Get the Bugs Out of Lice Treatment

July 18, 2016 Wilfredo Alejo, MD

lice-treatmentFor parents of school-age children, it sounds like the plot of a horror movie: Super lice, bugs that can be resistant to normal treatment, are on the rise. Cases of super lice have been reported in 25 states as of early 2016. In those states, people with super lice have had to use prescription medication to eradicate the pests, instead of typical over-the-counter treatments that use pyrethrin or permethrin. "Whether your child has super lice or the regular kind, successfully getting rid of the bugs requires certain steps," says Wilfredo Alejo, MD, a board-certified pediatrician at St. Jude Heritage Medical Group. "If people have a persistent problem with lice, it could be that they aren't following those necessary steps." Here are some of the most common mistakes people make when dealing with lice:

1. Not following the treatment directions. "This is a crucial misstep," Dr. Alejo says. "Lice require treatment, and if the treatment is not followed exactly, the lice will stick around. For instance, if a lice treatment calls for reapplication after a certain number of days, don't skip it. Reapplication is a way to catch lice that may have been missed the first go-round--and that may have laid eggs since then." Follow the treatment instructions to the letter, including the length of time the product should be left in the hair, how to rinse it out, shampooing guidelines, etc. If the lice aren't going away after a full course of treatment, you may have a resistant strain or the over-the-counter treatment wasn't the right fix for your child--in that case, contact your doctor to see if you need prescription-strength medication.

2. Not using the nit comb. It's a dreaded task, but somebody's got to do it. "And you can't just quickly brush through the child's hair or do it only once or twice. Going through the hair literally with a fine-toothed comb will help you make sure treatments have removed lice and nits, and it's a good way to make sure no nits or bugs crop up in the days after the medication has been applied," Dr. Alejo says. "It can seem like a tedious process, especially with long hair, but you have to be methodical to make sure you have thoroughly examined the scalp, behind the ears and the back of the neck. Rushing through the process means you're more likely to miss something." And don't make it harder on yourself by combing through dry hair--it's an easier task when the hair is slick with conditioner or olive oil.

3. Allowing kids to share hairbrushes, hats and other personal items. "Your daughter may not mind loaning her best friend a headband or scarf, but you should. Sharing these kinds of things is an easy way for lice to spread," Dr. Alejo says.

4. Not checking other family members for lice. "When it comes to lice, there may be nothing more frustrating for a parent than to finally get rid of lice from one child's hair, only to have the bugs pop up on his or her sibling because you didn't check for lice," Dr. Alejo says. "Examine everyone's scalps much like you do with the nit comb, making sure to check for white nit eggs as well as the bugs themselves. You'll want to check for about a week to make sure the family members stay lice free. It's usually OK to not use treatment products on other members of the household unless they have lice too."

5. Not cleaning up. While your first impulse may be to fumigate the house when lice is discovered, there's no need to go that far. However, some people don't go far enough--they don't wash bedding, or the clothes the child wore in the couple of days before the lice appeared; they don't wash the clothing and bedding in hot water; they don't vacuum surfaces such as car seats or couch cushions; or they don't disinfect hair tools in very hot water for five to 10 minutes. "Lice live only a couple of days maximum off a person's scalp," Dr. Alejo says. "Cleaning these essentials will help prevent lice from returning." 

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.



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