What You Need to Know about (not-so) Super Lice

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If you're a parent, chances are you remember standing in long, single-file lines within the first few weeks of school and at the end of each line was a chair and a school nurse. You'd plop down into the chair as if you were the unlucky winner of the worst game of musical chairs ever, and your scalp would be quickly examined, your mind racing hoping that this mythical wingless insect wasn't found in your hair. The nurse would tap you on the shoulder to stand up, you walked away, exhaled a sigh of relief, and the process continued.

Now school lice screenings are less common, so there's a bigger burden on parents to examine their children and know what to look for when it comes to lice. We had a chance to speak with Anita Moorjani, MD, pediatric medicine specialist who works with graduate medical education at AdventHealth, about how to spot lice, super lice, and available treatments.

So, just what are lice?
Lice are parasitic insects that can live in the scalp, eyebrows and eyelashes of humans and feed on blood. Symptoms include the feeling of something moving in the hair, an itchy scalp, irritability and difficulty sleeping.

What are the symptoms?
The tell-tale sign of lice is itching, usually behind the ears, on the scalp and at the nape of the neck. Itching is your skin's reaction to the lice's saliva.

What am I looking for?
In order to correctly spot live lice, you need to know what they look like first. According to Dr. Moorjani, many people incorrectly identify things in hair as lice. Live lice are about 2mm long, about the length of the tip of a crayon or a sesame seed, and are tan to grayish-white in color. Nits are tiny white casings that are empty eggs that have already hatched and can be tell-tale sign of lice. Nits can appear anywhere on the hair shaft, whereas eggs that haven't hatched are always at the base of the scalp. Nits are not contagious or active. Itching of the scalp usually occurs 2-3 weeks after an initial infection.

What are super lice?
Super lice are becoming more common in the United States, but don't worry, they're not as scary as they sound. The term super lice just means they're more resistance to the normal over-the-counter (OTC) medications used to keep lice under control. Dr. Moorjani says they've become resistant for a few reasons namely incorrect application of medications, not treating for the proper amounts of time, not using the product correctly (putting on wet or dry hair as instructed)

How do I treat lice once I find them?
Initial treatment with OTC products that contain permethrin are good first line options.  Permethrin works by paralyzing and killing live lice, but not their eggs, or nits. And since the eggs aren't affected, its usually recommended to retreat the hair. There are a variety of OTC shampoos containing the medication that can be applied to damp or dry hair. 

Says Dr. Moorjani, If you use the shampoo that's applied to damp hair, don't use conditioner, and leave it on for 10 minutes until rinsed, she said. Other shampoos should be applied to dry hair, then rinsed after 10 minutes. Be sure to reapply either treatment after 7-10 days because they only kill live lice, not the eggs that will hatch later on.

If you hear about home remedies from a friend or on the web, like tea tree oil, vinegar, or mayonnaise, you're more than welcome to try, but those remedies have not been found to be effective in studies. Some salons specialize in treating lice also, and can manually remove nits and eggs, which is helpful in addition to medications.

In general, Dr. Moorjani says, if these options are proving ineffective your physician prescribe a variety of other medications to help your child get lice free.

More helpful knowledge for parents
School outbreaks are uncommon, mostly because lice cannot jump or fly. Lice can, however, spread from direct head to head contact, so its probably a good idea to tell your child not to share hair products, hats or towels, and to check your child's head after sleepovers.

Head lice are only spread from human to human, so there's no need to keep the dog or cat outside if lice are present.

You should wash bedding in hot water and vacuum furniture, carpeting, and car seats, Dr. Moorjani said. Check other household members for lice, and anyone who sleeps with the infected child should be treated as well.

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