In my district, we are working on expanding our "Health Services" section of our web site. I have taken over the Head Lice section and have been doing a bunch of research on best evidence based practice for head lice removal.
The nurses in my district, who have all been school nurses way longer than me, all subscribe to the "suffocation" method of removal. They all say slather the head with conditioner (some say to leave it on for hours or overnight) and then comb every day for 6 weeks for lice/nit removal. No need for pediculicides. This is what they have been telling parents for years.
I pulled together info from AAP, IdentifyUS (Pollack), NASN, Pediatric Nursing Journal, my state's School Nurse Manual, and the EPA. And they all recommend slight different treatment of head lice. The "suffocation method" is not one of them. I actually put together a spread sheet becaue I was getting confused on who was recommending
Every entity I researched states the first line of treatment is OTC pediculicides. Most recommend combing every couple of days for 2 weeks. The EPA is the odd one out, they recommend combing only, no pediculicides. Most say using conditioner to make combing easier is OK, but should not be the only line of treatment, and should not to be used on the day of OTC pediculicide use.
My fellow district nurses are hesitant to recommend OTC pediculicides right off the bat, as this goes against when they have been telling parents for years. And they are concerned about resistant head lice, which is addressed in some of the research I have done.
So what do you recommend to parents? Or do you recommend anything?
I had a "Lice Removal" service drop some information off a few years ago. Their prices were outrageous though, and we live in a low income area. I told them flat out that most of the parents in this district were not going to be able to afford their fees. I used to have a coffee mug from them, but I din't know what I did with it. I wonder if they are still in business. I noticed on a "Lice removal Service" web site that I visited (none in my area), that they mentioned something about students getting lice at school.
I work at a high school too, and I occasionally get "Janie saw bugs crawling in Susie's hair. Can you check Susie for lice?" In one instance, Janie the student reported it to me, and I got also calls from Janie's mom AND dad concerning Susie. I stayed out of it. It felt like too much like a witch hunt to me.
I feel like we as a district need to recommend what is best evidence-based practice. That's going to be a bit of a change from what has been recommended for years in this district, but my fellow nurses are a reasonable bunch, and I bet we can come up with a good plan.
Thankfully, they got rid of the "no nit" policy before I started here!
Thanks everyone, for sharing your recommendations.
If Nix doesn't work after trying it twice, we advise on suffocating with Cetaphil cleanser. Blow the hair dry after soaking the hair with it, then rinse it out after 8 hrs. When I researched this method online, it sounds like it really works!
Specializes in Cardiology, School Nursing, General.
I give a lot of treatment options, some of them can range from OTC medications for that, the suffocation method, going to a professional lice remover person or the natural way, that I didn't know the plant was actually illegal here to sell, but we can grow them in our houses. Something called Rue, in spanish is Ruda. Basically this plant, when boiled and then hair soaked for an hour in it, can act like a way to make your hair taste nasty to the pests.
Most of them do a combo of the treatment, which is OTC medication, then suffocation method (To brush off all the dead lice and nits), then using the Rue plant to make sure the hair isn't accessible to the lice for a while.
That's something I recommend at times, but it all depends on the family and parents.
One bottle of liquid Campho-phenique saturating the scalp and hair, wrapped in a towel, sit for 30 minutes, and then wash out several times. The oily residue will remain for a couple days but keep washing it. Repeat in 2 weeks. No more lice!
I posted on this one time before on this site. If you use the OTC lice treatment, DO NOT overdo it! My ex's cousin did (overdid it) because she was so panicked re: getting lice from one of her students, and it affected her MIND, at least temporarily. Not something to mess with.
Specializes in School Nurse. Having conversations with littles..
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.
Thanks OD. I copied and pasted it into a Word document, so I can whip it out and use it when I need to explain more in detail about how lice shampoo works. It is saved as "Old Dudes Lice Spiel" :)
ohiobobcat
887 Posts
I had a "Lice Removal" service drop some information off a few years ago. Their prices were outrageous though, and we live in a low income area. I told them flat out that most of the parents in this district were not going to be able to afford their fees. I used to have a coffee mug from them, but I din't know what I did with it. I wonder if they are still in business. I noticed on a "Lice removal Service" web site that I visited (none in my area), that they mentioned something about students getting lice at school.
I work at a high school too, and I occasionally get "Janie saw bugs crawling in Susie's hair. Can you check Susie for lice?" In one instance, Janie the student reported it to me, and I got also calls from Janie's mom AND dad concerning Susie. I stayed out of it. It felt like too much like a witch hunt to me.
I feel like we as a district need to recommend what is best evidence-based practice. That's going to be a bit of a change from what has been recommended for years in this district, but my fellow nurses are a reasonable bunch, and I bet we can come up with a good plan.
Thankfully, they got rid of the "no nit" policy before I started here!
Thanks everyone, for sharing your recommendations.