Super Lice

By Dr. Michelle Myer, DHEC Child Health Nurse Consultant

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Recent news stories reported on the emergence of “super lice” in about half of the United States including South Carolina.  Scientists studying these insects found that large numbers of them have become resistant to some over-the-counter lice treatments.

Quite a few studies in the past decade have shown more and more resistance to over-the-counter head lice medicines, also called pediculicides.

The good news is head lice do not spread disease, and there are several prescription drugs that completely kill lice in one to two treatments.

How Can I Avoid Head Lice?

Head lice are spread from person to person, almost always through direct head-to-head contact. Preschool and elementary-age children, ages 3-10, and their families are infested most often. Girls tend to get lice more often than boys.

Lice can also be spread by contact with clothing or other personal items that were used by an infested person.

Children should avoid sharing hoodies and hats, scarves, coats, sports uniforms, barrettes or hair ribbons, combs and brushes, headphones or towels.  Lice or eggs could be spread from one person to another through these objects.

Companies sell products that claim to keep children from getting lice. Right now, there are no good studies showing whether or not these products work the way they are advertised. It is important to know that these might not provide complete protection, and you will need to continue to check your children for lice.

What Should I Do If My Child Gets Lice?

First of all, don’t panic!  Having head lice is very common, and does not mean that a person or family is not clean. There is also a very good chance that your child has not caught a case of “super lice.”

If you think your child has head lice:

  • Check the scalp, behind the ears, and near the neckline at the back of the neck.
  • Look for tiny moving insects (these can be very hard to see) or for tiny bulb-shaped eggs that appear to be glued to the hair.
  • If you are not sure, ask your health care provider, including your school nurse, to check your child’s scalp.
  • It is easiest to check when the hair is damp.
  • You can use a lice comb to check for crawling bugs and their eggs.

Your child may have been sent home from school or child care with lice.  If so, he or she will need to be treated before returning to school.  Some school districts in South Carolina require children to be “nit free” before they can return to school after a lice treatment.  Others just require that there be no live crawling lice on the child’s scalp.  Your school nurse or child care provider will tell you what the rules are if your child has to be treated for lice.

How Should I Treat Lice?

Most lice experts recommend that parents first try using an over-the-counter lice treatment. Common examples are Nix, Rid, and A100.  Follow the directions closely, especially how long to keep the medicine on your child’s head and how long before you should wash the child’s scalp again.  Some products keep killing lice even after the product has been rinsed off the head.

Check or comb your child’s head each day after the lice treatment.  It may take seven to 10 days for all of the bugs to die after the first shampoo or creme rinse.  If your child still has lice a week later, you can try the same treatment again, or call your health care provider about a prescription treatment.

Examples of prescription lice treatments include Elimite, Spinosad, Ulesfia, Ovide, and others.  Your health care provider will take into account your child’s age and allergies when making a decision on a prescription lice treatment.

Do Home Remedies Work on Lice?

Many people have favorite home remedies for lice.  Some people try to smother lice with shortening, cooking oils, or mayonnaise.  Some people use vinegar rinses.  These may work for your family; unfortunately, there are no studies that show that these completely get rid of all the lice a child has.  There are also no good studies that show whether essential oils, electric lice combs, or herbal remedies work to kill lice well enough for your child to return to school.  Check with your child’s school or child care to see when he or she can return if you use one of these remedies.

Kerosene and gasoline should never be used to treat head lice.

How Can I Keep Lice from Spreading in My Family?

When you find lice on your child’s head, they have probably been there for at least 30 days.  To help keep lice from spreading to the rest of the family:

  • Wash the infested person’s bed linens in hot water and dry in a hot dryer for at least 20 minutes.
  • Wash any clothes that were worn during the week before the lice were found.
  • Dry-clean any coats, jackets, favorite toys, throw pillows or other objects that might have touched your child’s head.
  • If something cannot be dry-cleaned, put it into a plastic bag and store it away from the child’s belongings for two weeks. This prevents any living lice or any newly hatching lice from surviving.
  • Check the heads of your other children or any other child who may have shared a bed or other sleeping space with the child who has lice.

For more information, please visit the Centers for Disease Control and Prevention’s (CDC) website.

Also visit DHEC’s website for school and child care exclusion lists.

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