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Creepy, crawly, bitey . . . How to get rid of lice

Registered nurse M.J. Eckert demonstrates her lice-removal procedures on her daughter, Libby Eckert, 13, in Annapolis, MD on Friday Feb. 13, 2009.  (AP file)

Registered nurse M.J. Eckert demonstrates her lice-removal procedures on her daughter, Libby Eckert, 13, in Annapolis, MD on Friday Feb. 13, 2009. (AP file)

It’s back-to-school season, which means it’s time to talk about healthy lunches, healthy sleep habits, hand-washing. But you know what? That’s all just a little too Pollyanna for us here at HealthBeat. Let’s get real.

Let’s talk about lice.

The first thing Janet Corkum told me about lice won’t comfort many parents who just sent Johnny and Janie back to school.

“What I find for the most part,” she said, “it’s always there to some degree.”

Dun dun duuuuuuun.

Corkum, whose been a nurse for 10 years, most recently at Mill Brook School, has come to terms with the fact that lice are a year-round problem, popping up in at least one of the classrooms in her building at any point in time.

“In my experience, no time of year is worse than others. I see it all year round. But I don’t see a lot of it, really. I see a fair amount, but I’m not inundated with it. It’s not like it explodes, It’s not like the entire classroom coming down with it.”

But how do you know when you have a problem?


Lice are most attracted to the hairline: nape of the neck, behind the ears, and under bangs on the forehead. If you see little red bites there, or excessive scratching of those areas or others, start looking more closely.

The bugs themselves look, well, like bugs. The nits, or eggs, can look like dandruff, but are attached firmly to the hair strand.

And when you find some? It’s time for . . .


This will take patience, time, some clean towels, and a few supplies.

When she finds a child has lice, Corkum calls the parent and sends the child home for treatment. Years ago, that might have meant a dousing with a harsh shampoo.

Corkum now recommends using oil or mayonnaise because of growing concerns about the toxicity of over-the-counter shampoos and other treatments, and evidence that the bugs have grown immune to some (more on that later).

The idea is to saturate the hair with an oil that will suffocate the lice and loosen the nits’ grip on the hair strand.

Then, comb through the hair section by section with a special fine-toothed comb, rinsing it frequently in very hot water or a diluted rubbing alcohol solution.

You’re looking to remove the bugs and especially the nits, so that none of them hatch and start the process over again.

“It’s a lot of work and it can take close to a month, using it once a week for three weeks and combing three or four times a day every day,” Corkum said. “I find that’s usually what fails and ends in them coming back, not because it doesn’t work but because it’s so much work and if you miss even one, it’ll start again.”


Corkum said there’s no way to prevent picking up lice if they are around, though some parents shared their methods with me (see sidebar).

What you can prevent are recurrences.

All the bedding and clothing the lice may have gotten into should be washed and dried on the highest setting the fabric can handle, ideally above 130 degrees. Anything that can’t be machine washed or boiled in water should be put in a plastic bag and sealed for 10 to 14 days. The lice can’t live without a meal for more than 24 hours after hatching, so any nits on those items should die in that time.

Also, all furniture, including mattresses, should be vacuumed.

Natural alternatives

Scientists worldwide have noticed over the past few decades that lice have grown resistant to traditional over-the-counter treatments, according to the abstracts of many scientific papers I found.

Last fall, the National Center for Biotechnology Information (NCBI), part of the National Institutes of Health, published a study looking for alternatives.

The earliest study they cited, from 1995, showed lice collected in a town outside Jerusalem had developed resistance to a certain treatment within four years of its introduction.

Lindane, malathion and permethrin crème rinses are the current chemicals approved by the FDA to treat lice infestations.

Lindane shampoo 1% is a brand name product that is no longer recommended by the American Academy of Pediatrics for lice treatment unless other methods have been tried and failed. Overuse, misuse, or accidental swallowing can be toxic to the brain and other parts of the nervous system, according to the CDC.

It should not be used to treat premature infants, persons with HIV, a seizure disorder, women who are pregnant or breast-feeding, persons who have very irritated skin or sores where the lindane will be applied, infants, children, the elderly, and persons who weigh less than 110 pounds.

It’s been off the market in Europe since 2007.

Instead of over-the-counter chemicals, some natural-remedy websites and online forums recommend mixing an essential oil like tea tree oil into the oil used to saturate the hair, but there are few clinical studies backing up their claims, according to the NCBI.

One study, done in Argentina in 2007, showed some benefit to using peppermint, eucalyptus and lavender oils dissolved in rubbing alcohol.

Another study, published by the NCBI last fall, tested a new product that is free of chemical insecticides.

Thirty test subjects applied the product generously over the whole scalp, completely covering the hair roots, especially behind the ears and on the neck after ensuring that the scalp and hair were dry. The product was left on for 45 minutes then rinsed off with plenty of warm water. Nits were carefully combed out and the hair was dried.

Nearly 40 percent of the participants were lice-free after three treatments in 10 days, and 90 percent were clear after four treatments in two weeks.

The product works in the same way as the oil and mayonnaise method, by suffocating the lice with Andiroba oil, with the added benefit of damaging the shell of the nits with vinegar.

So, you and your own little buggers may smell like a salad for a few hours (or weeks). But it’s better than itching from September through June.

(Sarah Palermo can be reached at 369-3322 or or
on Twitter @SPalermoNews.)

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