How to identify and treat head lice in children

It’s the note all parents dread receiving from school: your child or someone in their class has a confirmed case of head lice. With kids in close quarters at school, it’s not just viruses like the common cold that are being shared — it’s head lice, too. For many parents a case of head lice is much scarier than a virus. But don’t panic. Lice are annoying, but they are harmless and do not spread disease.

Lice are very common is school age kids, and occur most frequently in children between 3 and 12 years of age. They are tiny, wingless insects that live among human hairs and feed on small amounts of blood drawn from the scalp. You may have heard reports of “super lice,” lice that are becoming resistant to ingredients in some common shampoos used to treat them. The good news is, we haven’t seen cases like this much here in our area. But super lice or not, lice can be tricky to get rid of.

How to know if your child has lice

Lice are about the size of a sesame seed and can be seen by the naked eye. Their tiny tan-colored eggs, called nits, are found firmly attached to the hair shaft within a few inches of the scalp, hatching 1 to 2 weeks after they are laid. It is much more common to see nits in a child’s hair than live lice. The live adult can only survive up to two days off of the scalp, and it’s more common for people to contract lice through head-to-head contact than indirectly.

An itchy scalp is the hallmark symptom of a case of head lice. However, the itching may not always start immediately and may sometimes be delayed for weeks as a case of head lice develops.

If you suspect a lice infestation in your child or they had contact with another child who is infected, check for lice and nits using a fine-tooth comb on the scalp, behind the ears, and around the nape of the neck. A magnifying glass and bright light may help.

Over-the-counter treatments

If you do find lice or nits, stay calm. For kids, a parent’s strong reaction to their child having lice may be worse than the lice themselves. There are several over-the-counter treatments available that include guidelines to help rid your children and home of lice. Since these treatments are insecticides, be sure to follow the age guidelines and instructions for application closely.

After treatment, it is important to remove the nits from your child’s hair using a fine-tooth comb and repeat the treatment as directed in the package insert. This can help prevent re-infestation and resistance to treatment.

If over-the-counter treatment and removal of nits isn’t effective, talk to your doctor. There are prescription shampoos available.

Preventing head lice

Lice are spread mainly through head-to-head contact; however, sharing personal items like hats or hairbrushes can also pass them along. If your child has lice, check everyone in the household and treat as necessary to avoid repeat infestation. No need to treat Fido, as pets cannot get lice.

Around the house

Remember, lice can only live two days off the scalp, so a cleaning frenzy isn’t necessary. But be sure to:

• Wash all bed linens, towels and clothing in hot water and put them in a hot dryer cycle for at least 20 minutes. Bedding items that cannot be washed should be placed in an airtight bag for two weeks.
• Vacuum carpets and upholstered furniture and soak all hair-care items in rubbing alcohol for one hour followed by a wash in warm soapy water, or throw them away and replace.

If you are overwhelmed by discovering your child has lice or have any questions regarding diagnosis, treatment or prevention, be sure to talk to your pediatrician.

Frank Serrecchia, DO Pediatrician Kenosha Pediatrics

Children’s Wisconsin has more than 20 primary care offices conveniently located throughout the Milwaukee area and southeast Wisconsin. Find a pediatrician near you.