When fighting lice, focus on kids’ heads, not hats or toys

I recently attempted a technically demanding “around the world” braid on my kindergartner. On my sloppy and meandering approach to the South Pole, I discovered a loathsome sight that scuttled my circumnavigation — a smattering of small, brownish casings stuck onto hairs.

I tried to convince myself that I was looking at sand. She’s always covered in sand! But I’ve spent enough time around insects to know that I was looking at something biological. Bad braid abandoned, I began combing through, looking for more specks. And I sure found them: Lice eggs, or nits, that were glued onto the hair next to the scalp, and precisely one live bug.

Today, I am delighted to report that our outbreak is over. (Although with three young children, our situation will probably swing between “having lice” and “waiting to have lice again.”) Our first brush with the little buggers sent me into full research mode, and I’m now armed with a deeper understanding of lice habits and preferences. In the interest of streamlining your next lice experience, I offer below some little-known and helpful facets of lice life.

The best way to spot lice and their tiny nits is with wet combing.

Compared with spot-checking the scalp, pulling a fine-toothed metal comb through hair that’s slick with conditioner turns out more critters. 

Pepper-sized nits can range from white to brown in color and are glued to single hairs. These suckers are on tight: You might need a fingernail to pop them off. Live nits need to be close to the warm scalp to survive; casings that are farther than a centimeter away from the scalp are probably empty or contain dead eggs.

Once hatched, a live human head louse, or Pediculus humanus capitis, grows no larger than the diameter of a pencil eraser. It’s grayish white. And its favorite — and only — food is blood from a human scalp, which it slurps several times a day.

Super lice laugh at pesticides.

More and more lice can withstand permethrin or pyrethrins, the pesticides inside most of the boxes you’ll find in your panicked drugstore run. And there’s not much evidence for other treatments, including mayonnaise and tea tree or lavender oil. And please don’t even think about gasoline.

Lice burrowed onto heads are surprisingly hardy, even underwater.

In one series of experiments, researchers watched lice cling to cut hair in regular water, seawater, salt solutions and even chlorinated water. The pests didn’t respond to a poke, either, researchers found.

Another study looked at lice pulled off the heads of people in France. After six hours underwater, all the lice in the experiment (188 of them) were happily alive. About half of the lice were still alive after 24 hours underwater. Hardy, I say.

But: Lice are wusses when not on a head.

Off their favorite spot, adult lice quickly dry out and starve, particularly in dry environments. Most are dead within 40 hours after their last meal. And it is unlikely that eggs removed from a head can yield healthy adults.

Lice aren’t all that contagious.

They can’t jump, fly or swim. Their dire need for a human head means that direct head-to-head contact, such as the type you see with little girls coloring together, is what allows lice to crawl to a new home. 

“The control of head lice should focus on the head, not on the environment,” researchers wrote in 2010 in The Open Dermatology Journal. That paper mentions a study of over 1,000 hats, worn by students who, combined, had over 5,500 lice on their heads. The heads had lice, but the hats didn’t. The risks of transmission from hairbrushes, hats, helmets and toys are really, really low. The same goes for flooring: When researchers combed the floors of 118 classrooms at a school with a known lice outbreak, they turned up no lice.

All this to say that you don’t need to wage war on your house and bag up your kid’s clothes, bedding and stuffed animals for three days. “This recommendation has no basis in science,” a 2016 review stated.

Lice aren’t dangerous.

They are gross, to be sure, but they’re not a menace to public health. Kids don’t usually get sick from lice, beyond a little bit itchy. That’s why the American Academy of Pediatrics objects to “no nit” school policies that prevent kids with lice from attending. The Centers for Disease Control and Prevention agrees, as does the National Association of School Nurses.

Lice can be a valuable commodity, in exactly one scenario:

Shrek (the real ogre in the delicious book, not the sanitized movie version) trades several of his rare lice to a witch in exchange for his fortune. It’s a great deal.

So there you have it. I’d certainly prefer to live a lice-free life, but now that I know more about these relatively harmless insects, I feel a little bit better about our prospects.

7 Things You Don't Have to Do When Your Kid Has Lice

Not only am I the editor of our latest story on lice, which does a great job of outlining all of your possible treatment options, I'm also the proud mother of two little girls who've been infested. The first time, the call from the  school nurse downright paralyzed me. Stunned, I told my coworkers, who were all sympathetic either because they'd been in my shoes themselves or because they hadn't and live in fear of the concept. Then I sort of wandered around the office aimlessly, quite frankly dreading going home. The second time, I found the buggers myself and was more aggravated than panicked. I called Sally Kelly, R.N., the amazing professional nitpicker and school nurse who helped me the first time, and simply resigned myself to several days of laundering and combing. She's so wonderful not only because she can do a comb-out like nobody's business (and for a much lower price than her competitors), but because she's filled with helpful tips on the things that aren't necessary when your kid has lice. Thanks to Sally, I've learned what you don't have to do.

1. You don't have to freak out. 

   Of course you don't want bugs living in your kid's hair. But technically, from a health perspective, it's not worrisome. Lice don't spread disease. As Sally told me during our first call, "This is a nuisance. Nothing more." You lice vets out there know: Your first instinct is to wash or toss everything your child has ever come in contact with. But that's overkill. (The CDC backs this up--they point out that because lice can't live off the human head for more than two days max, "you do not need to spend a lot of time or money on housecleaning activities.") Speaking of...

2. There's no need to wash your child's bedding every day. 

   Wash the pillowcase, but the comforter/blanket, sheets, and stuffed animals and other lovies can simply go in the dryer on high for 20 minutes. As for the bottom sheet, you don't even need to remove it from the bed. Sally's tip is to take a roller lint brush--the kind with tape--and run it thoroughly over the top half of your child's sheet. Her logic: The odds of a louse or nit falling off your child's hair and getting under the pillow and remaining alive is remote.

3. Don't bother with the dust ruffle. 

   Lice won't be able to scoot all the way down past the mattress without dying, and your kid's head doesn't come in contact with it anyway.

4. You can skip vacuuming curtains and drapes. 

   Unless your child was, say, playing Hide & Seek and wrapped herself in the curtain in the 48 hours prior to you discovering she had lice, there's just no way that the bugs made their way over to your windows. Spare yourself. But you should vacuum any cloth furniture that your child's head may have touched in the two days before you realized she had lice.

5. You don't need to throw out your brushes and combs. 

   I drop my girls' brushes in a pot of boiling water immediately after I use them, turn off the water, and fish them out after a few minutes, by which time any bugs that were there are long dead.

6. You don't have to treat family members who don't have lice. 

   Once everybody has been thoroughly checked and you've determined who is and who isn't infested, just make sure that there's no head-to-head contact between the two groups. (No snuggling, sadly; no hunching side-by-side over a video screen--or Rainbow Loom kit, and so on.)

7. Hard as it may be, you really don't have to make your kid feel like she's a leper. 

   I distinctly remember one night when I'd finished the hours-long comb-out session with my girls and gotten them both bathed and brushed; I then went downstairs to wash their towels and boil their brushes. I came back up to my bedroom to find one daughter sprawled out on my bed. "OH MY GOD, GET OFF!" I shrieked, nearly causing her to have a heart attack. I immediately apologized, but the poor kid was wide-eyed, saying, "Mommy! You scared me!" Not to mention I made her feel as though she was repulsive. I quickly got a grip... and stripped my bed.

Whoa: Now There’s a Way to Track Head Lice Outbreaks in Your Area!

Find out in real time where head lice are 8 havoc and if you should check your kids ASAP.

I'll never forget seeing a tiny bug in my daughter's hair one evening after a bath and thinking, "Ew, it's a gnat!" Um, then I saw another "gnat." And another. My heart sank, as the realization that I was looking at head lice hit me. Oh, did I mention all three of my girls ended up with it? Let's just say it was not a fun week.

Later, I would learn our school district was being hit especially hard by an infestation of head lice. If only I'd known ahead of time lice was running rampant in our area, I might have been more on top of checking my kids' hair.

Well, now there is a way to track lice's whereabouts. One of the over-the-counter head lice treatment brands, recently launched an online tracker that allows parents and school administrators to see where outbreaks are happening so they can be prepared. Using IRI data from lice product sales and crowdsourced data from school nurses and parents (you can even report a "sighting!"), and Google Trends data to track lice outbreaks, the Lice Tracker shows in real time where those pesky buggers are wreaking havoc.

I decided to try it out and was relieved to see the incidence level is low in my area at this time. But, according to a study by Johns Hopkins Medical Institutions, the peak time for head lice to hit hard is in August and September when kids go back to school.

First, what should we be looking for? "Sometimes it's difficult to tell whether you are seeing lice or just some other scalp condition like dandruff, or even sand," Dr. Altmann says. "Adult lice are usually light brown in color and look like sesame seeds. They often move quickly and can be found on the scalp or hair. Eggs are yellow, brown, or tan. They look like tiny seeds that are firmly attached to the hair shaft and do not move."

Dr. Altmann suggests dividing hair into small sections to search for lice and their nits, or eggs. This can be pretty challenging with thick, long hair like my daughter has, and may take a while. But trust me, you'd rather catch lice early before it spreads to other members of the family. Unfortunately, according to Dr. Altmann, it's pretty darn near impossible to prevent your child from getting lice because it spreads easily in schools and daycares. But, she recommends taking these preventative measures:

• Teach your children not to share hats, hair accessories, combs, or other items that come into contact with hair. Discourage your children from sharing or stacking blankets, jackets, pillows, and towels, because lice can crawl from item to item.

• Check your children regularly for lice if there is an outbreak at their school, even if they aren't showing any signs or symptoms (like, itching and irritability) and especially if there is an outbreak in school or in the region.

• If you suspect your child has lice, make sure to wash all clothing, linens, and toys used by the infected person in hot water or through dry cleaning.

If your child ultimately gets lice, Dr. Altmann advises parents to act quickly to kill the lice, remove the nits, and stop the problem from spreading. 

P.S. Don't feel bad if your child gets it! When it happened to us, I didn't want to tell anyone due to shame, but guess what? As soon as I shared my experience, I found out almost everyone I know has had either a scare or their own encounter with the pests!