Lice-Removal Tips: Secrets of a Nitpicker

Try these surefire techniques from a school nurse who has seen it all (and then combed it away).

So your child has head lice.

That's not too surprising, according to the Centers for Disease Control and Prevention (CDC). Each year an estimated 6 million to 12 million children -- mostly 3- to 12-year-olds -- get head lice. These parasitic wingless insects live only on the human head and are extremely contagious. Chances are, your kid will have a head-lice scare at least once during your parenting career.

Kids get lice when their heads come into close contact -- hugging, crouching around a video game, doing each other's hair. Personal hygiene has nothing to do with it. Head lice do not spread disease, according to the National Institutes of Health (NIH).

Signs of lice may include a tickling feeling in the hair, sores from scratching, and difficulty sleeping, as head lice are most active in the dark. The itchiness mostly comes from human allergy to louse saliva as they feed on the blood of the head. (Some kids aren't allergic, so you'll probably just spot the bugs.)

A louse is a tan to grayish-white bug that's about the size of a sesame seed; nits are grayish eggs the size of a grain of salt, and they're attached to hair shafts a few millimeters from the scalp.

Lice "hot spots" are the top of the head, behind the ears, and the nape of the neck.

If your kid has lice, other family members might also have it. You'll need to treat those who do, as well as parts of your house.

That's where things can get tricky, says Sally Kelly, R.N., a school nurse who makes lice-removal house calls in and around Chatham, New Jersey.

You can go to the pharmacy and buy over-the-counter lice- removal shampoos, but the pesticides in these shampoos aren't 100 percent effective. Kelly uses a more natural method that, when closely followed, works for her every time. "Not only is it more effective, but you also don't apply chemicals to your child's head," she says.

Step One: First Comb-OutIn this stage, focus on getting the nits out.

Purchase a nit and lice-removal comb, usually metal and with teeth that are very close together. (Kelly likes LiceMeister, available online.)

If your child has thin hair, pour baking soda (an abrasive agent) into one bowl and cheap, thick hair conditioner into another bowl. Dip the comb first into the conditioner and then into the baking soda. (If your child's hair is coarse, you can skip the baking soda.)

Separate out very small sections of hair, and comb them through. Wipe the comb after every couple of swipes so you see what you're pulling out. Comb at a 45-degree angle, working each small section up, down, and side-to-side, making sure to run the comb along the scalp.

Step Two: Second Comb-OutNow, wet your child's hair. Apply the conditioner directly to the hair this time. Wrap it in a towel to absorb the bulk of the water, leaving the conditioner in.

Comb the hair again with the nit comb, this time working through slightly bigger, inch-thick sections. "This is when you'll pull the bugs out," Kelly says. "Do this comb-out fast, and don't worry about parting it. It's easier to capture those bugs when you don't part the hair, because lice are light-sensitive and they're fast."

When you're finished, boil the comb for a few minutes, disinfect it with a 20-minute soak in ammonia, or run it through a cycle in the dishwasher (put it on the top rack). Repeat this step every day for five days. Change your child's pillowcase and bath towel on each of these days.

Step Three: Delouse the HouseOn that first day, wash your child's bedding. Dry the pillow, stuffed animals, and comforter on high for 20 to 30 minutes. If you're worried you may have missed something, roll a sticky lint brush over the top half of bedding each day for five days. Again, wash all brushes in the top rack of the dishwasher, soak them in ammonia for 20 minutes, or boil them in water for a few minutes.

Now, think about your child's last 48 hours in the house. Vacuum rugs or furniture they've lounged on. "That's mostly for peace of mind," says Kelly, since lice and nits can't survive off the human head. "On the outside chance there's still something there, that'll get it."

In general, focus your efforts on those daily comb-outs. "Get your child's head -- don't get the car detailed," says Kelly.

Step Four: The Follow-UpTwo weeks from your first comb-out, do it one more time. "This is the part people don't do, because they think they've taken care of everything after those first few days," says Kelly. But do not skip this step! "If you left just one nit, the whole process can start over again. And you do not want that."

Know how to properly check and treat your child for head lice. Video courtesy of Le Bonheur Children's Hospital.

Copyright © 2013 Meredith Corporation.

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