ABOUT LICE

Lice infestation is common among young children. People do not get lice from being dirty. Lice are picked up from head-to-head contact with someone with lice and less commonly from sharing personal items like hairbrushes and hats. Itching may be a sign of lice infestation, but many people with lice are not itchy.
Head lice are wingless insects that live on the human scalp. Adult lice are the size of a sesame seed and either black or reddish-brown. Nits and eggs are tiny grayish-white, oval-shaped. Eggs are firmly attached to the hair shaft close to the scalp. Nits are also firmly attached and can be seen further down the hair shaft. Dandruff and hair debris can be easily dislodged and are not lice.

HOW TO GET RID OF LICE
Four-pronged treatment:
1. Pediculicides (medicines that kill lice)
2. Manual removal
3. Cleaning environment and personal items.
4. Treatment for infected family members and close contacts

PEDICULICIDES

(Check with your doctor or nurse practitioner before using lice treatment medicine if you are pregnant, nursing a baby, or have allergies or asthma.)

First try Nix. You can buy it in the drugstore without a prescription. Start by shampooing with a detergent shampoo without cream rinse or conditioner, then rinse and towel-dry hair and then saturate hair and scalp with Nix. Leave Nix on 10 minutes, then rinse. Avoid contact with eyes. Follow the rest of the four-pronged treatment plan as outlined below and repeat in seven days to be sure all the eggs have been killed.

If your doctor or nurse practitioner prescribes Elimite, apply to clean dry hair and leave on overnight with a shower cap on the head. Avoid contact with eyes. Shampoo in the morning. Follow the rest of the four-pronged treatment plan as outlined below and repeat in seven days to be sure all the eggs have been killed.

If Nix and Elimite donít get rid of the lice, try RID. Apply to dry hair, wait ten minutes, add water to form lather, then shampoo and rinsing thoroughly. Avoid contact with eyes. Follow the rest of the four-pronged treatment plan as outlined below and repeat in seven days to be sure all the eggs have been killed.

The combination of the antibiotic trimethoprim/sulfamethoxazole (Bactrim or Septra)plus Nix (permethrin 1%) has been shown to work over 90% of the time. This is sometimes used if other treatments have failed.

Cetaphil has been effective in eliminating lice as well. For more information click HERE.
 
Natural products may be tried as an alternative to the above-mentioned medicines: HairClean 1-2-3, Not Nice to Lice and Lice Be Gone, all available in health-food stores. You must repeat the application because they don't kill all the eggs.
Itching does not necessarily mean the medicine has failed. Itching may be due to an allergic reaction to dead louse proteins. Check the head for lice or eggs. If found, that means the treatment has failed.
If lice are found on eyebrows or lashes, cover with petroleum jelly before bedtime and remove by hand in the morning

Here are some common pitfalls to the effective eradication of headlice:

• Making the hair too wet before applying pediculicides, thereby diluting the medication.
• Using a crème rinse or conditioner before applying the pediculicide.
• Failing to leave the pediculicide on the hair and scalp as long as directed.
• Re-shampooing the hair after applying the pediculicide. DO NOT rewash hair for 1-2 days after treatment.
• Failing to use enough pediculicide: extra-long hair may require two bottles to saturate the hair completely.
• Inadequate fine-tooth combing to remove lice and eggs. A new comb called the LiceMeister has metal teeth that are very close together and is more effective than the plastic combs that are packaged with pediculicides.

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MANUAL REMOVAL

Removing lice by hand is a very very important part of the treatment. After a course of medicine as described above, saturate hair and scalp with olive oil, Vaseline or mayonnaise and place a shower or bathing cap on the head and sleep like this. In the morning, wash hair with shampoo and place vinegar on hair and wrap head in vinegar-soaked towel for 30-60 minutes, then begin combing process. (The vinegar may help loosen nits.) Olive oil or hair conditioner may make combing easier. Remove nits with a fine tooth metal nit comb and nymphs with a nylon brush.(One brand of comb is called LiceMeister.) It greatly helps to comb each strand of hair individually and to cut off a strand at its base when a nit is sighted and can't be moved down the hair shaft with the comb. Wipe the comb and brush frequently on a tissue during treatment. Good lighting and a magnifying glass help the search. Check hair and scalp 24 and 48 hours after treatment for signs of re-infestation.

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CLEANING ENVIRONMENT AND PERSONAL ITEMS

Soak combs and brushes in anti-lice shampoo and hot water for one hour. Vacuum carpeting and upholstery in home and car to pick up strands of hair. Dispose of vacuum bag. Most children can be treated effectively without extra efforts to treat their clothing or bedding. If one desires, one can wash sheets, blankets, pillowcases and anything worn in the past 48 hours in  hot water and dry in a hot dryer. Some experts advise that items that came in contact with the patient's head that can't be washed should be dry cleaned or put in airtight plastic bags for ten days. This may or may not be helpful. Treatment of dogs, cats or other animals is not necessary.

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TREATMENT FOR ALL INFESTED CLOSE CONTACTS

Treat all infested household members and other close contacts at the same time as outlined above. People should be treated only if they have signs of lice. Treating when there are no signs of infestation may cause resistance to future treatments when there is a real infestation.
Children should not be excluded or sent home early from school because of head lice. Treated children should be allowed back in school the next day, after a proper treatment. 
Donít hesitate to call Hyde Park Pediatrics if you have questions or concerns.

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