Your Family's Health: Coping With Head Lice

Itching, scabbing on scalp may signal presence of head lice. Learn what to do.

BySUZAN CLARKE via via logo
January 25, 2010, 8:18 PM

Jan. 26, 2009— -- Six million to 12 million school-age children in America get head lice every year, according to the American Academy of Pediatrics.

Dealing with lice is hard on parents and even harder on their kids. Children may have to handle not just the itching from the tiny parasitic insects that nest in their hair but also face teasing from their classmates.

The Mayo Clinic says head lice infestation is common. It's second only to the common cold among communicable diseases affecting schoolchildren, according to Mayo.

Dr. Richard Besser, ABC News' chief medical and health editor, told "Good Morning America" that head lice are harmless, adding that the worst possible outcome is infection resulting from too much scratching.

"Lice don't transmit disease, but there's a lot of emotional toil," Besser said.

He answered the following questions:

Q: How can you tell if your child has lice?

A: On dark hair, lice look like specks of dandruff. On sandy or blond hair, the insects, which can be tan to grayish-white in color, are practically invisible to the naked eye.

You can easily tell the difference between lice and dandruff because dandruff is easily removed from hair, whereas nits, or lice eggs, are firmly attached.

Itching is the most obvious symptom of a head lice infestation, but not all lice infestations cause itching. Itching is an allergic reaction to a chemical that the lice inject into the skin when they bite.

Aside from itching and scabbing on the scalp because of scratching, most parents discover lice on their children when the school nurse sends home a note about an outbreak.

Q: If there's an outbreak at school, what can you do to prevent your child from getting lice?

A: Because lice spread from head-to-head contact, your child should not share hat, scarves, helmets, headphones, combs or brushes with friends or classmates.

The good news is that lice in the school won't survive over the weekend -- they need frequent blood meals.

More information and resources on head lice:

Click HERE to get comprehensive information from the CDC, and click HERE for specific information on pediatric scalp care

For more information and comprehensive resources to treat lice, click HERE to visit

Q: Is it true that black people don't get lice?

A: All hair is not the same. Caucasians, Asians and Native Americans have hair that is round in its cross-section, whereas people of African descent have hair that is oval in its cross-section. The lice that predominate in the United States are thought to have arrived with the early Caucasian settlers. Having evolved with their early hosts, they are only able to grasp the rounded hair with their claws.

That's why black children in the United States are rarely infested with lice. Conversely, African lice evolved to be able to grip hair that is oval in its cross-section, so African natives are at high risk in their home countries, while non-Africans in those countries are largely protected.

Q: What are the best options for treatment?


For treatment to succeed, the infested person must be deloused, family members must be checked, and households must be cleaned.

Shampoos containing either pyrethrin or permethrin are the first treatment options, and they work best if you follow the directions closely. This may require that you use the shampoo multiple times to make sure you've gotten rid of all the lice.

Besser noted that lice have grown resistant to the ingredients in over-the-counter treatments, so if they don't work for your child, your doctor can prescribe shampoos or lotions that are stronger treatment alternatives.

Treatment Options Vary

Some of the prescribed treatments may include malathion, the controversial pesticide sprayed over crops. Malathion is flammable, so keep it away from heat sources, including hair driers and electric curlers.

Lindane is another prescription medication and comes in either a cream, lotion or shampoo. Its side effects include skin irritation and seizures, and it's actually banned in California.

A newly approved treatment, benzyl alcohol lotion, should not be used in children who are younger than 6 months. The side effects of this treatment may include skin, scalp and eye irritation.

If you don't want to use the chemicals, you can get a fine-toothed or nit comb and physically remove the lice, just as the Hair Fairies do. Comb through the child's hair every three to four days for at least two weeks. This is actually the preferred method of treatment for children younger than 2 . If you want to hire a professional, your school nurse can usually recommend a service in your area.

Q: Is it necessary to discard clothes or a mattress if lice have come into your home?

A: No. Once they're removed from the scalp, lice live between 12 and 48 hours, so there's no need to throw your things out. Wash your sheets, stuffed animals and clothing in very hot water and dry them on high heat. Soak all hair brushes and combs in hot water.

Bedding, clothing or things that cannot be washed may be sealed in an airtight bag for three or four days. This will kill live and newly hatched lice. After you've removed the items from the bag, vacuum them thoroughly.

Click HERE to get comprehensive information from the CDC, and click HERE for specific information about pediatric scalp care.

Click here to return to the "Good Morning America" Web site.

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