Ew, lice!

Parents have plenty of things to worry about. Few are as disgusting or embarrassing as finding out that your child has lice, especially with recent news reports of "super lice" resistant to common treatments. Not to worry; we can still treat them. Here are some questions that parents often ask me about lice.

What ARE lice, anyway?

There are more than 3,000 species of lice. Fortunately, they tend to be very picky about where and whom they like to infest; humans only host two main types of lice, and each prefers a different body part (head or pubic hair).

Lice are tiny insect vampires. Like mosquitoes they love blood, and they have needle-like mouthparts that pierce the scalp. While feeding, their saliva irritates the skin and causes itching. Lice do not burrow under the skin (as opposed to scabies).

How did my child get them?

Lice love kids. Most infestations happen to kids 3-10 years old who then can spread them to their family members. Girls are more likely to get lice than boys. Kids of African descent are almost immune since lice don't find their hair as appealing. Lice spread through head-to-head contact. In order to procreate, they lay eggs or "nits" on the hair shaft. These nits will grow into an adult louse. Although many parents worry that people will think their kids or households are unclean, just the opposite is true—lice seem to find it easier to attach to clean hairs.

How can I tell if we have them?

It's hard to see lice with the naked eye, especially in darker hair, and the bite reaction is often mild, so you won't find a rash between the hairs. Some children have no symptoms. If your child is scratching her head regularly and you can't see an obvious reason for it, get a louse comb. Most pharmacies have them; expect to pay about $14. Louse combs are fine-toothed combs that will get the lice off the hair. Unfortunately, your child may have had lice for a while; the itchiness generally peaks 3-4 weeks after exposure.

Gross! Now what!?

There is no treatment that is 100 percent effective. However, many treatment methods are successful to a varying degree, including chemical treatments, natural products, combs, shaving, hot air and silicone-based lotions. Note that the "super lice" being reported appear resistant to over-the-counter preparations derived from chrysanthemums (see below). They're starting to appear in Minnesota, but since many lice are still treatable with traditional methods, the treatment recommendations haven't changed. 

We recommend different treatments depending on the age of the patient.

Less than 2 months of age: wet combing or petroleum jelly 

To wet comb, shampoo hair twice a week with ordinary shampoo, then vigorously comb out wet hair with a louse comb. Success depends on good technique.  

Another option is to use petroleum jelly to smother the lice. Massage about 1 to 1-1/2 ounces into the entire surface of the hair and scalp and leave overnight. Remove the residue with repeated shampooing over the next 7-10 days. 

These treatments can also be used in older age groups. 

Two months to 2 years of age: over-the-counter treatments

Nix Creme Rinse is a standard treatment and is quite safe in this age range. Rid is a good alternative, though it can cause allergic reactions in some. It's very important to follow the manufacturer's directions closely. Those who want a "natural" treatment may be happy to know that both Nix and Rid are derived from chrysanthemums, which still generally work well.

If over-the-counter treatments don't work, talk to your doctor about prescriptions that are safe for this age group. 

Two years to adult

Both Nix and Rid are standard treatment in this group too, but there are more prescription options for resistant cases. Talk to your doctor about what's best for you or your child.