Head Lice Treatment Myths & Realities

What do you know about head lice treatments?

When your child has been diagnosed with head lice, you want to get rid of them quickly- and effectively.  But, you may not be aware of all available treatments.  Find out what’s true- and false- about current options.

 

True or False

Over the counter head lice treatments sometimes are not the most effective. 

True.  Here’s why:  Head lice can be resistant to the active ingredients in over the counter treatments in some communities.  These are the ones you can buy in the store without a prescription.  If head lice are resistant it means the treatments may not kill them.  The likelihood of resistance varies across the country.  Your pediatrician can assist in helping you choose an appropriate treatment option before you do so on your own.

Prescription treatments always cost more than over the counter treatments.                         

False.  Here’s why:  Parents sometimes treat their children with over the counter treatments up to 5 times before seeking help from their pediatrician.  You should consider the cost of potential multiple treatments, plus the cost of other infestation-related activities when choosing a treatment option.  That having been said, prescription medications are usually more expensive to purchase and may not always be covered by health insurance.  So, it is a good idea to check your coverage when you are making your decision.

All head lice treatments call for 2 applications.             

False.  Here’s why:  Several prescription treatments suggest using only 1 application.  Sometimes, a third treatment is needed if live lice persist following the second treatment. 

Prescription head lice treatments involve being left on the scalp and hair for 8 to 12 hours.                        

False.  Here’s why:  Some prescription products have application times as short as 10 minutes followed by a simple rinse with water.  That is why it is essential for parents to read and follow manufacturer instructions exactly as written.

All head lice treatments instruct users to nit comb.                              

False.  Here’s why:  There are some prescription products that don’t call for nit combing.  Nits are lice eggs.  Even when nit combing is not required to get rid of an infestation, you may choose to comb out nits while hair is wet with a fine tooth comb.  Removing nits may help decrease embarrassment to your child, as well as eliminate potential conflicts with school officials that you have not treated your child.

Due to stronger ingredients, prescription head lice treatments should only be used as a last resort.                                     

False.  Here’s why:  Prescription medications have different active ingredients than the over the counter products and may need to be used in the initial treatment of head lice in some communities based upon local resistance patterns.  Many newer prescription treatments can be used safely when prescribed by a pediatrician and carefully applied according to instructions.  Several prescription treatments are safe to use on children as young as 6 months of age. 

Home remedies to treat head lice are safe and effective.                          

False.  Here’s why:  Mayonnaise, olive oil, margarine, butter, and similar substances have not been proven as effective head lice treatments.  Substances like gasoline and kerosene have not been clinically proven and are flammable and carry substantial risk.  When your child has head lice, it is best to call your pediatrician before treatment.  Like any other health concerns you have about your child, consulting your pediatrician first can help you decide whether an over the counter or prescription treatment is best for your child. 

Once I apply lice treatment, it is ok to place a shower cap or plastic bag on my child’s head and leave my child alone until the treatment is complete.            

False.  Here’s why:  It is dangerous to place anything made of plastic on a child’s head because it sends a message that it is ok for them to do when you may not be around.  If left unattended a child might fall asleep with the plastic bag on his/her head and it could slip over his/her nose or mouth and suffocate.  While treating for head lice can be an annoyance, it can also be a close time for a parent and child to spend quiet time together and bond during a close and caring encounter.  Similarly, a child should never be left unattended with any wet chemicals on his/her head to avoid drippage of the chemical into the eye.

If you think your child may have head lice, please contact your pediatrician at Associates in Pediatrics and Adolescent Medicine.

Dana Fakouri, M.D.

Source Council on school health
(American Academy of Pediatrics)