Lice

Lice!  The diagnosis strikes fear into the hearts of parents when they hear that it’s been going around in the child’s classroom or, worse, that their child has been diagnosed with it.  Nowadays, lice are pretty resistant to over the counter treatments such as Rid or Nix, so if the diagnosis is definite, it would be recommended to go straight to a prescription medication.  There is the option to use Rid or Nix in family members in whom no nits or bugs are seen but who feel compelled to treat themselves “just to be safe.”  If Rid or Nix is used for the patient himself/herself, it does have to be repeated in a week to get the eggs that have hatched because it doesn’t kill unhatched eggs.

The prescription medications to treat lice are Sklice (which does not exist as a generic) or Natroba (which exists as the generic spinosad).  Both are reported to be effective against live bugs and against eggs.  Both need to be applied to DRY hair, starting at the scalp and fully saturating the scalp, and then the full bottle completely used up in one single application, reaching as much of the rest of the hair as possible.  Set the timer for 10 minutes after the application process is finished, and then rinse with warm water.  Do NOT shampoo with regular shampoo or conditioner afterwards.  Blow dry the hair and begin the painstaking process of removing the nits one by one.  I recommend using your fingernails, not the little metal comb, for better results.  Nits are easier to remove from dry hair (hence the recommendation to blow dry first) and when removed can be dropped into a cup of water that after the removal process can be dumped down the sink and thrown away.  Even though the nits should be dead, they will still stick to the hair shafts because they are “glued” there, and until that hair falls out you will still see the nits there;  as a parent, you will be much less paranoid about a re-infestation (trust me … I know!) if you don’t see the nits still there.

Then comes treating everything else in the home.   Lice are easy to see on nonporous surfaces that aren’t any kind of fabric, but because they’re so skinny, they’re able to crawl in between the weave and under fabric surfaces.  Nonporous surfaces can therefore be just wiped down with alcohol, but all fabric surfaces need to be washed in hot water if they can be launderable (bed linens, clothes, hats, hair accessories, carseat covers, stuffed animals), and if they aren’t machine launderable, they need to be quarantined in a sealed container for 2-3 weeks (if eggs are laid they may take up to 1-2 weeks to hatch and then the newly hatched lice may still live for 2-3 days without any blood supply before dying).  Sometimes it’s easier to replace hair accessories than wash or quarantine them, but do not start using the newly laundered/new items until after the above treatment.  Don’t forget about sofa pillows or sofa throws and vacuuming!

With fastidious management, this hopefully will get rid of this infestation.  Lice don’t jump but they can crawl pretty fast, and they can live up to 2-3 days without a blood supply.  Therefore, review with your kids not putting their heads next to their friends’ heads for selfies, not using their friends’ hair accessories/brushes or wearing head garments such as hats or helmets/sports gear, and not laying on their friends’ bedding if there are problems with reinfestation.