Another dreaded head lice post. This one's about treatment.

AdobeRN · Feb 17, 2017

I let my parents know the options that are available and give them handouts on treatment - we have our own district handout that basically takes the info from CDC and I give them additional info from NASN. I show them what to look for - you would be surprised at how many parents have never dealt with this issue and don't know what lice or nits look like. I suggest using the medicated shampoo but stress the importance (in my mind the most important part of getting rid of these things) of combing out the nits. I tell them to follow the directions of whatever product they use and if they find they can not get rid of the lice after 2 treatments to contact their pediatrician for prescription shampoo. I also give them info on the 2-3 lice removal places in our area if they want to go that route.

KKEGS, MSN, RN · Feb 17, 2017

Our lice procedure leaves it up to the nurse and parent to "hatch" (see what I did there) a plan together. :roflmao:

If live bugs are found we recommend OTC or prescription treatment but if it's only nits we recommend just hand picking them out and rechecking often.

We also have several companies who will do the treating for them so, although we don't recommend any specific company, we let them know those services exist.

Cattz, ADN · Feb 17, 2017

Whatever Dr. Pollack and the CDC says is what I recommend.

MrNurse(x2), ADN · Feb 17, 2017

I read an interesting story of a boy with recurring leukemia, and multiple infestations with lice. The interesting part, the leukemia always relapsed after the lice treatment. He was susceptible to those toxins. He ended up succumbing to the cancer. That may be why the EPA recommends combing. Something to keep in mind.

OldDude · Feb 17, 2017

Well since you brought it up...I left a tidbit of information out of my "New Head Lice Data" post. The test subject I removed from the girl's hair had just survived the previous night in an environment of olive oil covered by shower cap treatment. The parent said she did that based on friend's recommendations and Google. Enough said about "suffocation."

I'm sure there are strains of OTC med resistant head lice out there but not nearly at the prevalence as is reported.

Here is my head lice spiel...it works...I just used it on my 7th grade daughter who contracted head lice while on a new year's church retreat less than 2 months ago. Do the initial shampoo with the OTC treatment. Wait 10 days to retreat instead of the 7 day recommendation. That's it. No nit picking, no combing, no nothing. Think about the lice life cycle.

Initial shampoo kills the live lice but the eggs continue to hatch. The initial shampooing stops any further eggs from being generated. Studies have shown it takes 7 to 10 days for all the eggs to hatch if you have an active infestation. Lice aren't capable of reproducing until they are 16 to 17 days old. So if you hold off on the 2nd shampoo treatment until ALL of the eggs have hatched but before they are capable of laying eggs, you'll eliminate the problem completely. The empty nits will continue to be attached to the hair shaft but deteriorate over time and fall of.

I'm not against combing and I understand most people can't stand the idea of "lice eggs" in their child's hair. I'm good with that. I'm saying if the treatment timing is right you don't HAVE to comb or nit-pick. Of course, if you get re-exposed to head lice during this period - that's a completely different story.

The most common mistake in lice treatment is repeating the 2nd shampoo treatment too soon.

I recommend the OTC treatment as the first line of head lice treatment.

BeckyESRN · Feb 17, 2017

Our lice letter recommends the OTC treatment as the first line for head lice. I think the biggest issue with the OTC treatment is that parents are not doing the second treatment at all. I see the same pattern over and over again-Kid has lice, parent freaks out, treats kids, cleans whole house, checks head for 3-4 days then decides that all is well and moves on never to think about head lice again. Meanwhile, I have initials on my calendar to remind me to follow up in 10-15 days from the date of notification and lo and behold, no one else has checked the kid's head in 5-10 days, nits have hatched, lice have grown and we're back at square one. Now, this is ALWAYS the school's fault, someone infected their snowflake, it's an epidemic, alert the papers, tar and feather the nurse. You guys know the drill...

If the OTC fails to get rid of the lice, I recommend a doctor's appointment. There are a few newish RX lice treatments, one is a one time use lotion application called Sklice-I've heard good things about it from the parents that have tried it.

JenTheSchoolRN, BSN, RN · Feb 17, 2017

We have those "lice salons" popping up near me. I've had parents take their child there, get treatment and comb with OTC treatment, or do it at home themselves and I tell them to repeat OTC treatment in 10 days. It is working like a charm thus far.

Expect for the one parent that refused OTC treatment. Tried dying the child's hair instead. That did not work.

tining, BSN, RN · Feb 17, 2017

babycenter.com has great videos and printable facts sheets https://assets.babycenter.com/ims/Content/How-to-comb-lice-out-of-hair.pdf

that I give to parents.

The comb-out is the most important piece and I suggest using conditioner to make the process easier - but not leaving conditioner for days.

I also suggest getting a 'Nit Terminator' comb. I have some that I loan out to families that cannot afford the $9 comb.

BeckyESRN · Feb 17, 2017

We have those "lice salons" popping up near me. I've had parents take their child there, get treatment and comb with OTC treatment, or do it at home themselves and I tell them to repeat OTC treatment in 10 days. It is working like a charm thus far.
Expect for the one parent that refused OTC treatment. Tried dying the child's hair instead. That did not work.

I loathe the local lice treatment center! They call themselves doctors, um no, Brittany, you are a part-time wedding photographer, not a doctor. I know this because you sent me your card with a note stating that you verified that a child contracted lice in school because in your non-credentialed, no schooling required, didn't even use a microscope "professional" opinion the lice and nits were 3 days old. You spelled infestation wrong and for only $45 per student, you would gladly check the whole school.

A parent brought in a brochure from that place and everything written contradicts everything Dr.Pollack and the CDC say about head lice. They give the parents license to blame the school-the brochure actually said that most children get head lice from their school. nope, nope, nope.

Running Cat Lady · Feb 17, 2017

Our lice letter recommends the OTC treatment as the first line for head lice. I think the biggest issue with the OTC treatment is that parents are not doing the second treatment at all. I see the same pattern over and over again-Kid has lice, parent freaks out, treats kids, cleans whole house, checks head for 3-4 days then decides that all is well and moves on never to think about head lice again. Meanwhile, I have initials on my calendar to remind me to follow up in 10-15 days from the date of notification and lo and behold, no one else has checked the kid's head in 5-10 days, nits have hatched, lice have grown and we're back at square one. Now, this is ALWAYS the school's fault, someone infected their snowflake, it's an epidemic, alert the papers, tar and feather the nurse. You guys know the drill...

I just had a neighbor complain that it was the schools fault that her four boys caught lice. She did four rounds of treatment before giving in and shaving all their heads. She was the one who noticed lice in the first place, not the school. She was convinced that she was eradicating it on her end and the kids were picking it back up at school. To her the nurse there (my co-worker) was not doing her job. Nobody else had lice! Not even my son who goes to wrestling practice with her older two. She was convinced the school was at fault for not controlling the lice problem.

JenTheSchoolRN, BSN, RN · Feb 17, 2017

I loathe the local lice treatment center! They call themselves doctors, um no, Brittany, you are a part-time wedding photographer, not a doctor. I know this because you sent me your card with a note stating that you verified that a child contracted lice in school because in your non-credentialed, no schooling required, didn't even use a microscope "professional" opinion the lice and nits were 3 days old. You spelled infestation wrong and for only $45 per student, you would gladly check the whole school.
A parent brought in a brochure from that place and everything written contradicts everything Dr.Pollack and the CDC say about head lice. They give the parents license to blame the school-the brochure actually said that most children get head lice from their school. nope, nope, nope.

I've oddly never gotten any "info" from a center, a parent that used one and told me about it called it a salon and I started using that word ever since :).

But, honestly, I don't see too much lice at the MS/HS level - and usually the parent spots it, freaks out a little, and calls me. And both of my last kiddos with lice had seriously awesome parents that I love talking to. One was so appreciative that I don't send a "lice" letter home for one case and had treated her daughter and also had already notified her child's carpool because she knew the teenage girls loved to take "super close selfies" with hair everywhere. It ended there.