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Everything you need to know to treat and prevent lice

Do's, don'ts, and why there's no reason to panic.

Credit: Getty Images / YSach

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Head lice are creepy, crawly, and an aggressive nuisance that has been plaguing humans since the dawn of civilization. We aren’t exaggerating: mummified lice have been found on the scalps and in the combs of ancient Egyptians and Peruvians. Head lice are an equal-opportunity annoyance; if they were good enough for the pharaohs and kings they definitely won’t discriminate against your kid or their friends.

If your kid comes home with head lice, at least take comfort in the fact that they’re in good company. According to the Centers for Disease Control and Prevention, an estimated 6 million to 12 million lice infestations occur in the United States each year. Preschool and elementary-age children—aged three to 10—and their families are infested most often, but there has also been an uptick in infected high schoolers in recent years. No one is immune to the havoc that can be wreaked by the lowly head lice.

Should an infestation hit home for your family, here are tips on how to deal with them and some expert advice on why finding out your kid has them is no reason to panic.

Head lice don’t transmit diseases

Lice look like sesame seeds in your child's hair.
Credit: Getty Images / hirun

Lice look like sesame seeds in your child's hair.

Head lice, unlike body lice—which you are far less likely to contract—do not transmit any diseases. Sure the relentless scratching could cause sores, but the only real threat lice pose is that they are really, really annoying. While dealing with them can be stressful and exasperating the only real disease lice spread is fear and misinformation. “Lice don’t live for days in a carpet at preschool, they aren’t going on jumping from one head to the next and, honestly, they are really easy to treat,” says Pam Skinner, head lice expert, and owner of Picky Pam at the Beach Lice Removal in Huntington Beach, CA, and

Head lice don’t spread that easily

You are more likely to contract a cold, the flu, an ear infection, pink eye, or strep throat than lice. “Lice aren’t like fleas. They can’t jump from host to host and they can’t fly,” says Amesh A. Adalja, MD, Senior Scholar, Johns Hopkins Center for Health Security. Adalja says the most common way lice spread is from head to head contact. If a louse should happen to go rogue and land on, say, a yoga mat or an Elsa costume at school, it would need the kind of acrobatic prowess to stick a perfect 10 to attach to a new person’s head. While it’s recommended that kids not share hats, headbands, and headphones, lice are more often spread through rolling around in contact-play and huddling together to squeeze into group selfies.

You are more likely to contract a cold, the flu, an ear infection, pink eye, or strep throat than lice.

You can put your clippers down

Skip the clippers and give kids a good shampoo instead.
Credit: Getty Images / tcsaba

Skip the clippers and give kids a good shampoo instead.

According to Skinner, while long cascading hair may give head lice a longer “bridge” to get from one head to the other, if your kid does come home with head lice one of the worst things you can do is buzz your child’s hair in an attempt to get ride of them. “We need some hair left for the comb to grip onto if we want to remove the eggs,” she says.

Lice eggs, or “nits”, need to be within a quarter of an inch to the scalp in order to incubate and survive. They are glued to the hair shaft by a cement-like substance and are very hard to remove without a special comb. When a nymph (baby louse) is hatched, it must immediately have the warmth and food source of a human head to survive. Skinner recommends using a good lice-prevention shampoo to deter adults from camping out on the scalp (she recommends Suave Rosemary Mint shampoo), but in order to actually remove the eggs, you need at least a half inch of hair. “Any viable nit is smack up against the scalp and best removed with a special comb. Without hair to grip onto, a lice comb can’t do its job,” she says.

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Without a host, lice are toast

You are very unlikely to see a louse fall off someone’s head, but if you do, they are most-likely ill or dying. Furthermore, a head louse without a strand of hair to grab onto, can barely move around.

Lice can only survive with a human host. Any lice that might be on your couch, bedding, costumes, or Fido will die if they can’t find another human to climb onto within three to four hours, says Adalja. Lice need human blood to survive and they produce an anti-clotting enzyme in their saliva that allows them to feed. While lice can live up to 48 hours without a host, if it doesn’t find one within three hours it loses its ability to make that saliva that is crucial to their survival–so even if they do manage to find their way into your locks, they stand zero chance for survival.

You don't need to spring clean

If you’re like me, any excuse to give your house a deep cleaning is probably a good one, however, it’s just an old myth that you’ll need to sanitize your house and throw out your carpets if you find head lice on your child or yourself. For peace of mind, you can wash and dry your bedding and towels on hot, give your house a good vacuuming, and take a lint roller to couches and cushions, but both Skinner and the entomologists at advise you to chill. “I’d just wash my sheets on hot and throw my comforter in the dryer on hot and call it a day,” says Skinner. “I think people really over estimate the life-span of head lice and their ability to survive.”

Your dog won't spread them

While dogs and cats can get lice, lice have adapted to be species-specific and cannot go from one to the next. Head lice have adapted to live on the scalp of humans exclusively. That means that you can spare kitty a bath and your dog doesn’t need a trip to the groomer. Just focus on ridding your human family of the pest and let the animals alone.

Your kid may be back at school the next day

While some school policies may require a child with lice be sent home, there is growing research to suggest this doesn’t prevent the spread of lice and only contributes to social stigma. According to the CDC, “students diagnosed with live head lice do not need to be sent home early from school; they can go home at the end of the day, be treated, and return to class after appropriate treatment has begun.” Skinner agrees, “For a mom treating at home, there is a 7 to 10 day window to hatching, but if you get your child professionally treated you can feel pretty confident that the lice are gone and they can go back to school.”

A good comb can work wonders

A good lice comb is worth purchasing before any sign of infection.
Credit: Nit Free

A good lice comb is worth purchasing before any sign of infection.

“Combing works,” says Dr. Claire McCarthy, a pediatrician at Harvard-affiliated Boston Children’s Hospital. But, she says, it takes patience and perseverance. She also recommends checking everyone’s head in the family, adults included. “Not only does it get rid of both live lice and eggs, it’s completely nontoxic and without side effects. That can’t be said of any other treatment for head lice, ivermectin included.”

Buying your family a good lice comb before an infestation strikes is an offensive move. Because head lice don’t know that they should take a break for holidays and vacations, it’s recommended that you bring a lice comb on all family trips. “You can pop into a store and find a good conditioner anywhere, but a good lice comb is hard to find. I take one with me on every trip,” says Skinner.

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Lice don't always itch

Itching is an allergic response to louse saliva
Credit: Getty Images / Sophie Walster

Itching is an allergic response to louse saliva.

Itching is an allergic response to louse saliva that only about half of people have. That’s why it sometimes takes four to six weeks for people to even know they have head lice, and your child could go months without knowing they have lice at all. Just keep an eye out for other symptoms—red bumps on the neck, scalp, and ears; and when you comb their hair keep an eye out for tiny white sesame seeds stuck to the hair shaft or something that looks like immovable dandruff. What looks like dandruff could actually be nits.

Super lice are sort of science fiction

They aren’t bigger, stronger, or faster. They aren’t able to leap tall buildings in a single bound. What is happening, Adalja says, is lice are beginning to show a resistance to certain over-the-counter medications. This is, in large part, due to an overuse of permethrin. Unless a specific resistance has been seen in the community, the American Academy of Pediatrics says an over-the-counter medication with 1 percent permethrin should be enough. "Over the counter medications are incredibly effective, if the directions are followed," says Adalja.

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