Here are two words that strike fear in the heart of every parent: head lice.

The very thought that tiny blood-sucking, parasitic bugs are living on your child’s head and could spread among other family members before you kill them is enough to send even the toughest parents running for cover at the nearest pediatrician’s office.

“Head lice cause no medical harm, but lice cause an enormous amount of anxiety among parents and teachers at schools,” said Dr. Michael Cater, an Orange County pediatrician with an office in Tustin.

Adding to this anxiety is a new study revealing that some lice in California and 24 other states have become resistant to over-the-counter medication. Prescription medication may now be required to eradicate lice; however, natural alternatives can sometimes produce good results. 

Head lice are mostly spread from head-to-head contact, and lice infestations are common at many schools worldwide. In the United States, head lice infestations are most common among preschool- and elementary school-age children and their household members and caretakers, according to the Centers for Disease Control and Prevention.

t’s a myth that only poor or unclean children get head lice; lice infestations are common in all communities. In fact, it’s estimated that 6 million to 12 million lice infestations occur each year in the United States among children ages 3-11, said the CDC.

Head lice move by crawling; they cannot hop or fly. They are spread by direct contact with the hair of an infested person. Anyone who comes in head-to-head contact with someone who already has head lice faces the greatest risk, according to the CDC. Dogs, cats and other pets do not spread head lice, said the CDC.

If your child has an itchy scalp and the itching doesn’t stop, or you notice sores on the child’s scalp from scratching, the first step in dealing with a suspected head lice infestation is to call your pediatrician, said Cater. The pediatrician will examine the scalp and look for a living louse or nits (eggs) on the hair shaft, he said.

Keeping the child’s environment clean and free from lice and nits is equally important to prevent a re-infestation. Parents should also wash the child’s bed linens twice in hot water and wash all combs and brushes. The goal is to rid the child of the infestation and prevent the lice from returning. However, if you have taken all these steps and your child’s head is still itching, she might have lice again. 

Your child’s pediatrician can tell if the lice have returned or the medication didn’t work for some reason, whether it was ineffective or applied incorrectly, said Cater. He said a different medication can be tried if necessary for a re-infestation.

Finally, a word about schools: The policy of the American Academy of Pediatrics is that a child should not be restricted from attending school for head lice, said Cater. Every school district handles the issue differently. Parents can ask their child’s school for its head lice policy, if there is one.