PEDICULUS: AKA HEAD LICE. IT’S GOING AROUND.

PEDICULUS: AKA HEAD LICE. IT’S GOING AROUND.

I’ve gotten an unusual number of phone calls in the last few weeks about head lice, so it’s definitely going around our community. Random factoid: Did you know that 1 in every 10 kids at school acquires lice at some point? If you know Indiana Jones and his aversion for snakes, you’ll begin to understand my feelings towards lice. Blood, vomit, poop, wounds, pus, whatever, bring it on. It doesn’t phase me. Head lice, however, makes me instantly start itching. I can’t help it (I’ve scratched my scalp five times since starting this article). So in case your family gets tagged with this little bug, here’s the scoop:

What is head lice?

The head louse (plural is lice) is a little parasitic insect that lives among hair and feeds on blood sucked from the scalp. Despite common myths, they do not have wings. The eggs are called nits and look like tiny yellow/tan dots. Nits are typically found on the base of the hair shaft. After 1-2 weeks, the nit hatches and leaves a white or clear shell. Baby lice, nymphs, take 1-2 weeks to mature to adulthood. The adult louse is about the size of seasame seed, has six legs, and is tanish in color. The whole life cycle repeats itself every 3 weeks. The lice need blood to live, but can survive up to 2 days off the scalp. The bite of the louse is what causes the itching (it’s a reaction from the saliva of lice).

Head lice symptoms

  1. Note: It can take a few weeks for the reaction to happen before a child starts itching his/her head.
  2. Head tickling. Sometimes a child will complain of feeling like the head is tickling.
  3. Red bumps. If the reaction is big enough or the child itches significantly, the scalp can get localized infections.

How are lice spread?

Fact:

  1. Spread is person-to-person contact (head-to-head) or by sharing infected items (e.g., clothing, pillows, combs/brushes, hats)

Fiction:

  1. Lice don’t fly or jump from person-to-person (Fact is: They crawl).
  2. Your cat or dog didn’t spread lice (Fact is: This is a human problem).

Lice treatment:

  1. Special medicated shampoo: This is considered the mainstay of treatment. There are both over-the-counter options and prescription options. They often involve repeating the treatment in 7-10 days. Read the labels carefully (different formulations are approved for different age groups and have very specific lengths of time for the products to be applied; anywhere from 10 mins to 10 hours depending on the product).
  2. Combing out nits: This is often done in combination with the shampoo as part of the treatment. It involves using a very fine toothed comb.
  3. Extreme measures: Shave the head. Over the years, I’ve seen a lot of moms buzz cut their infected boys hair. (It’s a lot harder to sell that option to a girl).
  4. Exceptions: The child under 2 months. To my knowledge, there aren’t any treatments approved in children under 2 months old. Infected infants will require manual removal of the lice (wet the hair and comb with a fine tooth comb every 3 days for 3 weeks). Or honestly, bald infants are cute, consider the buzz cut.

Common treatment mistakes:

  1. Don’t use a hairdryer after applying the shampoos. A lot of the ingredients are flammable.
  2. Don’t use a conditioner (or shampoo/condition combo) prior to the medicated shampoo.
  3. Don’t wash your child’s hair the first couple of days after using the medicated shampoo.
  4. Three strikes you’re out: If you’ve tried the same medication three times and can’t clear the lice, time to talk to your doctor and change it up (there is such thing as a treatment resistance lice).

Now time to treat the house:

Once you’ve got someone in your house with lice, you’ve got some serious cleaning to do to prevent reinfestation. Wash and dry on the hottest settings all bed linens and clothing used by the infected person. Dry clean all the things that can’t be washed (think scarves, stuffed animals, etc.). At the very least, put them in big airtight bags for at least 3 days (the lice will die without food). Vacuum/clean all carpets and upholstery (then throw away the vacuum bag). Clean (or pitch) all combs, brushes, hair clips/bows/bands by soaking in Lysol or rubbing alcohol for an hour.

Check out everyone in the family:

If finding one person in your family with lice didn’t freak you out enough to instantly start checking everyone else, now’s the time to do it. Lice are pretty contagious and you don’t want to go to all the treatment effort only to find you haven’t cleared the pesky little bugs from your house.

Is there any long-term damage?

Aside from the gross factor and the colossal amount of work that is involved in shampooing, combing, and cleaning after a child is diagnosed with lice, there is no actual long term damage done by the lice. It is a nuisance, but once treated, the problem is solved.

Can my infected kid go to school?

Hold onto your hats, you aren’t going to believe this. The American Academy of Pediatrics (AAP) states that an otherwise healthy child who is infected with lice should not be restricted from attending school. The child should finish the school day, be treated at home, and go back to school the next day.  Note: This is in direct opposition to many schools “no nit” policies. This last little nugget may be reason enough for you to remind your kids not to share hair things with their friends.

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About The Author

Dr. Monica Wonnacott

I'm a pediatrician and a mom. I've been doing this doctor thing for 10 years, and love it. I'm known for giving parents the straight scoop without always sugar-coating it. And I believe in educating parents. The more you know, the better care you give your kids.

Dr. Monica Wonnacott


I'm a pediatrician and a mom. PediatricAnswers.com is my blog where parents can get the straight scoop on their child's health, largely based on my experience in the office and at home. I don't diagnose on the site, so please don't ask. These are just my opinions. Use this site as a resource. And trust your parent gut.

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