a brightly lit room.
• Part the hair and look at your child’s scalp.
• Check for crawling lice, which can be difficult to find because they avoid light, and also for nits (eggs). Nits look like small white or yellow-brown specks firmly attached to the hair. They are typically found near the scalp, hairline, back of the neck, and behind the ears. Nits can be confused with dandruff or dirt particles, but if they are difficult to remove, they are likely nits.

How is head lice treated?
Initial treatments for head lice include over-the-counter shampoos or rinses. The AAP recommends using products containing one percent permethrin lotion, an active lice fighting ingredient. Follow the manufacturer’s instructions, repeating the treatment 7-10 days after the first application. Parents wanting to avoid chemical treatments can use the “comb-out” method—combing your child’s damp hair daily for two weeks with a fine-toothed comb designed to remove nits. However, the AAP cautions that this method often fails. Many websites tout the effectiveness of home remedies such as herbal oils, margarine, mayonnaise, olive oil, and petroleum jelly, but there is no data to support their use. The AAP also warns against coating your child’s hair with potentially toxic products such as gasoline, kerosene, or products intended for use on animals. In addition, do not spray pesticides in your home. Instead, wash your child’s clothes, towels, sheets, and hats, along with any other cloth items he is in close contact with in hot water and dry them on high heat. Your child’s health care provider can suggest treatment options and assist in the event the “comb-out” method or over-the-counter remedies don’t do the trick.

How can head lice be prevented?
Children should avoid sharing hats, scarves, coats, brushes, hair ties, bows, and other personal items. Parents, teachers, and caregivers should learn to spot the signs and symptoms of lice, so that any infestation can be discovered and treated as soon as possible. Though schools often institute “no head lice/nit” policies, the AAP declared in 2010 that healthy children with head lice should not be sent home from school because lice are not a health hazard. To read the AAP’s clinical report in its entirety, click here.

When should I call a doctor?
Contact your child’s health care provider if your child still has head lice after two treatments with over-the-counter products.

Katie Porterfield is a freelance writer and former magazine editor in Nashville, Tenn. She is mom to twin boys.