Dr. Alan Greene on Head Lice

How do kids get head lice and what's the best treatment?


How do kids get head lice and what is the best way to treat lice so they don't come back?


Back-to-school time is "lice time." Lice prefer children to adults, long hair to short hair, and they especially like the hair of girls for some reason. Lice are most common in kids ages 3 to 10, although they can occur at any age when kids spend a lot of time together. They spread from person to person when kids' heads touch, but can also be spread by sharing clothing, headphones, hats, combs, towels, or toys.

There are several different ways to treat lice. The simplest is to use an over-the-counter preparation like Nix. Depending on how resistant the lice are in your area, the treatment product may need to be left on for longer than the time recommended on the package. It's not uncommon for it to be needed for 30 minutes or more. Be sure the hair is dry when the medicine goes on. The way these products work is to temporarily paralyze the muscles the lice need to breathe. Ultimately they die from lack of oxygen. But when lice are wet they have a self-protective mechanism and can hold their breath for 30 minutes or more!

Nix and similar products contain a pesticide, so I prefer using an alternative treatment if possible. At Stanford, we use regular shampoo mixed with three tablespoons of olive oil, one teaspoon of tea tree oil, and one teaspoon of rosemary or eucalyptus oil. (These oils can be found at a health food store.) We mix it all together, work it into the hair, and leave it on for 30 to 60 minutes under a tight-fitting shower cap. We seem to get good results with this, though unlike Nix, there are no controlled studies to provide statistics on success. Also, eucalyptus oil is very poisonous, so it's important to be careful when using this mixture on children. It must be kept out of the eyes, nose, and mouth of kids. The most important part of treating lice is to carefully comb through the hair using a nit comb. However treatment is done, it is a good idea to repeat it a week later just in case one louse survives. One louse lays three to ten eggs per day so a child could get re-infested quickly.

Since lice can also live on bedding, clothing, and toys, and can jump right back on the kids after they have been treated, all of these things need to be cleaned or isolated for a period of time. Lice live on a very simple diet -- human blood. If they do not have access to blood they will die, usually within 48 hours, though sometimes they live a bit longer. If you close up your home and take off for the weekend, any lice left in the home should be dead when you get back and you can skip the huge cleanup!

The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.

Healthy Kid


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