A healthy living blog from Marshfield Clinic Health System

What parents need to know about head lice

The start of a new year brings more than just back to school and resolutions for families. The start of the year can also bring a rise in head lice infestations.

Head lice commonly see the colder seasons as the perfect time to nestle up in warmth. Unfortunately, that warmth is often on human heads. The return to school, holiday travel and holiday get-togethers provides an opportunity for lice to spread as people gather close together.

If you or your children find yourself with lice, don’t panic. These little bugs can be treated.

Parent brushing lice out of child's hair

If you or your children find yourself with lice, don’t panic. Lice can be treated.

Diagnose lice by carefully combing through hair

The best way to diagnose lice is to identify a live nymph (hatched egg) or adult louse.

The American Academy of Pediatrics recommends examining wet hair. Carefully comb through the hair with a fine-toothed comb (a nit comb) from the scalp to the end of the hair. Using a lubricant, such as oil or conditioner, may help slow down the movement of lice.

They can be identified and diagnosed at an appointment with a health care provider, or at home.

“Appointments are easy and painless. I examine the scalp very thoroughly, looking for adult lice and nits. Nits look like tiny, one millimeter, gray-white specks. They usually are well-adhered to the hair shaft, usually within one centimeter from the scalp,” said Melissa Koopmann, dermatology physician assistant with Marshfield Clinic Health System. “Special attention is paid to the area behind the ears, as well as the back of the scalp and hairline. These are areas that lice like to live.”

Treating at home with over-the-counter products

If you have lice, you may notice a tickling feeling of something moving in your hair, itching, redness or small scabs in the scalp, due to scratching.

“There are products available that are typically applied to dry hair, for 10 minutes, and then rinsed out and combed through with a nit comb,” said Koopmann.

Over-the-counter products available include:

  • Nix® or RID® (with active ingredient Permethrin, 1%)
  • Sklice (with active ingredient Ivermectin, 0.5%). Sklice does not require nit combing.

“Due to the high-resistance of over-the-counter treatments, I typically recommend repeating the treatment in eight to 10 days,” Koopmann said.

If these treatments aren’t effective, there are prescription-strength treatment options available. These include topical products – like Elimite and Ovide lotion – and oral Ivermectin.

“While you can diagnose and treat lice at home, I would recommend seeing a provider if you or your child is not noticing relief within one to two applications of over-the-counter therapy,” Koopmann said. “An appointment is needed sooner if severe redness or itching occurs.”

Cleaning is essential after discovering lice

Lice typically don’t live more than a day off a human scalp. However, it’s good to take precautions to clean items that the affected person has used over the previous couple days.

“If lice is found on someone, make sure to wash and dry clothing or linens that were used in the two days prior to treatment,” Koopmann said. “Soak combs or brushes in hot water, at least 130 degrees Fahrenheit, for five minutes.”

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