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FAQ

Nit and Lice Frequently Asked Questions

You receive the dreaded call from your child’s school, “Your child has lice. Please come pick her up immediately.” You feel like the world’s worst mom. Doubts go through your mind: maybe you don’t bathe your child often enough; perhaps your need to vacuum the house more often; is your whole house infested now? Should you move? These fears may sound a little over done, but in our society lice has gotten a bad rap. Your child, and perhaps your whole family, will be shunned by the school and the neighbors until you can prove to them that your entire family and house has been sterilized and is now lice-free.

The truth about lice is that it has nothing to do with hygiene, socioeconomic status, or ethnic background. Most importantly it has no health consequences. Here is a brief discussion about lice, how to treat it, and how to get your family accepted back into society again.

WHAT ARE LICE?

Lice (singular – louse) are tiny insects called mites. They are not microscopic – they can be seen with the naked eye. The proper name is pediculosis. Adult lice lay eggs on the hair shafts of the head, about 3 mm from the scalp skin. After one week, the eggs hatch and an immature, mobile louse nymph emerges. This nymph hides in the scalp and after 2 to 3 weeks it matures enough to begin laying eggs. Adult lice can only live 1 or 2 days away from a warm body, and the eggs must be close to the warm scalp in order to hatch. They feed on human blood through tiny bites in the skin.

HOW DO I TELL IF MY CHILD HAS LICE

There are several things to look for:

  • Itchy scalp – this is the most common symptom, although very light infestations (5 or less lice) may not itch.
  • Visible live nymphs or adult lice – this are tiny, clear to white mobile bugs visible on the scalp or hair shafts. They are most often seen in the hair behind the ears and the nape of the neck. Adult lice are quite fast and therefore more difficult to spot.
  • Visible nits – “nits” are tiny white shells that are glued to the hair shaft near to the skin. The nit can either contain a live egg, or can be empty (the egg already hatched). Nits close to the scalp are more likely to contain eggs, and those more than ½ an inch away from scalp are probably empty. Nits are often difficult to distinguish from normal dandruff in the hair shaft. One way to tell is that dandruff will easily slide off the hair with your fingers, whereas nits are glued to the hair shaft and are not easily moved.

HOW DO I TREAT LICE?

Non-medicated treatments – here are several harmless, messy, ineffective home treatments that probably will not eliminate lice.

  • Mayonnaise
  • Petroleum jelly (Vaseline)

The idea is that these work by suffocating the lice and their eggs. Read more about Lice Home Remedies and Why They Don’t work .

  • Pesticide-free Shampoo
    There are several different ways to treat lice, both medical and non-medical. Over the years most lice have become resistant to the commonly used medicated shampoos, we recommend trying a pesticide-free shampoo treatment.
  • Medicated shampoos – We will discuss these in order of least toxic to most toxic. While the first several shampoos are very safe when used as directed and have virtually no chance of side effects, the last two – Lindane and malathion are more potentially toxic. We suggest you try some of the non- medical treatments before resorting to these two strong prescription shampoos.
    • Pyrethrin or pyrethrum (brand names RID, A-200, Clear, Pronto, R & C) – The pyrethrins are a pair of natural organic compounds normally derived from Chrysanthemum cinerariifolium that have potent insecticidal activity. Pyrethrins are neurotoxins that attack the nervous systems of all insects. When present in amounts not fatal to insects, they still appear to have an insect repellent effect. Pyrethrins are gradually replacing organophosphates and organochlorides as the pesticide of first choice. They are non-persistent, being biodegradable, and break down on exposure to light or oxygen. The chemical structure of pyrethrins inspired the production of a variety of synthetic insecticides called pyrethroids such as bifenthrin, permethrin, and cypermethrin.
    • Permethrin 1% (brand name NIX) – this over-the-counter rinse is a synthetic pesticide.
    • Malathion (brand name Ovide) – this pesticide is available by prescription. It is for kids 6 years and older. You may have heard of this pesticide – it is sprayed from aircraft over cities to control certain agricultural insects including fruit flies. This shampoo lotion was previously used in the U.S., then was taken off the market for a while (although it was still used in other countries), and is now recently approved again by the FDA for use in the U.S.
    • Lindane – this is another pesticide available by prescription. It is approved for children of all ages, although should be used with extreme caution in kids under 2 years. It is the most potentially toxic of all the lice shampoos.

WHAT ELSE DO I NEED TO DO TO PREVENT RECURRENCE OR SPREAD OF THE LICE?

  • Examine household and close contacts – check for nits or live lice. Anyone with visible lice should be treated. You do not need to automatically treat everybody that has come into contact with your child.
  • Brushes and combs can be soaked in hot water (more than 128 degrees F) for 10 minutes. Water that is close to boiling is plenty hot enough.
  • Pillow cases, sheets, hats, clothing worn in the past few days, coats and ornamental hair clips and ribbons can be machine washed in the hot cycle then dried on the hot cycle or put in the freezer if they have glue on them or can’t be washed
  • Vacuuming is a good alternative to bagging items.
  • Check your child’s scalp every 2 to 3 days for any new lice or nits. Use a professional steel nit comb. (This is key to elimination and prevention)
  • Lice don’t live in your environment – they live on your head. Spend your time and energy on the head – it’s where they live!

DO I NEED TO BE METICULOUS ABOUT REMOVING ALL THE NITS FROM MY CHILD’S SCALP?

Yes, you do need to try to get all the nits out. This is where the term “nit-picky” comes from – being meticulous about picking out all the nits.

Some schools have a “no nit” policy, stating that your child must be completely free of nits before returning to school. This policy has not been shown to decrease the spread of lice, but some schools remain strict nonetheless.

Read More:

What is the Best Treatment for Lice?

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