I’m not trying to ruin your holidays (or your appetite). I really couldn’t and wouldn’t make this stuff up. But yes, we have had a lice infestation for the holidays. Last Thursday we flew to California to be with family for Christmas. Before that, I was in the midst of typical holiday madness, but I also felt this year, in particular, I’d managed not to get stressed. While in clinic on Wednesday, I made a conscious decision that I wasn’t going to stress about the to-do list awaiting me at home. The perspective I get while seeing patients often helps me frame my own stress. Compared to a broken arm or a bout of RSV, a packing list is really nothing. My husband was on call on Wednesday, so when I returned home from clinic around 6:30pm, the to-do list was mine alone. I needed to pack the family for the holiday, finish off some writing, wrap some gifts, and find something for dinner while completing the Christmas cards. I had about 12 hours before we needed to leave for the airport. But this is the life of nearly every parent at one time or another, particularly around the holidays. Then it hit.
Just before our nanny left, she mentioned F was complaining of an itchy scalp. The rest goes something like this:
Me: “Really? F, Lovie, come here, let me look at your head.” Pause. Gulp…….wait for it……..”You’ve got to be kidding me, lice for Christmas.”
F had lice. Yes, we’d received a letter the week prior that a “sibling” of one of the preschoolers had lice. The letter seriously sounded like the stories we hear from others about a “friend” with an STD or a “neighbor’s child” who bites. I figured one of the kids in school really did have lice and yes, the threat was there, but then blew it off and went on with life. New recommendations from the AAP this past fall encouraged schools not to send children home with lice or keep them away from school. I tend to agree with the recommendations as having families leave work and sending kids home seems an enormous interruption for a “non-health issue.” Maybe because of this, I was just about to have a front row seat in a major infestation.
Just then, the doorbell rang. Does this sound like a sitcom? One of our new neighbors was at the door, huge warm smile on her face. She was inviting us to a quick impromptu holiday party next door. Would I like to come? One of the older children had been offered up to watch the kids so I could head over and have a glass of wine. Pâté. Meet the neighbors, embrace the holidays.
I faked it; I smiled. I don’t eat pâté, but the wine sure sounded good. I didn’t tell this holiday-cheer-infused welcoming neighbor what was going on. I mean, when someone is standing in your home, for the first time, meeting your family and offering pâté and wine, do you tell them your child is covered in bugs?
I shut the door, said I would try to make it (that was the truth), and planned my attack.
First of all, I think (and have previously thought) lice can be difficult to diagnose. One study found that many presumed “lice” and “nits” submitted by physicians, nurses, teachers, and parents to a laboratory for identification were found to be artifacts such as dandruff, hairspray droplets, scabs, dirt, or other insects (eg, aphids). I’m a pediatrician and I doubted F’s diagnosis at first. To be honest, I didn’t get a lot of training on detecting lice in medical school or residency. It’s just simply not a medical issue, so families often don’t seek medical care. It may seem easy to find the bugs, but in a restless toddler or preschooler, it can be a feat. Lice also move quickly and avoid the light. Only after I got the uber-louse-killing-electric-comb thingy at the local pharmacy did I know for certain, in my heart of hearts, that yes, we were dealing with Christmas Lice.
Most of the statements in pediatric literature and in the typical teaching about lice sound something like this what the AAP says: “Head lice are not a health hazard or a sign of poor hygiene and, in contrast to body lice, are not responsible for the spread of any disease.” It doesn’t feel this way as a parent. Nope. Bugs crawling all over your son just doesn’t feel devoid of disease. Everything about it, at first, feels hazardous.
But let’s start with some facts to calm down. BTW, since starting reading this, have you started to scratch your head?
Head Lice Facts:
- Head lice infestation is very common among children 3 to 12 years of age. A 1997 report estimated that approximately 6 to 12 million infestations occur each year in the United States (this may overestimate as the number comes from sales of pediculicides). The AAP says, “anecdotal reports from the 1990s estimated annual direct and indirect costs totaling $367 million, including remedies and other consumer costs, lost wages, and school system expenses.” So a fairly BIG deal, actually.
- Head lice usually survive for less than 1 day away from the scalp at room temperature. Their eggs cannot hatch at room temperature lower than that near the scalp. So once they fall off a child’s head, lice pose very little threat. You don’t have to vacuum the carpet, sterilize the toys, wash the house top to bottom. The August 2010 AAP Head Lice Statement helps clarify. In 1 study, examination of carpets on 118 classroom floors found no lice despite more than 14,000 live lice found on the heads of 466 children using these classrooms. In a second study, live lice were found on only 4% of pillowcases used by infested volunteers. Thus, the AAP suggests major focus of control activities should be to reduce the number of lice on the head and to lessen the risks of head-to-head contact.
- With a first case of head lice, itching may not develop for 4 to 6 weeks, because it takes that amount of time for sensitivity to result. The lice live near the scalp, feed of blood from little bites and hatch eggs. The casings of the eggs (nits) are often the easiest thing to see. Nits in some writing refers to the eggs, and in some just the casings of the egg.
- Lice are not a hygiene issue. (I’m not just saying this as I out my son, really). Studies find that contracting lice has nothing to do with bathing standards or socioeconomic level. Translation: anyone, even those with pristine bathing routines and immaculate homes (who are those people?), can get lice!
- Lice spread by crawling (they can’t hop or fly). They move from person to person by direct contact. Believe it or not, it’s rare for lice to spread via a brush, comb, or shared hat.
Treatment For Head Lice:
- Electric combs: This is what I started with first. I went to my local drug store (circa 6:45pm) and talked with the head pharmacist. The pharmacist recommended the comb. The comb claims to kill both lice and eggs(nits) with no toxic exposure. The only precaution on the box was to avoid use in children with epilepsy or pacemakers. At home, (see photo) within seconds I heard the comb’s buzz stop indicating a dead louse. Within the hour, I had 38 dead lice! I combed and re-combed for over an hour. After about 20 minutes with no positive results, I stopped my search. Satisfied and exhausted, I thought I had done it. Only issue is that because lice move rapidly and shy away from light, they may be moving about the scalp while you work. This made me a little crazy….I kept combing and re-combing and re-combing…and the result? On re-combing the following day, I found 2 more live lice! That’s when I decided to go for a pediculicide. We were already at the in-laws for the holiday, Santa was on his way, and I felt I had no choice…The bottom line, I think these combs can work well, but not 100% of the time. They are tedious and you’ll never know for certain each bug or egg is killed because lice can move during treatment. If you chose to use one, you’ll need to repeat your work daily for 7-14 days. A HUGE time commitment. I couldn’t find any good research studies and data on these combs. Further, the AAP states, “No randomized, case-controlled studies have been performed with either type of comb.”
- Pediculicides: These are chemical treatments that kill both the lice and the eggs/nits. 1% permethrin lotion (i.e. Nix) is currently recommended as one of the drugs of choice for head lice in the US. It claims to kill lice and their eggs for 14 days. However because of silicon-based additives in most shampoos/conditioners that remain on the hair shaft, there is concern that the permethrin may not stick to the shaft of the hair well and allow for ongoing killing of eggs. Many experts recommend re-treatment at 7 days and then again at 13-15 days after the first dose. Read a summary of chemical treatment options.
- Hot Air: A recenty study in Pediatrics found that using hot dryers, called “LouseBusters” for 30 minutes (think salon type hair-dryer-chairs) may be a great cure for lice. But where do we find those? They are rare and expensive machines. Until they are found more readily, it’s hard to know how effective and useful they are.
- Benzyl Alcohol: FDA approved use of 5% Benzyl alcohol in 2009, The product is not neurotoxic and kills head lice by asphyxiation. Studies demonstrated that more than 75% of the subjects treated were free of lice 14 days after initial treatment. Not perfect, but not bad. It doesn’t kill the eggs so you HAVE to retreat at 7 and maybe 13-15 days, even if you’re a master with the nit comb. You need a prescription for this.
- Lindane: I don’t recommend it as it is considered neurotoxic and there have been numerous reports of seizures after use. With all the other options out there, avoid it. I’d say it’s better to have bugs.
So what about Nit Picking?
Until now, I’d never understood the rationale for nit picking when pediculicides kill both the live lice and the eggs. You may not need to do the combing, but your freedom from the comb will depend on your decision to re-treat. Reality is, none of the pediculicides are perfectly 100% ovicidal (egg-killing). So, removal of nits (especially the ones within 1 cm of the scalp) after treatment with any product is recommended. Nit removal can be tedious and challenging (I’LL SAY!!!). However, combing every last centimeter of your child’s hair may be worth your while. The AAP states that studies have suggested that lice removed by combing and brushing are damaged and rarely survive. So at least you’ll add to your electric comb, permethrin, or benzyl alcohol efforts…
Many urban areas have hair salons and private business that specialize in removing lice–and most offer a guarantee. If you’re not up for the lice-zapping electric comb or the Permethrin shampoos and subsequent nit picking, you can hire this out. I’ve known other friends who have done this and were satisfied. Often they did this after a second case of lice or a recurrence.
Although the whole experience of using an electric comb, followed by drowning our heads of hair in Permethrin one day later wasn’t ideal, it did feel a bit like a rite of passage in parenting. In the end, lice didn’t feel like disease, just incredibly disgusting and disruptive.
My plan for the week: I’m going to use 5% Benzyl Alcohol as a follow-up treatment for my son at the 7 day mark. And then re-comb with my electric comb. Want this done for good…
- And you? Share your life lice story. I hear a lot about the huge cost of time and money in riding lice along with the recurrent infestations from many patients and friends.
- Fill us in–what is your secret–what worked for you?
- How do YOU feel about the new recommendations from the AAP about keeping kids in school with lice?
I was getting notes constantly from school, so I had gotten in to habit of weekly head checks, which was awesome, when we did indeed get head lice. We actually got it over the summer. I was doing the weekly head check and noticed 10 nits at the top of head. At first I thought it was dandruff, but I had to use my nails to pull it off the hair shaft. So off to the drugstore we went got the bottle of Rid and an Acculife Ultimate Lice Comb. I used the shamppo and combed the hair out. I never did see a live bug, just the Nits. Then I washed all the bedding and Vacummed the house (Info I have read said they can live for 48 hours after they fall off your head, so I wasnt taking any chances of any one else in the family get it). I had an appointment with our family doctor for something entirely different and asked him for advice. He said make sure to use the lice comb daily for 3-4 weeks to make sure you got all the eggs. Most of the products on the shelf say they kill the eggs, but they have become resistant so combing makes sure you get rid of them. We did this and didnt find any more.
I since have found a non pesticide brand, that I purchase and have on hand for when it happens again (I have a 6 and 11 year old), I also find a line of products that supposdly repel lice, called Fairy Tales Hair Care. Unsure if its a gimmick or it really works, but I use it daily on my kids. Its organic and smells good and so far (knock on wood) we have been clear of lice.
As for the new AAP recomnedations, I think they are wrong!!! Yes they are not a medical issue, but there are parents out there that do not take care of the problem when told, so letting these kids back to school without proper removal, can spread it to other children. Then it become an out break! Just my thoughts, we will have to see how it all works out especially since my school district was one of the first to allow it.
First, thanks for a wonderful blog. The first and only one I read. Loved the vaccine series which I now use in my classes.
I was troubled by the AAP recommendation when it came out and wonder what impact it will have on the incidence of lice over the next few years. More contact = more cases.
One concern is why this is not viewed as a disease, any other parasitic infection/infestation would be – think pinworms here. Not to pick nits (sorry), but I think they are off on the definition. There is a reason why the bites itch and, while very rare, the chance of secondary bacterial infection. Here are two (admittedly online) definitions that would seem to place a lice infestation squarely in the category of disease:
disease /dis·ease/ (dĭ-zēz´) any deviation from or interruption of the normal structure or function of any body part, organ, or system that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be known or unknown. (SO: https://medical-dictionary.thefreedictionary.com/disease)
and much looser but relevant:
“A disease is any abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person affected or those in contact with the person.” (so: https://www.wordiq.com/definition/Disease)
More importantly, if the discomfort, both physical and emotional, can be reduced by avoiding contact then we should make every attempt to do so.
The crux of the problem of course is economic. Many parents risk loosing their jobs if they miss any time at work. That is a long term and complex problem that we need to resolve for an admittedly broadening sector of the US population.
The rest of us, however, should be be more sensitive when balancing work ethic with community responsibility. I am especially sensitive to this as the parent of a child whose immune response to common respiratory ailments sends him to the ER 2-3 times each year with what manifests as simple coughs and sniffles in the other kids in his classroom.
Thanks for all you do!
Wendy Sue Swanson, MD says
Yes, I agree, the issue and impetus behind the AAP recs are economic. Particularly because the ultimate “risk” is low. I think time will tell if the burden of lice outweighs the benefit of productivity.
On an individual basis, it likely won’t feel that way…
We went with RID from the local pharmacy – and lots of nitpicking. Also frantically cleaned the bed linens and clothing to later find out that effort was wasted. It was awful but not as bad as I imagined it would be. Older son says that if he ever gets the problem again, he’s going to shave his head.
Nix burns like heck. We used it once, then followed up with olive oil and saran wrap and combing. No lice returned.
Laura Hamilton says
Why wouldn’t you just shave his head? I mean really…electric combs and permethrin and all that….I can see perhaps going through that for a girl, but for my boys who wear close-cropped haircuts most of the time anyways…I’d just put the shortest guard on our hair clipper and take it down to the scalp. Done! No hair, nothing for nits to cling onto.
However, if that’s not an option, I have heard of people having great success with oil-based treatments and a shower cap. Apparently olive oil is the one to use, because it doesn’t go rancid and smell, it kills the lice effectively and it is fairly easy to get out of the hair afterwards.
You will still need a nit comb to get rid of the eggs, but the olive oil makes it a whole lot easier to comb through the hair.
Wendy Sue Swanson, MD says
Well Laura, yes, shaving would have been EASY. And most definitely was an option.
I’d say the short answer is vanity. I love F’s hair. Love it. So we did the whole comb, nix, nit combing route. Maybe silly in retrospect.
If I were to face last Wednesday again, I’d call in Benzyl alcohol and do it that way.
But I am happy to have the electric comb around. Works great as a diagnostician. And satisfying, yes.
I, too, read have heard about suffocation from petroleum products and olive oil. Glad to hear of the great results!
Lice knowing you says
Hi Dr. Swanson,
I am the owner of a Seattle based Lice removal company called Lice Knowing You. As you are finding out, the only guaranteed way to get rid of a head lice infestation I’d to get rid of all nits and lice on the head. Even one viable nit and you are back to where you started. While products like the Robi comb and Ulesfia can be helpful, combing is still required or you will be in the same boat a couple of weeks from now. Same with the Lousebuster device you mention. Combing is still required. Our company performs full lice and nit removal in one treatment with a free follow-up check one week later. We offer a 60 day guarantee. Our services are often covered partially by insurance and 100% by fsa
accounts. We recommend checking the entire family as we find that other siblings and often parents have it too. With 38 bugs found in your son, chances are pretty good that you may have it too. Please call us at 1206-654-5424 to set up a check. We are doctor, nurse and school recommended.
We too, just had lice, right before we let out for break. In November, got a letter from 1st grade that someone in the class had lice. With two girls with long hair, went out that night and bought lice repelling shampoo and used it frequently for the 1st grader, not as frequently for the pre-schooler.
Pre-schooler ends up with lice. I picked and picked and picked lice that first day and slathered all of our hair in a tea tree oil/water combo (not too much b/c I didn’t want to burn their little scalps!) We packed up all bedding/toys/washed all bedding daily for six days – seems after reading; this may have been overkill 😉 Second day picked nits/eggs/whatever out of her hair. Third day found one tiny lice louse and 4 nits. Did this twice a day for six days, poor girl.
Then, finally, I read about the heat! I used a straight iron on high heat on her hair for about three days – no sign of eggs, nits, lice after the first day. Could have been b/c I was so diligent the first few days but I really do think the heat helps. They aren’t supposed to survive on high heat from the dryer or washer and my straight iron is much hotter than my curling iron.
I’ve been checking scalps daily and keeping my fingers crossed that we are done and that it was short-lived!
Marna Fasteland says
Good Morning Dr. Wendy Sue Swanson –
Headlice! Yikes, it brings back memories (not fond ones – read on …)
When Lydia was 5 and Elle 2, Lydia had head lice that we discovered on a visit to the doctor for an ear infection. This is 15 years ago and the doctor prescribed the lindane shampoo to get rid of the lice. Of course as soon as we treated Lydia we found Elle had head lice so we treated her with the shampoo too. (I am wiser now and would not even consider using lindane shampoo, but it was prescribed so, we used it. ) We also got a nit comb and combed through their hair like 5 times a day. And put all of their favorite stuffed animals in plastic bags for weeks. And washed bedding every day. And guess what? Within a week they both had head lice again. This was just 15 years ago but we did not have home internet so I went to university extension for help. After reading about lindane, we did not use it again and started using Rid or Nix treatments and even used Prell Shampoo. And combed, and combed and checked for nits, and combed ….
We were doing everything right, but could not stop the head lice. The public health nurse came to our house three times to check the kids hair to cerify they were “clean” and could go back to pre-school and day care, but within a week they had head lice AGAIN.
ALL OF OUR NEIGHBOR’S SHUNNED US!! No play dates for us! Some folks even lectured us about not doing what we were supposed to do to get rid of the lice. The public health nurse visited the day care twice and did not find head lice on any of the kids. This went on for 8 weeks until I was frantic and almost hysterical. I was vacuuming 3 times a day and doing laundry all day and checking heads constantly. I finally brought the kids in to get extra short haircuts so I could find the critters easier.
We were thinking that Lydia was getting the lice and sharing them with Elle, but it turned out the other way around. On the third visit to the day care by the public health nurse, she checked the adults that worked there. One of the younger part-time helpers had the head lice. It turns out Elle loved being held by the helper. This young woman had beautiful thick long hair and a rampant infestation of head lice that did not seem to bother her (she was not present when the public health nurse checked the two previous times since she was just part-time). One she was treated our head lice problem went away.
It was a memorable time for our family! To this day, I really cringe when I hear “head lice.” I have always been hypervigilant when the kids came home from school with the note about the latest head lice infestation and luckily we never had another bout of it.
Thanks for sharing your experience in the blog! I wish there had been an electric comb available way back when this was happening to us.
Wendy Sue Swanson, MD says
Well Marna, thank you.
The end of our story is not pretty–similar to yours. After the electric comb, AND the Nix, F kept itching….
AND SO DID I. Not my husband or O (thank goodness)
Eventually, late last week we had some professional nit pickers help us out. They found more live bugs on F and many nits on me!! We’re better, but I’m now using a new nit picking comb daily to prevent recurrence. I’m learning, more and more, that it is the fastidious nit picking that is essential for keeping the lice away.
More updates when we do our final re-checks in a week or so.
But yes, lice = gnarly. And others shunning, yes. I’m astonished how much time an money we’ve now put into riding ourselves and our home of lice. Let’s just say I would have preferred to put the nearly $400 into a college account. EEEEK!
My sister sent your blog to me. I live in Virginia and it looks like we both had itchy guests for the holidays. I’ve been an elementary school teacher for 15 years and have had numerous cases come and go in my own classroom. Last week it hit our house, just a few days after Christmas. My 5yo complained of an itchy head. We used RID (Target brand) and I picked every last nit out of her beautiful hair (2 hours+). I followed with a lot of itching and a lot of washing! Like my husband said, it was time for a deep cleaning around here everywhere. We were fortunate that the 2yo didn’t get the itchy visitors. I’ll be repeating the shampoo tomorrow, as recommended and will live happily ever after if I don’t experience this again! Maybe I’ll buy the comb as a safety measure, kind of like a snowblower to keep away a Snowpocalypse repeat. By the way, what a great blog!
Sarah Pulliam says
Hi, I enjoyed the post in the way only a parent looking back at an infestation can. My daughter returned to school this year and instantly had lice. She has very curly long hair. Cutting it was not an option because she has been growing it out painstakingly since her adoption. We tried several herbal rememdies and mayonaise treatments, all aimed at smothering lice, followed by the ubiquitous Saran Wrap headdress. And combing, hours and hours and hours of combing, with various metal lice combs. Every time I thought I had them all, one or two would survive and the process began again. I lost a lot of sleep and productivity. In the end, what worked was combing followed by daily hot hair from the regular old hairdryer. All told, my daughter had lice from September through November. If she had not been able to go back to school in that time, I would have probably lost my job! Now we talk about “head hygeine,” namely not leaning over tables where other kids are working, since her hair is basically a magnet for lice. I wish I could have prevented all her tears, and all that pulling. I have her using tea tree shampoo as a preventive measure. If she gets lice again I swear I am going to bawl with frustration and self-pity.
I feel your pain, too! Lice hit our house a couple of years
ago and I still start to itch when I even think about it. We went
with Nix treatment, hours upon hours of combing and another dose of
Nix for good measure. I also bagged up stuffed animals and hats
that couldn’t be washed and washed all other bedding, clothing and
car seat covers. I felt terrible for my kids because it was hard
for them to sit still for so long and the Nix stinks beyond belief.
The only perk, for them, was that I let them watch TV as we did all
of that combing for several weeks! Despite the studies that claim
that hats, pillowcases and carpets rarely pass lice to kids, I
believe that lice is often passed by these environmental fixtures,
and not just with head-to-head contact. It just seems much too
widespread and contagious to be limited to passing between those
who touch heads. I am not a fan of the newer AAP recommendation. I
am in favor of public health resources to help parents rid their
homes of lice and limit economic setbacks caused by lice.
Hello! I’ve enjoyed reading everyone’s post about this issue! I got a call last Wednesday that my 5 yr old was having to be picked up from preschool because she had head lice. Also her friend that lives close to us, they sit together on the bus, and play together every chance they get had it also. So we went to pick them up to find out that my daughters friend had it worse than mine. I had stuff prescribed by the doctor already at home from an inncident earlier this year with my 3 year old son. I stopped on my way to get her to get some bedding spray. We came home and started the treatment! She had it from the same friend when she was about 2 1/2. I was freaking out! When I was in school my hair was very very long and never got it. The thing that bothers me is that I’ve washed our bed sheets twice since we found out, treated hair, sprayed bedding spray, picked and picked her hair. It has been 4 days and the other childs parents have not half of what I have. This is very frustrating to me!! I have limited the time the two girls can play together and if we get it cleared up at our home and she gets it again I think their going to have to end their friendship.
It’s been quite a day for my wife and kiddo. About the only good thing about J discovering lice on M’s head this morning (after I’d left for work) is that I knew there was sound guidance to be found by Seattle Mama Doc. I remember reading this post back in December and thinking \oh no, what a drag!\ There is an amazing amount of opinion, myth, and here-say about lice treatment on the interweb and it is such a blessing to have a trustworthy source in Dr. Diligent-Mama-Doc. Thank you for sharing your experience. If today’s combing didn’t work, it’s off to the treatment place. (btw – i’m excited to try the new ‘notify me’ feature!)
Wendy Sue Swanson, MD says
Thanks, Chris. BEST OF LUCK. I’m planning on writing a follow up to this post. I learned MORE with the re-infestation we had. Re-infestation, yes.
Comb. Then comb again. Then comb daily for the next 7-10 days. Notify school/class if you can. Re-infection is common and it would be nice to have others in the class who are also likely infected treated thoroughly as well.
In the end, we had our heads (INCLUDING MINE!!!!) combed by the professionals. Not cheap, not entirely fun. But effective. After the official combing ended is when the chaos ended, too. Others seem to have better luck!
And then, there’s always the total shave. But how could you ever do that to that lovely hair?
We had a traumatic lice infestation last summer. We were in the midst of a remodel, but still living in our house — all 5 of us (me, husband and kids, age 8. 7 and 3) — in our basement on a couple matresses and one crib. Our daughter got lice at daycare. We thought we got rid of it with lice shampoo and a few infrequent combs with the metal nit comb. Three weeks later, after returning from vacation, all 3 of the kids started itching. Since we obviously failed to get rid of it the first time with our daughter, we went to a lice treatment salon for family head checks. All of us had lice except my husband. All of us got treated (basically sitting in a chair for a few hours and getting all the nits picked out of your hair). Then we had a week at home of combing every day to make sure no nits returned. It was a long process, with three kids and me having to do this each day. Then back to the salon for a check-up in a week. Plus lots of house cleaning, washing and agonizing in the midst of all this. It cost a lot of money, but having failed the first time to get rid of my daughter’s lice, and knowing that my chances of getting rid of all lice on all three kids (plus me) by myself was limited, that’s why we chose the salon route. We also lucked out because our insurance covered much of the cost.
Now, today, almost a year after the first lice infestation, I think my boys may have it again. Have to check today when they’re back from summer camp. Just found out our new health insurance does not cover the salon treatment. However, that’s where we’re going to need to go or else I’m sure it will reappear. I was vigilant for many months after last year’s infestation — but it just got really tiresome to always check. But guess I’ll have to do that again, especially if they really do have lice again.
Michael Smith says
My daughter had a terrible infestation we tried everything to get rid of the little suckers. I was about ready to shave her head (kidding!), when instead I decided to call some of the local services. I had a long conversation with Robin of Nitwit Seattle and she was incredibly helpful. I finally got how the whole life cycle worked. And I am proud to say I finally tracked down some lice and knits. The next day, Robin found about a dozen more and we were finally lice free. The whole thing freaks me out less now because I feel like I know how to prepare and deal with it. Stay away from the chemicals and employ the power of knowledge instead.
Jana Sheehan says
I have just met with Robin – the same Robin Michael mentions in the previous post. Couldn’t agree more – strongly recommend to use her (or someone like her) services. Nits and lice take patience to pick – or shave off the hair. But I’d rather have someone else do it. It takes a long time to get rid of the pest….
Jana Sheehan says
Oh – I wanted to mention th econtact for Robin in case anyone who reads this blog is interested… https://www.nitwitseattle.com (I did not realize it would not show up after I wrote it in)
I was looking up lice and came across your blog…thanks for sharing. We are going thru the lice infestation now. My 5yo was scratching his head of course at bedtime on Sunday night. Sure enough he had lice. Found some live bugs and lots of nits. My older son had lice just over a year ago so I knew the process. He came home from practice, and sure enough I found nits on his head….then on mine! eek…About 2am I finished the treatment and combing of all 3 of us. re-combed in the morning, found a few more on older son, 5yo looked good as he had much shorter hair. I did buzz cut #3 cutters for 5yo! made sure I got them all!
My husband took another 2hrs monday combing out my hair just to be certain. I’ve been doing wash non-stop, bagged up all the stuffed animals, pillows, etc! I do not want re-infestation. I notified kids school, they were checked by nurse and allowed back in yesterday. Said my kids were the first reported…but, we live in stuck up area so i’m sure others did not report! that makes me mad. Esp. with Kindergarten students! Teacher bagged up all dress up, stuffed animals, etc. in the classroom.
I’ve been putting tea tree oil on all of our hair.
I had used Fairy Tales shampoo every washing on kids, so that did not work. My hair is color-treated and that did not keep them away. Another thing i’ve been using my flat iron really hot. I head that kills nits too…not sure but it makes sense since its salon quality one and it does get really hot!
I think i will start doing 2x/week checks from now on…sees like the little buggers like my family 🙁
I live in an area where there are no professional services for nit-picking available, and after finding lice in my 5 year old daughters long beautiful hair 3 weeks ago, we are still dealing with it. I believe (pray) that we are near the end of this ordeal, but it has been a process of diligence. I have used 3 treatments of NIX now, but I feel the turning point for the better, came when I bought a new comb. The answer is in the combing!!!! Don’t waste your time using the comb that comes with the kit. They’re good to get the larger bugs, but you’ll miss so much. I didn’t know a thing about lice prior to 3 weeks ago, so I didn’t realize how tiny some of this stuff is. The new comb has been wonderful for taking out nits and the tiny bugs that you can’t see. It all seemed very daunting in the beginning, but now I feel like, with patience and perseverence, this can be tackled.
Wendy Sue Swanson, MD says
Agreed!! The magic is in the combing and the diligence to keep on going with it. Good luck and hang in there! And then keep up with your surveillance. We try to check every week, still.
Robin Lofstrom says
Hello Dr. Swanson – People who come across this blog are certainly lucky – I think it’s tremendously reassuring to see that educated people, and those in the healthcare field, no less, get lice, are unhappy about lice, and try multiple approaches until something works for them. The number one thing to remember when beating head lice is that you can do this! But before you try, learn a little louse biology. I have some great blog posts about lice education on my website, if anybody cares to visit. Finally: no matter which treatment you choose that’s right for you, the #1 thing you can do is to maintain your vigilance, because you don’t ever want to go through this again. I know – I’ve been through it three times with my three kids, which is partly why I started my lice treatment service. I’ll come to clients’ homes, bringing everything I need with me, and leave my clients feeling informed, reassured – and with a guarantee that if they’re lice-free one month after our first appointment, I actually pay the family $25/child.
Jen Stein says
I have had success with the Cetaphil treatment for lice. My child has many allergies, and so I don’t use any chemical products on her at all, and my older child was subjected to the same treatment seeing as well, the whole family got lice for the holidays this year. What I did was get those excellent RID Combs, with the two sided teeth. Then I covered her head in 1/2 a bottle of Cetaphil and massaged it in as I would shampoo or conditioner for a few minutes, and then let it sit while I got things ready.
1 stack of paper towels, about 15.
2 towels, 1 around the kid and 1 to protect the couch.
A bowl of rubbing alcohol + water.
A wide-tooth comb to detangle.
So I used the big comb to detangle her hair (my girls have longish hair so this was important). Then I would take the long teeth of the nit comb and pull through the hair, section by section, and after each pull through I’d wipe the comb on paper towel. I found HUNDREDS of brown specks, nits and lice. Wiping on paper towels let me see just how much was in the hair. You comb the cetaphil through until very little gets on the comb but the hair is still soapy.
Then get the hair dryer. On medium high heat to not burn little scalps, you take time to dry the cetaphil onto the hair, shrink-wrapping the hair strands. 8 hours later all the remaining eggs will have suffocated, and the child can wake up and shampoo and go.
I read a NYPost article that says this is 95% effective, even on lice that haven’t responded to treatment. I just thought I’d share it here for other parents who can’t use the pesticide type shampoos.
Robin Lofstrom says
I use the Cetaphil method in combination with a thorough nitpicking and I have to say that thus far, after being in business for a year, and having my three children get lice every year, the Cetaphil method has been remarkably effective.
Im a pharmacist in Canada and we have a new product here, not sure if it’s available in the US, called Nyda. It’s dimeticone. It is non toxic, no pesticides. It smothers the lice, cuts off their breathing. We have found resistance rates for permethrin and related pesticides to be upwards of 50% in many areas. Dimeticone as a physical treatment has no resistance issues. I’ve been using it with patients since It became available a few months ago with great success. Of course combing still recommended 🙂
We live in Israel where lice is rampant. The 2 best things you can buy are the Nitty Gritty comb (I think in the US it is called the Nitfree Terminator comb) and Hedrin Once (or LiceMD in the US). The comb picks up every tiny nit and louse from the hair. This comb is amazing and a must have! I comb my daughter’s hair with it every few days as a precaution. Hedrin/LiceMD are silicone-based treatments and are pretty effective. They suffocate the lice and make it very easy to comb them out of the hair. They do not contain pesticides so you can use them as much as you need to, though the 2 times my daughter has had lice, I’ve only had to do one treatment with one extra a week or so later just to be sure. I always have a bottle on hand just in case I find something.
My daughter had lice exactly 5 weeks ago. We treated with the lice shampoo, sprays, and nit combs. I only found one live bug but lots of eggs. Luckily she was the only one in the house that had it. We all did treat though and did the crazy house cleaning. Today while fixing her hair I noticed more nits. I’ve heard of reinfestation but everything I’ve read says 7-10 days. Has anyone else heard of this after a month? Does this mean she’s rubbing heads with a lice infested kid at school?
Wendy Sue Swanson, MD, MBE says
So frustrating! Typically re-infestations do happen after 10 days or so because a nit evolves into a louse….that being said, when we had lice we had 2 more infestations as my son got re-introduced to lice at school! so yes, clearly that could be what is going on. Check in at school and ask perhaps to have a classroom check?
My son wound up getting lice at a Cub Scout camp and I didn’t really want to use the chemicals. After a few hours of research I discovered that dawn dish soap will kill the live lice and vinegar breaks down the not glue. Meaning less chemical exposure for my littles.
We have been battling head lice for five months now. We have been using over the counter remedies and retreating as directed. It has been five weeks since the last treatment and my daughter came to me this morning with a single lice bug in her hand. Oh no!!! I am so frustrated! How is this happening? I’ve washed everything, I’ve treated, I’ve sprayed and I’ve even put there stuffed animals in a garbage bag and placed them outside in the freezing cold temps. I figured since they like heat the would definitely die in temps below freezing. That’s before I have learned they live less then a day off of the head/scalp. What am I doing wrong? I’m afraid I have treated with pesticides over the maximum amount of times. My youngest has claimed she had a headache and neausa after a treatment. Each child has been tested six to eight times.
My two boys had lice about a month ago I took care of them through a mixture of methods, thanks to your informative and relieving post. They were discovered at the hair salon, the hair dressers found them half way through the cuts and stated they could not complete the hair cut under Washington law. Is this true or perhaps it is really only their policy? I have been hard pressed to find anything regarding any such law in any state online. They were stuck with funky half hair cuts for two weeks.
My head started itching while I was only half way through the reponses…
Look up a product called quit nits. I highly recommend it. It’s completely chemical free and it kills eggs and live lice. You can use it daily in between the chemical treatments every 7 days.
Oh this is a great blog,, I’ve been through this so many times with three girls,, for everyone’s sake,,let me tell you what worked for us,, not any OTC shampoos, not combs, prescription shampoos,, I used a clear gloss, bought at Sally’s beauty supply with developer, I applied like doing a retouch to the roots, combed thru, then I put a plastic cap on their heads and waited 45 min, then I blow dry with a round brush by sections…. And I repeat this process once a year before school starts,,, it’s worked for me for years,, I’ve 7 year old twin girls, and a 13 year old girl.. Hope this helps someone:)
Our daughter is a BIG MAGNET and is extremely touchy feely…so if there is lice around she pucks it up and distributes it VERY well.
We have had mild success with olive oil treatments lice md and nix…None of them work well. Last year I ordered NYDA from Canada and Germany on the internet. We had done treatments and washes and shaved heads and they always come back. This time after the NYDA there were gone. HISTORY. SEE YA ! Today we have it again and if one has it we all have it. On to Amazon to order NYDA and wait…We will do some combing treatments and washing and bagging to minimize the itch til it gets here !
I found your blog when searching for other frustrated mothers. My daughter goes to school with a little girl who’s mother clearly has no problems with spreading lice to an entire town. After stripping down her room to nothing, vacuuming, endless laundry, you name it, we were good for two whole weeks. Now after treating her 4 times in a month span I think the health issue comes from me having to put chemicals on my daughters head. I hate having to do it and our pediatrician believes we are just being reinfected at school. I’m ready to give that mother a phone call.
I think that schools should rethink letting kids with lice stay at school. While some may not want to treat, maybe lack of funds, time, knowledge, or pure laziness. Those of us who would like to stay lice free have a hard time doing so. I have 3 daughters with long hair, since we have been of school age my daughter has gotten it 5 times. We switched schools, and had no problems till recently. I still work at the other school, and there are 3 second grade classes invested with lice. I myself contracted lice, and I wish the school wouldn’t let you come back till after at least one treatment with no signs of lice. This is getting so ridiculous!! Something needs to be done. I’m in the process of coming up with a plan with the teacher of the class I work in. I know they don’t carry disease, but I don’t want to live with them.
We are supposed to leave in two days to drive 6 hours for family Christmas weekend. My daughter has lice. Eggs and live ones. Just used the rid stuff but can we still go? She is 12 long hair. Will be joining 3 other teenagers for the 2 girls one w long hair too.
Wendy Sue Swanson, MD, MBE says
Yes, of course you can go! Lice isn’t dangerous…..for anyone. But I’d continue daily combing and follow instructions for repeat of treatment!
Hello. My kids had a mild case. I used the shampoo right away and on day 2 took them to a professional clinic. They examined and combed out all the nits. There were very few. They suggested we continue to comb every other day. At day 5 after treatment I took them back for a re-check and they saw nothing! We just need to do surveillance combing every week. Do I still have to shampoo with the OTC shampoo at day 7-8? I called or pediatrician and they said do it again at day 14. No need to keep combing I’m so confused. I trust the clinic when they say there is no lice. I have been checking but just want to stop being paranoid about this!
dawn bohman says
I am a new comer to lice infestation. I have had 4 children who have never had lice. I come from a family with the poorest economic backround you can imagine, and none of us had ever had lice. A few weeks ago my 5th and youngest child complained of itching and I blew it off. bought her some body cream with anti-itching properties and called it a day. a couple of weeks later she is telling me that her head is itching so bad she can’t stand it. So I proceed to look and see what I can see…..by the way, it is mothers day and 8:00 at night. Well we looked and saw things. I had no clue as to what lice looked like, so we’re on the wed looking up lice and my daughter is crying a freaking out and I go and do a walgreens run to get lice treatment and I get the most expensive one cuz I want to get them gone. I get back home,follow the
Danielle Burkhart says
Thanks for a sane post about Lice!
I tell people now I will take lice over the FLU any day. They have a relatively predicable life cycle and it is now known that dimethicone, alcohol as well as the pesticide treatments can get the buggers.
Wendy Sue Swanson, MD, MBE says
Thanks for the link! I’m about to publish 2 new posts with updated info. Stay tuned this week!
Melanie M Austin-Stickels says
I am a 60 year old woman. I live with my best friend, her two boys ages 8 and 11 and her boyfriend who also has a son 8 years old. We have been dealing with head lice since at least June. I’m not kidding!! We have done absolutely everything possible that’s recommended and safe from the Doctor to the department of health. Today is October 7th. And once again we’re nitting and applying different product to our hair. I have come to the conclusion that due to the fact the orher parents that DON’T live here are refusing to deal with it on their end, they are reinvesting the children on “their” visit times. No a darn thing we can do about that. I must say, it’s making me absolutely crazy and my hands are tied.
Dave Anderson says
That is really cool that benzyl alcohol kills head lice by asphyxiation. That sounds like a pretty easy treatment that I would love for the doctor to do. If it has great results then I am all for it since my child has lice.
Emily Baird says
I’m bringing in the rear of this conversation but oh wow I can relate!! Being a single mom of 3, I’m also pediatric RN but even with 20 years in pediatrics I STILL struggle to be objective and bring my nurse knowledge home…so, be gentle. 🙂
I spent 4 or 5 days cleaning housES over the holiday break and I must say there’s not likely any amount of education that will prevent my cleaning. Yep…that is pleural. divorce=2 homes for my kids. Any illness that is contagious does spread and it seems I am the only one who notices the circulation of symptoms twice around…even 3 times and if I don’t wipe door knobs and strip the bedsheets at both houses it’s been historically proven that
a) no one else will do it and b)everyone is likely to keep getting sick. Not to say all should do this to themselves!! My circumstances are unlike any other with the kids boomeranged alongside their bugs from here to dad and back every 3rd day. Sleep 2 nights at moms, one night at dad’s(per our decree correlated to his work schedule cycle: 24hr shifts then 48hrs off…yes actually I do know I am an idiot)
In this particular bugapaloosa it was my youngest 11yo daughter who fell victim with her babyfine long blonde hair that slips right through the teeth of any nit comb I’ve ever tried (this isn’t our first bug-rodeo). These combs are 100% useless to me leaving myself to be the lone manual remover and unless I bring home the papoose board, these torturous hair pulling sessions are tolerated only briefly!! I’m not too great with tortuting kids into PTSD so I ask this question…. What about the dryer bonnet?
Did I miss the commentary about heated dry air?? Aside from someone who mentioned the hairdryer… There’s a product at the local mega-mart store that looks like an inflated foil helmet: “soft hood” or hair bonnet. It attaches to your hairdryer and inflates when you turn the dryer on. It’s supposed to circulate hot air over the head. Made for hair rollers or home perms, why wouldn’t it work to kill these pesky critters and without a toxic mess of screaming sounds of firetrucks coming from my babygirl OR the self motivated act of my 14yo son who, while watching as I pull bug after bug from little sister’s hair, dissappears to shave his own entire head of hair in panic and fear of having these bugs live on his own head.
At a price tag of $3(online. free shipping) up to $12(walk-in store) I can volunteer as a willing participant if i can prevent such future mayhem (let’s face it and call out the elephant) when these creatures return.
Lice Charmers says
Hi Dr. Wanson,
I was wondering if you will be updating this article in the near future with the latest developments regarding lice treatment. This study came out not too long ago showing a correlation between pyrethrin exposure and mortality. As you may be aware, the bulk of drugstore lice products are pyrethrin based and if there is evidence that it’s harming adults, think of what it could be doing to children. If you’d like to discuss this further feel free to contact me as there are other new developments in lice treatment your readers would be interested to know.