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How to cope with head lice

Talk about a head scratcher. Your child comes home with head lice and instantly your own scalp starts crawling with guilt and fear. What do you do?

MomsMiami consulted the experts for the best advice on how to get rid of the pests and keep them from coming back. Three things to know right off the bat:

1. Accept that there is no shame in getting lice, said Shirley Gordon, director of the Head Lice Treatment and Protection Department at Florida Atlantic University's Christine F. Lynn College of Nursing.

"That is a common myth, that it has to do with poor hygiene, poor parenting or a dirty household,'' Gordon said. "But we see it in all socio-economic groups - the children of doctors, the children of lawyers. In fact, head lice prefer healthy people and clean heads.''

2. There may be no obvious symptoms.

"Most people associate itching with head lice, but not everyone itches,'' Gordon said. About half do, she said, because of an allergic reaction to bites.

3. There is no miracle cure.


Until the mid-1980s, a parent's best hope for relief was a box of Rid or


The eggs, called nits, are teardrop-shaped, about the size of a knot in the hair. While dried bits of gel or hairspray may linger in hair, nits are cemented in place. If you pass your fingers over a spot in the hair and it doesn't move, it's likely a nit.

Home treatment involves lice-killing shampoo and manual nit removal using a special comb. After treatment, the hair should be checked every two to three days for nits. Lice eggs take a week or more to hatch, so the hair is often retreated seven to nine days later.

Nix from the drugstore. Rid and most generic products contain pyrethrins, an insecticide derived from chrysanthemums. Nix contains permethrin, a synthetic form of pyrethrins.

The American Academy of Pediatrics recommends treatment with one of these over-the-counter products, and if that doesn't work, consult your pediatrician for a prescription.

But many lice experts, including Lidia Serrano, clinical director of Lice Cleanique, a lice removal service with three South Florida locations, say these products are no longer effective.

"The lice have become resistant because the products are pesticide-based,'' Serrano said.

A crop of organic, chemical-free products have hit the market, offering families a less-toxic means of ridding their homes of the pests. But do they work?

Gordon says she's wary of natural products that don't have FDA approval. She recommends combing out nits - lice eggs - and reserving lice-killing products for live lice, not just nit sightings. In clinical trials, only a portion of nit sightings resulted in live infestations, she said.

At Lice Cleanique, Serrano uses a product called Lice Cure and said the odorless LiceMD also works well.

Katie Shepherd, executive director of Lice Solutions, a nonprofit treatment center in West Palm Beach, said, "The real solution is knowledge - what to look for - and using the right tools. There's no miracle product.''


Shepherd said using the right comb is the real secret.

"It gets about 85 percent of the bugs out of the hair,'' she said. "The more you get out with the comb, the less time you spend picking.''

It's a tedious process, she said, so infamous it's even added some new terminology to the English language: "Where do you think the term 'nit-picking,' comes from?'' Shepherd said. "And a 'lousy night's sleep?' That's because the bugs are more active at night.''

Lice Solutions recommends the Terminator, a $10 metal comb with closely-spaced spiral teeth.


"In South Florida, it's always lice season because it's warm and humid,'' Gordon said. She recommends a weekly head check:

  • Wash your child's hair.
  • Apply conditioner, but do not rinse.
  • Comb through with a nit comb.

Katie Shepherd's book Lice Advice: The Shepherd Method of Strand by Strand Nit Removal, will be published in February. Here are some tidbits:

  • You don't have to bag your kid's toys. "Bugs can live for 24 hours off of the head, but they don't survive off of the head,'' she said.
  • African-American children can get lice. "They are less likely, because their hairs are oval-shaped, while Caucasians are round,'' Shepherd said.
  • Lice do not jump or fly. Most lice are transferred by head-to-head contact, such as through hugging. Less than 5 percent of lice are transferred through the sharing of hats, hairbrushes and headphones.
  • Don't be embarrassed to tell. Notify your child's playmates so they can be checked and treated, or your child may get it back.
  • You don't have to sanitize your house. Do common sense cleaning. Wash sheets and pajamas. Clean the hairbrush, or don't use it for 24 hours. If the child sleeps with a blanket or stuffed animal, throw it in the dryer.

"The problem is, everyone is so fixated on the wrong stuff,'' Shepherd said. "Moms are wearing themselves out cleaning, meanwhile the bugs are playing happily on their kid's head.''


Some can be dangerous:

  • Do not use kerosene. It can ignite from a blow dryer or from static electricity from toweling hair.
  • Mayonnaise is gloppy and greasy and hard to remove. It may immobilize the bugs, but it does not affect eggs or newly hatched nymphs.
  • Do not use dog flea shampoo. It is more concentrated and can hurt your child.
  • Do not use malathion from a home and garden store. It is not intended for use on people, and can kill. (There is a safer form available by prescription.)

"Because of the stigma attached to head lice, parents can do some fairly dangerous things,'' Gordon said.


Since the mid-1990s, centers that treat lice infestations in their own clinics or in your home have become available. Lidia Serrano, who


Information on other local treatment centers can be found at, and

worked in a school clinic, helped found Lice Cleanique, one of the country's first.

"When people first came, they would wear big sunglasses and hats, they were so embarrassed,'' she said. "Now, parents are more educated about it. They just come right


Lice removal services offer trained professionals to manually remove head lice and treat with a lice-killing product, about a two-hour procedure. The centers educate the parent about the process, so screenings can continue at home.

The child can return to school the same day with a note verifying treatment. Retreatment is recommended seven to nine days after the initial visit.

Fees average $140 for the first treatment, and $40 for a follow-up treatment. Some clinics check family members for free; others charge a fee. Most clinics work with families who are financially unable to pay.