I would appreciate detailed information on how to treat head lice. My child is in year-round school. Last year, we battled head lice all year long. Over her last break we were able to get it under control. She just started another session and already we've had an outbreak. It has become a serious subject of concern among the parents at my daughter's school. What should we do? What are the latest recommendations? Is there anything that is not toxic that we can use?
Woodstock, New York
As I picked up the chart in my inbox, I glanced down to see what the nurse had written. “Lice.” Just looking at the word made my head itch.
Entering the exam room, I could tell that Mrs. X felt a bit uncomfortable.
“Hello, Mrs. X! How can I help you?”
“I can’t believe it!” she said. “There’s another outbreak of head lice at my kids’ school and this time, my kids have been sent home.”
Just listening to her made my head itch worse.
“Why can’t they do something about it? Now we’re stuck dealing with it, too! What can we do? I don’t want to deal with this ever again!” she cried.
Mrs. X’s feelings, and your feelings, are understandable and more common than you might expect. There are about 12 million cases of lice per year in the United States alone. Each year, many day-care centers, schools, neighborhoods, extended families, and small family units face this problem. You and Mrs. X are not alone.
Historically, the main method for getting rid of lice has been mechanical — physically removing the nits, or “nit-picking,” such as apes do for each other during their daily grooming routine. About 30 years ago, powerful pesticides were introduced as lice treatments. For a time these pesticides made treating lice much easier. Over the last several years, however, the lice have become increasingly resistant to these medicines. This resistance is growing. Now, once again, mechanical nit removal is the cornerstone of lice treatment, although the medicines can still be a real help.
It is important for everyone potentially involved in an outbreak to be treated at the same time. If 99.99% of the lice are killed, but .01% are not, you already have the makings of another outbreak!
Here is a step-by-step guide for using common, over-the-counter medicines to kill the lice, followed by several great natural remedies:
Not all of the following steps are always necessary for an individual child. For stubborn cases, especially during school-wide outbreaks, following all of the steps can actually save a lot of hassle and repeated exposure to pesticides!
Using stronger pesticides can set up a pattern of using more and more powerful pesticides as the lice develop ever-increasing resistance. This pattern has a definite negative long-term impact on the environment. It also exposes children to greater and greater levels of toxins.
Most alternative treatments are untested, but early reports are promising. One method with widespread stories of success is the Vaseline (or mayonnaise) treatment. Cover the infested head liberally in Vaseline. Place a shower cap over the entire head for the night (or an eight-hour period). Then shampoo the Vaseline out of the hair. This treatment is reported to “smother” the lice. The downside of this method is that the Vaseline does not shampoo out of the hair easily — in fact, it usually takes a week or so to get it all out. The upside is that it is not toxic, and from all reports, it seems to work. Washing the hair with dishwashing liquid, which has a degreasing agent in it, may help. I’ve smothered my own hair in mayonnaise (loved the smell), and it came out easily with dishwashing liquid.
To date, the jury is still out about whether or not these alternative treatments are effective. One research scientist has published several articles stating that Vaseline, mayonnaise, and other oil-based treatments cause the lice to go into a dormant state where they are inactive, but not dead. These dormant lice can later “revive” if they are not removed from the hair shaft. It’s important, when trying this method, to brush out any remaining lice to prevent reinfestation after the Vaseline (or mayo) is washed off.
The Packard Children’s Health Services Pediatric Hotline at Stanford is hailing another popular treatment. It uses regular shampoo and three ingredients that can be found at most health-food stores:
Shampoo 3 tbsp olive oil. 1 tsp tea tree oil. 1 tsp rosemary or eucalyptus oil.
Add the oils to a small amount of shampoo and mix well. Work into hair and leave on for half an hour with a tight-fitting shower cap. This mixture has a strong smell. The fumes may burn the eyes, so don’t lean forward. Wash hair two or three times to get the oil out. Repeat the procedure if necessary.
I’m hearing positive reports about this nontoxic treatment, though to my knowledge, no medical studies have been conducted to establish the efficacy or possible side effects of this treatment.
Meanwhile, several other natural compounds are being studied as possible treatments for head lice. Recently, a group of scientists in Argentina published a study looking at treating head lice with the fruit of the “paraiso” tree (Melia azedarach L.). This is a tree that grows easily all over Argentina, also known as “chinaberry tree,” “Indian lilac,” or “white cedar.” They found that both the extract and the oil of this fruit were able to kill adult head lice and some of the nits (Carpinella et al. Journal of the American Academy of Dermatology, 56(2) 2007).
One of our readers suggested using a hot blow-dryer for 15 minutes, morning and evening, in conjunction with thorough nit combing. The heat helps to kill the nits and adult lice, but the combing is essential to the process. This type of treatment should not be combined with the over-the-counter chemical treatments such as Rid and Nix since those chemicals are deactivated by the heat of the blow-dryer. . I’ve had great success combining the blow-dryer with an application of Cetaphil, though.
As a last resort for extra resistant lice, the Red Book 2000 mentions two prescription medications creams — Lindane and Malathion. To me these cures are worse than the disease — both for those being treated and for the environment. In fact, these creams are thought to be so dangerous in our water supply that the state of California banned the use of lindane to treat lice or scabies.
There are also several prescription oral medications currently being looked at as possible treatments. In the May 1999 issue of Infectious Diseases in Children, Septra (trimethoprim-sulfamethoxazole) is mentioned as a possible treatment for lice. The regimen is twice a day for three days with re-treatment after 7 days. There is some controversy as to whether or not it works. According to the article, it works by changing the bacteria in the gut of the louse, preventing the absorbance of vitamins. The lice then produce infertile eggs and die of malabsorption.
Whatever treatment you choose, removing lice from the environment is critical to breaking the cycle.
Cleaning Method No. 1
Cleaning Method No. 2 — The Real Alternative
Going back to school to face another year of lice must be very discouraging. Remember that you are part of a community. Blaming others doesn’t help anything; it is important for everyone to work together. By staying positive, the whole process can actually help bring a school together! I know my own children have fond memories of The Great Lice Adventure — now that it’s over!