If Your Child Has Bugs

Head lice have plagued children and disgusted their parents since the dawn of human civilizations.

And now the number of head lice cases is increasing, researchers suggest, because lice are developing a resistance to a lot of current head lice treatments, such as chemical shampoos and various home remedies.

But a new study published in today's issue of Pediatrics suggests that a 30-minute blast of hot air can kill the little bugs with no reported side effects. Researchers from the University of Utah used a custom-built machine called the LouseBuster.

Head lice are an emotional issue for most parents, but the LouseBuster seems like overkill. Are there other ways to kill head lice? Will the old standby treatments still work?

Well, yes.

How This Doctor Handles Head Lice

Here is the information that I -- as a pediatrician and as a parent -- want other parents to know.

First, this is not your fault. Head lice are acquired from other children in settings where children congregate such as schools and daycare facilities.

They do not indicate poor hygiene or an unclean home. Head lice do not come from pets, so please don't send Fido to the pound.

Next, head lice do not carry and spread other diseases in the way that ticks transmit Rocky Mountain Spotted Fever or Lyme Disease. But head lice are certainly unsightly and do cause the scalp to itch.

They also may spread to other family members, so it is wise to rid your child of the infestation (viruses and bacteria cause infections, insects cause infestations).

Friends, neighbors and grandparents might offer any number of folk remedies to get rid of the pests. They could suggest anything from coating the scalp with an oil slick to actually shaving the head.

I have heard of folks using vasoline, olive oil and even mayonnaise. If I were a louse, I'd certainly try to find another home if confronted with an oil slick on my home. Parents who have tried these treatments usually don't admit it in my office so I can't vouch for their effectiveness.

Most doctors I know like to recommend over-the-counter insecticides such as permethrin (sold as Nix), pyrethrins (Rid, Pronto plus) lindane (Kwell) and malathion (Ovide). Since these are essentially bug poisons, use them carefully and according to the instructions on the bottle.

I've known parents who have been so distressed by the thought of these little creatures on their beloved's head that they've overused these insecticides and caused severe scalp irritation, hair loss or worse. For example, because children under age 1 have a large scalp-surface-area, there is in theory a risk of a lethal dose of insecticide. Also, children with bone marrow conditions may also become anemic from prolonged insecticide exposure.

More Bug Zapping Options

One cure I've used when it seemed that the insecticides weren't working is an antibiotic called Sulfamethoxazole/Trimethoprim (Septra or Bactrim). Taken for five days at standard dosages for weight and age, the antibiotic actually kills the bacteria in the intestinal track of the louse. In turn, the lice die of acute hemorrhage.

Even Dead Bugs are Bad Bugs

Killing the lice isn't enough -- lice leave behind their shells and their eggs that cling to stands of hair and have to be combed out, one by one. The louse eggs look like tiny white specks on the hair shafts close to the scalp.

I advise parents to try to comb these nits off the hair with the special combs that often come with whatever over-the-counter lice killers they buy.

If a parent is especially distressed by the little critters, I'll suggest that the parent go through the scalp, hair by hair, clipping of any hair that still has a nit attached. This usually does the trick.

When one family member is found to be infested, it is wise to check all others in the household. Everyone should be treated at the same time. Notify schools or day care centers so that all kids in the classroom can be treated over the next few days. Some parents might want to wash a child's sheets, blankets, pillow cases and hats, although this is not usually necessary.

My ultimate advice to parents is to stay calm, follow directions and worry about more important threats to their offspring -- like vaccine-preventable infections and childhood obesity.

Dr. Chuck Willson is a clinical professor of pediatrics at the Brody School of Medicine, East Carolina University, Greenville, NC.