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Ask CityLab: How Do I Get Rid of Head Lice?

They multiply like bunnies. The sooner you spot them, the better.

Uh-oh. (wckiw/Shutterstock.com)

Dear CityLab: My son brought lice home from summer camp. What should we do now?

First, try not to panic. Those bugs scampering around your kid’s scalp are super common. The CDC estimates that as many as 12 million infestations occur each year in kids younger than 11.

Despite the myth that infestations are caused by sharing hairbrushes, hats, or pillows with someone who has lice, most cases are the result of direct hair-to-hair contact. Unfortunately for you, when a kid’s got them, 80 percent of moms and ten percent of dads will contract them, too.

Your kid is definitely not patient zero—10,000 year-old louse egg fossils have even been discovered on Egyptian mummies. That doesn’t make them welcome visitors, though.

How do I get rid of them?  

Detecting lice is really difficult. It’s easy to mistake early-stage lice for dandruff or dirt. (Wishful thinking?) Even adult lice are hard to spot because they’re tiny, and scurry away from light before being spotted and squished.

Adult nits are a still a fraction of the size of
a penny. (CDC)

By the time you can spot the crawling bugs, “the nits have been there for 6-10 weeks,” says Melissa Black, the owner of Honeycombers, a lice treatment salon in Palo Alto, California.

A female louse can inseminate herself and lay up to five eggs per day for a month. The eggs hatch about a week later, and can then lay their own eggs within 14 days. Left unchecked for 30 days, a scalp is home to a veritable kingdom of vermin.

You can’t conquer them with at-home remedies such olive oil or mayonnaise or by dunking a child’s head in glycerin. Glopping on the Hellman’s will do little but leave your kid with a greasy head that smells vaguely like a deli.

The American Association of Pediatrics recommends over-the-counter medications containing one percent permethrin or pyrethrins as the first course of treatment.

Do we have to be shut-ins until they’re gone?

Much like a bed bug infestation, the mere mention of lice can make people start to squirm and itch. That reaction is largely a result of the stigma about lice signifying uncleanliness. Who hasn’t seen the odd cockroach scuttling around the sink, or an occasional mouse dropping in a cranny of an old apartment? But lice? That seems way more intimate.

Black sees a lot of sheepish clients. “I’ve had people who want to come in the back door and they sit in the chair and sob with shame,” says Black. “A case of lice is not about being dirty,” she says. “And yet people still don’t want the information getting out.”

For years schools often perpetuated a culture of shame around the bugs by mandating random lice screenings and shipping the kids with nits back home. This no-nit policy excluded many kids from educational days, and the policy didn’t translate to a decrease in lice cases. So in 2010, The American Academy of Pediatrics (AAP) began advising schools to cease routine lice checks and end the policy of sending kids home from school. And in May 2015, the AAP reiterated its stance with guidelines that read:

Head lice are not a health hazard or a sign of poor hygiene and, in contrast to body lice, are not responsible for the spread of any disease. No healthy child should be excluded from or miss school because of head lice, and no-nit policies for return to school should be abandoned.

The AAP’s stance is supported by the National Association of School Nurses and the CDC.

Still, Black recommends that kids (or parents) with lice should avoid crowded places (such as movie theaters, playdates, and school) until all the bugs are gone. She encourages parents to tell the school so other families can check their own kids.

How do we prevent them from coming back?

The bad news: You can’t. But routine at-home screenings can increase the likelihood of spotting a new infestation as early as possible.

It’s a misconception that an itchy head is the only catalyst for a head check. Only people who are allergic to the louse saliva will have a reaction, so you could miss infestations if you only check when your kid starts scratching. That’s why Deborah Z. Altschuler, president and co-founder of the National Pediculosis Association, a non-profit lice health and education agency, recommends routine home combing and continued and regular school screenings—itch or no itch.

Black tells all her clients to start a Sunday evening routine that includes 30 minutes of meticulous hair combing with a metal fine-toothed comb. At the end of the very, very itchy day, “prevention is key,” she says.

Top image: wckiw/Shutterstock.com.

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