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Lice: Treatment and Prevention

As the time nears for kids to head back to school parents are understandably excited. One aspect of being in school not to be excited about? Head lice. Head lice are tiny bugs that live in the hair and bite the scalp. They spread easily with close head-to-head contact. Many parents worry that they have done something wrong if their children get lice, but anyone can get lice and it does not reflect hygiene or cleanliness. Lice attach eggs (nits) to the hair. Nits can be recognized because they are white, and unlike dandruff or other fuzz, they cannot easily be shaken off. Symptoms of lice include scalp itching and sometimes a rash at the back of the neck.

Lice can be difficult to get rid of because they pass easily within a house. Contact your pediatrician right away if you are unsure if lice are present or to discuss a treatment plan. Usually an over the counter lice shampoo is the first step to getting rid of lice. Everyone in the house with lice should be treated at the same time. Shampoo alone, however, usually does not rid the household of lice. Nit removal is a key step that is time consuming an often difficult depending on the age of the child. Most shampoos come with a “nit comb” which a fine-toothed comb is used to comb the nits out of hair. This should be done daily until the hair is nit free.

The final step to get rid of lice is cleaning the house. Disinfect any brushes, combs, by soaking them in hot water (at least 130oF) for 5- 10 minutes. Adult lice cannot live for more than 48 hours without access to a human host, however nits can survive up to a week so you need to vacuum rugs, change out your comb or brush, and wash all bedding in hot water and dry them on the hottest setting. If there is a stuffed animal or favorite item that cannot be washed (or discarded!), you can seal it in a plastic bag for two weeks.

Paige Perriello, MD FAAP
Pediatric Associates of Charlottesville

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