Want to try a magic trick? One, two, three… lice. You’re rubbing your scalp right now, aren’t you? Don’t worry. It’s all in your head. Well, they’re probably not actually on your head, but just the idea of being in contact with these parasites has likely made you scratch. It’s understandable. An occurrence of lice is never great news for you or your child. But it happens. And some people might feel like it happens to their kid over and over again. So if you’re asking yourself why your kid keeps getting lice, take a breath and know there are solutions. When you’re dealing with the condition, which can be quite common in childhood, according to the Centers for Disease Control and Prevention (CDC), it’s a good idea to ring your pediatrician to discuss treatment options. If your child attends school, you’ll also need to let teachers and caregivers know.
And then forget feeling embarrassed (remember, this happens!) and try to resist angrily playing the blame game. Instead, check out this expert advice to help you navigate through this rough patch. And remember, this has nothing to do with your kid’s hygiene.
First, A Few Facts About Lice
They suck, literally. The parasites live on human blood, and lay eggs that can cling to body hairs. The CDC shared the three stages of life for a louse: Egg, nymph and adult, all of which can take up residence on a person’s head and cause itching and discomfort. They’re persistent travelers, but can’t leap. Instead, they are good at crawling over fabrics (from pillowcases to hats), hairbrush bristles, and hair strands, all of which could potentially serve to transfer the insects from person to person, shared the CDC.
Why Does My Kid Keep Getting Lice?
You might not necessarily be experiencing multiple cases of lice, but more so the consequences of an ineffective initial treatment, Krista Lauer, national medical director with Lice Clinics of America, tells Romper. “In other words, lack of elimination of all lice and their eggs perpetuates the initial infestation,” Lauer says. Treating lice correctly and effectively the first time around shrinks your chances of finding them again. “Most head lice treatments can eliminate hatched lice — nymphs and mature adults — but, they do not kill the eggs. The eggs are removed by combing through the hair with a louse comb.” And we’re not talking about a quick brush-through; even though you may feel squeamish, you have to try and sort through every hair on the head. “A louse cements each egg to a single hair shaft. They are firmly secured and therefore difficult to remove. If even a couple of viable eggs are missed, these will develop, hatch, and reinitiate the cycle of infestation.”
Less likely, says Lauer, is to repeatedly become infested from a new exposure after an effective treatment. Though, it can happen.
How Can I Treat Lice So They Don’t Come Back?
You can first consult with your pediatrician and health care providers to help wade through common lice treatment options on the market. Some, Lauer points out, range from ineffective to potentially dangerous. You can get a prescription, or buy an over-the-counter remedy, shared the U.S. Food & Drug Administration (FDA).
There are several over-the-counter head lice treatments available. Ones that are FDA approved include permethrin lotion and pyrethrins, says Dr. Karan Lal, DO, marketing and communications committee member, Society for Pediatric Dermatology. “These are over-the-counter and typically only kill live lice and not eggs/nits.”
Now this is where it’s helpful to really understand the lifecycle of a louse, as, after treatment, you may kill off most mature, walking insects, but still see some eggs clinging to hairs. Nits, reported the CDC, take approximately seven days to open up. “Treatment is often required seven to 10 days after initial treatment to kill living lice that hatch after the first application,” says Lal, who is affiliated with Umass Medical School department of dermatology. “Because it is over-the-counter, resistance has been reported to these agents.”
This prompts introduction to the idea of super lice. In brief, there’s been discussion of lice over the years becoming more resistant to certain ingredients. But some well-known brands that offer topical treatments, says Lauer, have reworked their formulations.
Lal says that the prescription agents that are FDA-approved include ivermectin lotion, which does not kill eggs, malathion lotion that kills live lice and eggs, spinosad suspension that also kills live lice and eggs, and lastly Benzyl alcohol — which kills only live lice. “All of these agents are approved at certain ages, so you have to make sure you talk to your doctor before using any of them.” The CDC shared details of these treatments, noting Lindane shampoo is not approved by the AAP. And Lal tells Romper, “Typically we avoid malathion because it is flammable, so one must be careful about staying away from heaters, curling irons, fires, hair dryers.”
One treatment you may have heard of is Sklice. The lotion, containing ivermectin, was previously a prescription, but late last year, the FDA green-lit a nonprescription formula for those past 6 months old.
And if you’re dealing with what you perceive to be repeat occurrences, it’s important, again, to understand that eggs can open up after your initial treatment. Lauer says, “to address the inability of most head lice treatments — both over-the-counter and prescription — to kill the eggs, the majority require a second treatment in 10 days. The timing of the second treatment must be precise. A louse that hatches after the initial treatment requires 10 days to reach maturity before it can lay its own eggs. Treating too early, means all eggs may not have hatched. Too late and some of the hatched lice will have matured and started to lay eggs of their own. This is one of the reasons head lice infestations are so difficult to manage.” So whatever treatment you’re looking into, read the directions carefully and make sure you’re willing and able to follow them precisely.
Lauer, who is with Lice Clinics of America, says the most effective and safe treatment is “precision-controlled heated-air. The AirAllé medical device, an FDA-cleared, precision-controlled heated-air device found in Lice Clinics of America head lice treatment clinics, eliminates hatched lice and their eggs. The mode of action is dehydration and desiccation. A single 30-minute treatment is over 99% effective.”
If you don’t want to try medication, says Lal, “Things I recommend are using a lice comb to comb the hair from a wet scalp daily.”
And, as if personal treatments weren’t tedious enough to accomplish, there’s laundry to be done. The CDC shared that clothes and fabrics potentially in contact with the individuals can be washed in hot water, and tossed in the dryer, as the bugs and eggs can be zapped at 128.3 degrees Fahrenheit or more. (You don’t have to wash and dry everything in your house. Lice can’t live very long without human contact.)
Is There Any Way To Prevent Lice?
The American Academy of Pediatrics (AAP) shared the most likely way of transmission is direct contact (so think more, kids sitting side by side with their heads together, and less about kids sharing their hairbrushes — though both scenarios should probably be avoided if you’re dealing with lice).
There are natural remedies that may help. But experts may disagree in their effectiveness in actually treating lice, and say evidence may be anecdotal. “In reality, the best method of prevention is making sure kids don’t share combs, hats, or other head-to-head contact,” says Lal.
Lauer tells Romper that when it comes to prevention, “there are no products available that can truly prevent a head lice infestation. Certain products may repel lice, which may reduce the chance of an infestation. These products generally contain essential oils.” Lauer notes taking care when using essential oils. Talk to your doctors about usage, dosage, and potential effects that might arise with using oils, or any treatment ingredients.
And after a lice diagnosis, Lal says, “I would also make sure all family members get evaluated for lice at baseline and seven to 10 days later.”
Lauer says that education about lice is key. “Head lice are transmitted through direct head-to-head contact. They do not jump, fly, or swim. They do not live on inanimate objects. One of the best ways to prevent recurrent infestations is to share information with the people with whom you are in close contact.” And no shaming, please. “By eliminating the inaccurate and harmful social stigma associated with head lice, we can normalize the experience and manage spread within our community more effectively and appropriately.”
Dr. Karan Lal, DO, marketing & communications committee member, Society for Pediatric Dermatology