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Sharp Health News

5 things to know about (not-so) super lice

March 23, 2016

5 things to know about super lice

No one really prepares you for the realities of parenting.

Although I had it myself once as a child, I've known countless parents who battled it and my kids' elementary school sent home dozens of letters about it, I wasn't prepared for lice.

Yes, lice. Those tiny, fast-moving bugs that cling to the hair shaft and lay dozens of eggs (or more!) — also called nits. My rational mind knows that getting lice is not a sign of poor hygiene or poor parenting, but I still couldn't help but feel like we had done something wrong to bring this upon ourselves.

And I do mean that in the plural sense. Having a child with lice is a family affair. It took an entire household to strip every bed, bag up every toy and blanket, and vacuum every upholstered surface. My dear husband was hair washer-in-chief, washing four heads — multiple times — with the most powerful over-the-counter solution available.

After each wash, we carefully combed through thousands of hairs, looking for the telltale signs of brown or white spots near the scalp or worse, live lice. After three rounds of chemical treatment, I knew we had met our match when we found several — very live —lice. It was time to call in the professionals. Several hours (and more money than I'd care to admit) later, we were certified "lice-free."

5 things to know about "super lice"
With at least 25 states in the U.S. reporting cases of "super lice," —bugs that can't be killed with standard over-the-counter treatments — I turned to Dr. Matthew Messoline, a board-certified family medicine doctor with Sharp Rees-Stealy Medical Group, to find out what parents can do to avoid following in my footsteps.

Why are lice becoming resistant to standard over-the-counter treatment?
Resistance to treatments like pyrethroids varies geographically and is due to a mutation in the louse's genetic makeup that makes them resistant. Still, these treatments are the first-line recommended treatment. Only if they do not work after two applications, as directed, would we go to the second-line treatments that require a prescription. However, if there is a known outbreak of resistant lice, consult your pediatrician first for treatment options.

Is it true that lice are only transmitted by head-to-head contact?
Direct contact is the primary mode of transmission as the lice cannot jump, fly or be carried on pets. According to the American Academy of Pediatricians, only items that have been in contact with the head of the person with infestation in the 24 to 48 hours before treatment should be considered for cleaning, given the fact that louse survival off the scalp beyond 48 hours is extremely unlikely. Such items may include clothing, headgear, furniture, carpeting and rugs. Washing, soaking or drying items at temperatures greater than 130° F will kill stray lice or nits. Furniture, carpeting, car seats and other fabrics or fabric-covered items can be vacuumed.

Should children be kept out of school if they have active lice?
No. Because affected children have likely had lice for a month or more, they pose little risk by the time the infestation is discovered. However, affected children should avoid direct head contact with other individuals and should always be treated as soon as diagnosed.

Can parents develop lice when their children have it?
All family members of an infected person should be checked for lice and anybody who shares a bed with them should be treated, even if no lice are found on exam.

Is there anything you can do to prevent getting lice?
It is a good habit to teach children not to share personal items such as combs, brushes and hats. While this is not likely to prevent all cases, it can minimize outbreaks.

With this information in hand, and armed with a metal nit comb for regular head checks, I'm ready.

For the media: To talk with Dr. Messoline or another Sharp Rees-Stealy doctor about "super lice," contact Senior Public Relations Specialist Erica Carlson at

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