Don’t Worry If Your Child Has Lice
If you hear that your child (or one of his friends) has lice, your first reaction may be a mixture of disgust, panic and a desire to disinfect everything in the house. This would be unnecessary, since the CDC admits that they do not recommend sending children with lice home from school. Head lice can be a nuisance, but they do not pose an immediate threat to anyone’s health and do not spread easily.
Head lice are not dangerous
Head lice are small insects that live in hair and feed on the blood of the scalp. Disgusting, of course. They are perfectly adapted to life on our heads: their small legs cling to strands of hair. When they lay eggs, they glue them to individual hairs, right next to the scalp.
However, that’s all they do. They do not transmit disease or cause serious health problems. Their distant relatives, body lice , also exist, but they are insects that live on clothing and can only become a problem if you don’t change your clothes for weeks. On the other hand, having head lice does not mean you are living in filth. Head lice can survive shampooing, so they can end up on any head, no matter how clean it is.
Head lice have to bite your scalp with every meal (again, yuck), and after a few weeks you may become sensitive to their saliva and start to itch. Children are often not diagnosed with head lice until a parent or teacher sees them scratching their head. I asked pediatrician Dr. Cynthia D. DeVore, who wrote the American Academy of Pediatrics’ head lice guidelines in 2015 (there has since been an update in 2022 ), what the worst-case scenario would be for a child with a terrible case of head lice. She said it was possible that with enough scratches, a child could break the skin, which could lead to infection. However, the same can be said about any scratch or cut. She asked me to “emphasize… that lice are a nuisance and not a life-threatening condition.”
A few years ago, difficult-to-treat “super lice” began to appear in the news. A paper in the Journal of Medical Entomology reports that a gene that gives insects resistance to certain insecticides is more widespread than we previously thought. But that’s just a tally of a problem that doctors and entomologists already knew about: Some insects are resistant to some insecticides.
Head lice don’t spread as easily
You won’t have to worry about your pets, stuffed animals or furniture. Head lice live on human heads, that’s all. They die after a day or two without food (human blood, sorry), so you have nothing to fear from a hat that was last worn a week ago or a stray louse that fell on your carpet.
In fact, you are unlikely to get lice from a hat or pillowcase. Transmission this way is possible but rare . Instead, lice move directly from head to head. If two children are engrossed in the same book or iPad game and look at it with their heads touching, lice can spread.
In fact, most back-to-school lice infestations probably don’t occur in schools at all, since children typically don’t rub their heads during class. Devore notes that if you don’t get head lice until your child starts scratching their head, you’ll probably only find cases that are a few weeks old. This means that if they start itching in September, they are more likely to get lice at summer camp.
If you want to spot lice when they first appear, you’ll have to check your baby’s head frequently. Lice can be difficult to see, so this is not an easy job. Although DeVore recommends it, I don’t think I would take the time to check my kids’ hair regularly.
It’s probably wise to avoid sharing hats and other items that come into contact with your hair, but don’t be paranoid about it. For example, if a sports team shares helmets, it is better to wear a helmet rather than risk head injuries for fear of contracting lice. Wiping a hat or helmet with a damp paper towel is usually enough to get rid of stray lice, Devore says. You can also leave the hat in a plastic bag for 72 hours. She does not recommend using insecticidal sprays because the benefits of exposure to the chemicals contained in the spray are largely outweighed.
Getting rid of lice is unpleasant, but possible.
Every year, between six and 12 million children get lice. Adults can get them too. You’ve probably heard about a few cases at your school (some schools notify parents) or perhaps heard some buzz about “super lice” in your state. If you do get lice—on your baby’s head or even yours—don’t give up hope.
First, if lice are found by a teacher or school nurse, they should not take your child out of school for the day. School policies vary, but the American Academy of Pediatrics is adamant that children “should not be restricted from attending school because of lice because head lice have low infectivity in classrooms.” The National Association of School Nurses agrees . Devore says a child with lice should remain in class and parents can treat the child for lice that same evening. The school nurse should then examine the child’s head for lice every day for two weeks. Some schools require children to stay home until treatment is complete and the eggs are gone. DeVore says if your child is going to miss a lot of school and you want to fight this policy, consider contacting the U.S. Department of Education’s Office for Civil Rights because it shouldn’t interfere with their right to an education.
The best treatment for lice is using an insecticidal shampoo, but there are some caveats. First, you can check to see if your child actually has lice before dousing his head with pesticides. Dander and dirt are often mistaken for lice eggs, and even if you find real eggs, they may be from an earlier infestation that cleared up on its own before you noticed. Instead, you’re looking for real, live lice. They are tiny, about the size of a sesame seed, and their eggs are found within a half-inch of the scalp. Use a lice comb ; in a typical infestation there are only about 10 live lice, making them difficult to see. The comb catches nits and lice and removes them from the hair.
Insecticidal shampoos are not perfect, but they are the most reliable treatment.
There are many different types of shampoos that kill lice, but insects, including the previously mentioned “super lice,” may be resistant to some of them.
Devore says it’s a good idea to consult with your pediatrician because he or she can get an idea of what shampoos work best on local lice. They can also offer you strong prescription shampoos. (Here’s a handy chart of the different treatments available.) Prescription drugs cost more, up to $250, according to Devore. Drug prices at drug stores are most often $25, but if they don’t work and you end up trying them several times, they may end up being more expensive.
Besides resistance, there may be other reasons why treatment does not work. The CDC outlines the culprits here : You may not have followed the instructions exactly, you may have conditioned your hair initially, or you may have used a product with two treatments but applied the second treatment too early or too late. It’s worth double-checking that you followed the instructions exactly to avoid having to repeat the procedure again.
If insecticidal shampoos seem too complicated or dangerous, you may be tempted to just put mayonnaise on your baby’s hair and call it a day. The idea of treating with mayonnaise or olive oil is to smother the lice, but there is not enough evidence to say whether these treatments are effective. Take risks if you want, just embrace the uncertainty.
By the way, if your child really wants to shave his head, this is an effective treatment. Although this is not at all necessary. If it’s not their favorite hairstyle, use shampoos and the like.
There is another option: a professional lice removal service. They may use the same treatments you can try at home, but many also use AirAllé , a device that dehydrates lice with air. It’s kind of like a low-temperature, high-speed hair dryer. The manufacturer of AirAllé lists removal services that use their product here . Many others are independent, local businesses that you can find by searching in your area or asking for recommendations. Technology aside, I believe the big appeal of hiring a service is that you don’t have to personally deal with a head full of your child’s mistakes.
If there are a few lice on shared pillowcases or hats, simply wash or dry them. Temperatures above 130°F kill lice. Leaving the items in a plastic bag for a few days will kill the live lice, and if you’re worried eggs might hatch on your hat or hairbrush (unlikely since they require body heat to survive), you can keep them. the bag is closed for two weeks.