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Avoid a louse-y experience.

One in four children will experience the itch of head lice. These tiny insects infest the head and live on the scalp. They can spread from person to person through shared hairbrushes, combs, hats, clothing, bedding, or by direct contact.

The only way to prevent lice is by avoiding physical contact with people who are infected and not sharing things that touch the head. Unfortunately, lice often spread quickly through a group of children or a school, and no one is safe.

Does Your Child Have Head Lice?

Head lice are tiny and difficult to see. When they feed by sucking blood from the scalp, they cause an itchy rash. The rash is often easier to notice than the lice themselves. The adults lay eggs on the hair shafts.

Lice eggs -- also called nits -- appear white, grayish-white, or yellowish. Look for them at the nape of the neck and over the ears. The adults attach the eggs near the base of the hair, where it joins the scalp. Use a special fine-toothed nit comb to check for active lice or eggs.

If someone in your family or a visitor has lice, take some precautions to prevent lice from spreading or returning. Soak combs and brushes in hot water for at least one hour. Wash clothing and bed linens in very hot water or dry clean them.

You don't have to fumigate your house to get rid of lice -- adult head lice can't survive for more than 48 hours apart from a human host. If your child has items that can't be washed but might be infested with head lice, such as a stuffed animal, place them in a sealed plastic bag for three weeks.

First line of attack

Only treat people who have active adult lice or visible eggs. Medications cannot prevent you from getting lice and can be dangerous if misused.

Once a louse problem is established, you can choose from several effective over-the-counter remedies. The best treatment for children age 2 and older is permethrin 1 percent cream rinse (brand name: Nix). It's even more effective than prescription treatments, curing 99 percent of cases after a single application.

Nix continues to work for up to two weeks after the first application. It also kills lice eggs. A second treatment seven days later may increase its effectiveness. The most commonly reported side effects of permethrin products include mild itching and stinging of the scalp. In rare cases, Nix may cause difficulty breathing or an asthma attack in susceptible people.

Another over-the-counter medicine is pyrethrin (Rid) shampoo. It's effective for 93 percent of people after one application. Possible side effects include mild scalp irritation. People with ragweed allergies should check with a doctor before trying Rid because it may lead to allergy symptoms. Rid does not have long lasting activity.

Make sure to keep lice treatment products from getting in your eyes or contacting mucous membranes such as the mouth or nose because this may lead to irritation. If one of these products does contact the eyes or mucous membranes, rinse well with plain water. Lice treatment products should never be swallowed.

Make sure that hair is completely dry before using Nix or Rid. Don't use a cream rinse or conditioning shampoo before or for two weeks after using these products. They coat the hairs and can protect the lice.


After using a lice treatment product, use a nit comb to remove nits and dead lice. Metal nit combs are more effective than plastic ones. Make a solution of equal parts of vinegar and water. Dip the comb in the solution, and comb the hair. The vinegar will help dissolve the glue that holds the nit to the hair. Clear Lice Egg Removing Comb and Enzyme Gel System can also make it easier to remove lice eggs from hair.

Naturally Nit-Free

Some people recommend an overnight treatment to suffocate the lice. Smear petroleum jelly, olive oil, or mayonnaise on the hair, then cover it with a shower cap. The effectiveness of this treatment method is unproven.

Anise is an herb that has been used to treat head lice. You apply an anise oil extract to the surface of the scalp. Medical research has not proven anise's effectiveness in treating head lice, and it hasn't been directly compared to over-the-counter or prescription medicines. Anise may make skin more sensitive to sunlight. Less often, it causes allergic skin reactions. Don't swallow the anise extract--it can cause vomiting, fluid in the lungs, and seizures.

Rx Extermination

If over-the-counter or alternative remedies don't get rid of the lice, if you are pregnant or breastfeeding, or if your child is under the age of 2, see your doctor. Permethrin (Elimite) is a prescription topical cream that can be used to treat head lice by altering their nervous system. Other prescription creams to treat head lice include gamma benzene hexachloride (Lindane), malathion (Ovide), and crotamiton (Eurax). These treatments are all powerful insecticides and may be toxic if not used as recommended.

In the rare cases when prescription creams don't work, your doctor may prescribe ivermectin (Stromectol). It's a new tablet that is taken in a single dose to treat lice by damaging the insect's nervous system. It has not been studied in children weighing less than 35 pounds.

Many schools have a policy of sending children with lice home until they're lice-free. They can usually return to school and sports after treatment if there are no visible lice or nits. But keep combing the hair with a nit comb daily until you find no lice for two weeks. Be sure to avoid contact with people and objects that still carry lice to prevent another nit-picking adventure!

Holly Vance, Pharm. D., is a clinical pharmacy specialist. She works for, the leading online pharmacy. Readers can find more answers to health questions online at at
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Author:Vance, Holly
Publication:Pediatrics for Parents
Article Type:Brief Article
Geographic Code:1USA
Date:Sep 1, 2001
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