From the Doctor: Lice in your life

By Elizabeth Lee, M.D.

The school year is upon us. Time to see old friends and meet new ones. New teachers, new rules, and new bugs? Or is that old bugs?

Probably the most dreaded of the school-acquired infection is lice. Just the mention of it makes people wince and scratch. It is likely that more elementary school children are affected by head lice more than any other communicable disease, other than the common cold.

Usually topical insecticides such as permethrin, pyrethin and malathion have been used to treat lice. But lice are becoming more resistant to these treatments.

Here is the protocol we use at PAMF for lice.

1. Apply Cetaphil^© body cleanser (not face cleanser) thoroughly. Wait two minutes.


2. Comb out all Cetaphil possible, first with coarse detangler comb, then with a fine comb. You may then finish combing with a nit removal comb (the LiceMeister comb is best). This part is optional, and only necessary if your child's school has a "no nits" policy. Otherwise, it adds a lot more work, and does not increase the cure rate.


3. Dry the hair with a handheld hair dryer.


4. After waiting eight hours or more, shampoo with your regular shampoo.
   Repeat this weekly, up to three treatments, or until no more nits or lice are found. Nits more than one-half inch from the scalp are empty egg cases and are not contagious.


5. Bedmates should be treated as well.


6. If you want to remove nits, wrap the hair in a towel soaked in white vinegar for 30 to 60 minutes to loosen nits. Then comb the hair with a nit comb.


7. To eliminate transmission in the home, wash all potentially contaminated items (bedding, clothes worn in the last three days, hats, towels, stuffed animals, etc.) in hot water (less than 120 degrees)> Alternately, dry clean the items or store them in sealed plastic bags for two weeks (the longest period nits can survive without contact to a person). Immerse combs and brushes in boiling water or soak in isopropyl (rubbing) alcohol.

Note: this is a suggested treatment and we cannot guarantee results. If there is a recurring rash, reappearance of nits or lice, or sores on the scalp or skin, see your doctor.

Check out PAMF's Word from the Doctor for more health information.