Lice

Lice are parasites that live on your head, usually in your hair, eyebrows, or eyelashes or in the pubic area. They are usually passed on by sharing combs, brushes, hats, towels, sleeping bags or bed linens with someone who already has lice.

You may have itching, but you can be infected with them without having any symptoms. Look for small white or yellow-brown specks stuck to your hair. They do not like light, so they can be hard to find. Check the area under the hair (scalp), top of neck (by the hairline) and behind ears. They look like dandruff, but are much more difficult to flick off the hair.

Treatment:

Note: Cleaning should be done right before washing the hair or showering.

A special shampoo or lotion is used to kill the lice and nits (eggs) called a pediculicide. Recommended ones include Nix (permethrin) or Kwellada (lindane). Before using any of these products on children under 6 years old and women who are pregnant, you should check with the doctor or pharmacist. Wear gloves when putting the shampoo or lotion on especially if you are putting it on more than one person.

The directions on the package need to be followed exactly in order for it to work properly.

• Wash all shirts, underwear, sheets and pillowcases that the infected person has come in contact with in the last 14 days. You should wash them in hot water and dry them in the dryer on hot setting. Clothes that are hard to wash may be turned inside out and taken outside and shaken hard. Wet all seams and iron with a hot iron.
• Dry cleaning works well, but can be expensive.
• Soak all combs and brushes in hot water for at least 15 minutes.
• Place all other things that you think might be contaminated, such as stuffed animals and dolls in a tightly closed bag for 2 weeks. This will cause the lice to die.

Vacuum any exposed areas like mattresses, furniture and carpets. You should throw the vacuum bag out when you are done.

One repeat treatment is usually needed in 7 to 10 days.

Important: You need to check your child's head every day for 7 to 10 days to make sure you did not miss any nits.

Home Treatment:

Taking the nits off the hair can take a long time. Here is a way to make it easier to make sure you get them all:

• Rinse hair in warm vinegar to loosen the nits.
• Divide the hair in 4 sections.
• Start with 1 section of hair and lift up a small amount and comb from the head in a downward direction. Make sure the teeth of the comb reach the head (scalp)
• When you get some nits, wipe them off the comb with a tissue and put them in a bag that you can close.
• To keep the hair that you have already done from getting reinfected, you may need to pin it up.
• When you have removed all the nits you should rinse the hair with warm water.

If nits are in the eyebrows or eyelashes apply petroleum jelly (Vaseline) very carefully. Leave it on overnight. Wash off in the morning.

Does everyone in the family need to be treated?

Everyone should have their head checked for lice and nits, but only need to be treated if some are found.

Return to the Emergency Department IF:

• After using one of the lotions and/or shampoos to treat lice you get a new or different rash.
• Anyone drinks any of the shampoo or lotion. It is a very toxic drug (especially for children)
• You have any trouble breathing or tightness in your throat.