WHAT ARE HEAD LICE?

Head lice are tiny insects that live in human hair and feed on human blood.  They are not dangerous and not a public health hazard.  They are simply a real nuisance because they are difficult to get rid of.  They multiply rapidly and lay silvery-colored oval shaped eggs which are known as nits.  These nits glue to the bades of the hair close to the scalp and are very difficult to see and remove.  If you see white flecks in your child's hair that can be easily combed or picked off of the hair shaft, your child DOES NOT have lice.  Dandruff, dirt and other debris are often mistaken for lice.  The best place to look to see if your child has lice is the nape of the neck and behind the ears.

HOW LONG CAN LICE SURVIVE?

Because they need human blood to live, head lice usually do not live more than two days away from the human body.  Nits found more than one centimeter or about 1/2 inch from the scalp are usually not able to live.  If you find white flecks located more than 1/2 inch from the scalp they are either dead nits or something other than lice.

HOW DO I TREAT LICE?

Treatment should be reserved for those who have live lice bugs seen in their hair or have nits.  The recommended treatment is an over the counter medicated shampoo.  We highly recommend using the NIX brand.  First, shampoo the hair with the non-conditioning shampoo and then towel dry the hair.  Apply the NIX, which is a cream rinse, directly to the SCALP.

A few important reminders:

• NIX needs to be applied directly to the scalp.  It is not applied to the hair like normal shampoo.  Picture the hair as a grid with one inch squares.  Aply the NIX to the schalp of the individual square and massage it in.
• Leave the NIX on for ten minutes and then rinse. 
• The residue left on the hair is designed to kill young lice emerging from the nits or eggs not killed with the first aplication.
• Repeat treatment in 7 days and not any sooner
• If live lice or nits are present in 7 or more days, call the office for an office visit to ensure that we are dealing with lice.  If positive, we will prescribe a new treatment to be used 14 days after the original NIX treatment.

WHAT IS THE BEST WAY TO REMOVE NITS?

Nit removal is recommended as the shampoo treatment is not 100% effective.  This can be a difficult and frustrating process, but nit combs do make the process easier.  Lice are easier to find in wet hair.  If using NIX, DO NOT RINSE THE HAIR WITH A VINEGAR RINSE WHICH IS SOMETIMES RECOMMENDED TO MAKE A NIT REMOVAL EASIER.  This will interfere with the residue left over by the NIX product, designed to kill the remaining lice.  You must nit pick everyday for about 5-7 days to ensure that all of the nits are removed as they are very difficult to see, especially in ligt colored hair.  You may find one today that was there yesterday, but was missed.

HOW CAN I KEEP THE LICE AWAY AND KEEP IT FROM RETURNING?

The first thing that should take place once it is determined that someone in the house has lice is to check everyone else in the household.  If others are found to have lice, everyone should be treated on the same day.  Any towels used to dry hair should be washed immediately.  The following cleaning protocols are recommended if the items have come into contact with the head and hair of the person who had lice within the last 24-48 hours prior to treatment.

• Clothing, bedding and toys should be cleaned using hot water (at least 120 degrees Fahrenheit) or placed in clothes dryer set at a high/hot setting for at least 20 minutes.  Dry cleaning is also an option.
• Items that cannot be washed should be sealed in plastic bags for two weeks.
• Floors, furniture, car seats, and upholstery should be vacuumed.  Do not use insecticides.  Going wild and disinfecting the whole house has not proven to be effective.
• Combs and brushes should be disinfected and washed in hot water daily.  Items may be disinfected by soaking in lice shampoo for 4 minutes or by soaking in a 2 % Lysol solution for one hour or boiling for 10 minutes.  You may also throw them out.
• Most importantly, remember children should be told not to share headgear, coats, combs, headbands, ponytail holders, head phones, bats and anything that comes in contact with their hair/head with anybody at school including their best friends.

WHAT HAPPENS IF MY CHILD HAS LICE?

Usually when a child is found to have lice, they have probably had the infestation for at least one month, in some cases longer.  They pose little risk to others therefore, the child may remain in the classroom to avoid embarrassment from fellow students.  Discourage close direct head contact with others.  When a case of head lice is discovered in the classroom, it is most efficient to notify the parents and guardians of the child.  The parents of this child as well of the parents of all of the other children in the classroom need to be checked for lice and treated appropriately.

WHEN CAN MY CHILD RETURN TO SCHOOL?

A child should be allowed to return to school 24 hours after proper treatment.  However, check with your school nurse because different schools follow different guidelines.

Please see the CDC website/link from this site for more information.

This information was created for Reston Town Center Pediatrics using information from the American Academy of Pediatrics and the State of Virginia Department of Health.