By Dr. John Chambers 

Question: My child still has lice after using the medicated cream rinse! How can I get rid of her lice for good?

“Nit Picking” is a phrase many of us use, but only those who have had lice or children with lice truly understand what it means to stand over someone’s head and strand by strand remove those pesky eggs! For those parents who have not struggled with achieving a “nit free” child here is what the rest of us have learned the hard way. A nit is the egg form of the louse. Once hatched the female louse will be an adult in a little over a week and only lives for less than a month but can produce up to 10 eggs a day her last 2-3 weeks of life!

Treating lice is not easy. Actually treating the live louse that has hatched is easy. There are multiple options for treatments including either chemical agents called pediculicides that kill on contact or the less toxic but sometimes more greasy ways of suffocating the hatched louse like mayonnaise or petroleum jelly. The problem is none of these are effective at killing the unhatched louse (nit). Many chemicals recommend a retreatment in 7 days hopefully killing all the newly hatched adolescent lice before they able to reproduce. If you follow the directions for the over the counter chemicals and still see live lice immediately after use, it might be due to medication resistant lice. Call your doctor to try using a prescription medication. Since no treatment is 100% after using a chemical it is best to remove the nits by hand after the initial chemical treatment.

Nit picking is very time consuming but important. There are places that will do this for you, but if you have the right tools and patience in you and your child, you can be successful at home. Use a metal nit comb and if you can find one, get one with spiral teeth. Using multiple hair clips to hold the hair out of your way and using a utensil like a chopstick to go methodically over every part of the scalp helps not to miss a nit. Using a strand by strand technique will help you be more effective but doing a “head check” every 3 days will help cut down on reinfestations. Exhaustive cleaning measures of the home and school are not beneficial.

Reinfestations are very likely, but if you repeat your pediculicide after 7 days and do your due diligence with nit picking it is very likely YOUR child will be louse-free. Everyone in the house should go through the same process. Once your family is clear of all lice and nits, it possible they will get lice again in the following weeks. This is not due to your lack of technique or medication resistance but usually your child’s friend. Start by encouraging your child when they are at school or playing with friends to minimize putting her head near any item that might have lice like pillows, caps, brushes, her friend’s head, or the comfy reading couch at school. There are no creams or oils to put on your child’s head that help protect her from reinfestation. School is not as likely a source as sleep overs and friend’s houses. Talk to your child and teacher or even school nurse in getting all the parents in your child’s class working together to eradicate lice from the classroom. Have them work on minimizing the events where lice can spread from head to head. Since lice do not carry disease and cause no major health problem and missing school can put your child behind, your child can return to school no matter how close or far away you are to a “nit free” head. The American Academy of Pediatrics does not encourage a “nit free” policy at schools. For more information check out our website.