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'Super lice' not a cause for concern, but here's how to treat them

Posted on Sep. 25, 2015 ( comments)
Head lice hair nit comb

With children back in school for the fall, it’s prime time for head lice. Parents may be especially wary this year, considering recent news about so-called “super lice.”

According to new research, Washington is one of at least 25 states where head lice have developed a resistance to the pesticides in common over-the-counter shampoos or rinses such as Rid or Nix.

But this is not a huge cause for concern, local doctors say. Your child’s pediatrician can prescribe medications that are more effective at treating drug-resistant head lice.

Plus, lice don’t spread disease — they’re just an annoyance, says Bruce Oriel, MD, a pediatrician at Mary Bridge Pediatrics Union Avenue.

“It is a benign condition,” says Dr. Oriel. “If you wanted to talk about what’s going to harm your child, this is at the bottom of the list. Lice is nothing more than a nuisance."

Prescription medications to get rid of drug-resistant head lice are similar to over-the-counter products and come in the same form: cream rinses or shampoos.

The problem with over-the-counter products, Dr. Oriel says, is that we’ve overexposed lice to them, allowing them to develop a resistance.

“Like anything else, the more you expose them to medications, the more they’re going to mutate,” he says.

Head lice 101

Head lice are parasitic insects that can take up residence on the head, eyebrows or eyelashes of people. They’re spread by direct head-to-head contact with another person who has lice, not from pets or a lack of cleanliness.

“Lice carries with it such a stigma,” Dr. Oriel says. “But it affects every class of people.”

An estimated six to 12 million head lice infestations occur each year in the United States among children 3 to 11 years of age, according to the Centers for Disease Control and Prevention (CDC).

Common symptoms include itchiness, scratching and sores on the head caused by scratching. Irritability and difficulty sleeping may occur, too.

What to do if your child has lice

If you suspect your child has head lice, first:

  • Take a closer look behind the ears and at the base of the scalp. Lice live near the scalp, so they won’t be found at the ends of the hair.
  • Try to brush away what you find with your hand. If it easily detaches, it’s not lice. The nits (eggs) cement themselves to the hair shaft.
  • If it’s difficult to remove, it may be lice.

You can always have your child’s pediatrician take a look if you’re unsure, Dr. Oriel says. But if you’re certain, you have a few options:

  • Try an over-the-counter shampoo or rinse such as Nix or Rid. Be sure to follow the instructions carefully and administer a second treatment after about 9 days. A second dose will kill any nits that have hatched since the first treatment. (The products don’t kill the nits.)
  • If you’re hesitant to use a product with pesticides, remove the lice and nits manually with a nit comb. Tip: Apply vinegar to the scalp first to slow the lice down.
  • Remember to check the heads of other family members, especially siblings sharing a bed.

If you’ve tried these methods and you still see lice moving in your child’s hair, you may be facing the drug-resistant type and need a prescription product. Dr. Oriel recommends contacting your child’s doctor.

The American Academy of Pediatrics (AAP) echoes this advice, and suggests involving your pediatrician if you live in an area with a known resistance or when over-the-counter products don’t do the job.

What about home remedies?

You may have heard of using mayonnaise or essential oils to get rid of head lice. The jury’s still out on those methods, Dr. Oriel says, because there’s not enough data to back them up.

If you don’t want to use products with pesticides, a nit comb is the way to go, he says.

“The best home remedy is to manually remove them with a comb,” he says.

How do I make sure the lice are really gone?

There’s no need to fumigate your home or launder every fabric, Dr. Oriel says. Lice die within 24–48 hours of not being in contact with the scalp.

Laundering anything that came in contact with your child’s head should be sufficient. If you’re concerned about stuffed animals or heavy coats you can’t launder, you can bag them for a couple of weeks, but it’s probably not necessary.

And there’s absolutely no need to shave your child’s head or cut their hair, Dr. Oriel adds.

“Lice have to feed regularly, so they’re very close to the scalp,” he says. “If it doesn’t stay near your scalp, it’s not going to live.”

Looking for a doctor for your child?

Try our Find a Doctor tool or view our Pedatric Clinic locations.

Posted in: Kids' Health

About The Author

Roxanne Cooke

Roxanne Cooke tells stories in words, photos and video. She manages VitalsKite Strings and Bring Happy Back, plus special projects such as CeCe's Journey24 Hours at Tacoma General Hospital and The Healthy Futures Project. You can reach her at [email protected]

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