Experts explain everything you could possibly need to know to make everyone less itchy and more comfortable.

By Liz Steelman
Updated August 11, 2015
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What’s four letters, looks like dandruff but moves? Lice. And getting rid of it is definitely no joke. But dealing with it doesn’t have to be the downer of the school year. Outbreaks are often found in the end of September to the beginning of October. However, since it takes four to six weeks for people to become sensitive to the saliva, many cases actually occur from children touching heads at camp or sleepovers over the summer. We’ve consulted experts for their tips on what to do if you encounter an infestation.

1. Breathe. Don’t be alarmed. Every generation for a millennium has dealt with lice, Cindy Devore, board-certified member of the American Academy of Pediatrics (AAP) with more than 30 years of experience in schools, says. If your child is infected, it doesn’t mean they’re dirty—lice affects all economic groups and only discriminates based on the girth of hair shaft. Penny Warner, RN, president and CEO of The Lice Place, a lice removal service, calls it, “an equal opportunity parasite.” Making your child feel ashamed or guilty for acquiring lice will only make the removal process harder.

2. Call your pediatrician. Before starting any treatment, consult your child’s doctor to discuss the severity of the case. In some regions, strains are resistant to over-the-counter medicines. A 2016 review published in Pediatric Dermatology found that popular home remedies, such as mayonnaise, essential oils, petroleum jelly are not safe or effective in fighting lice. “Don’t rely on what neighbors might tell you,” Devore says.

3. Begin Treatment. Depending on your pediatrician’s recommendations, you will either be doing at-home OTC treatment, prescription strength treatment, or seeking out a professional head lice removal service. No matter the avenue, experts recommend wet combing your child’s hair with a fine tooth comb to remove eggs closer to the scalp and then surveilling for any eggs, nits, and adult lice daily for at least 10 days after the last treatment.

- Over-the-Counter: The two most common, safe and affordable medications recommended by the AAP contain permethrin, a synthetic that remains active for two weeks, or pyrethins, a natural plant extract that will need to be reapplied seven to 10 days after the initial application. Both compounds kill by over-stimulating a louse’s nervous system. However be aware that because of widespread use, many strains of lice have become resistant to these OTC remedies. The Pediatric Dermatology review found that permethrin, especially, has become less effective over time in fighting the bugs. Talk to your doctor for more info.

- Prescription strength: Pediatricians will likely recommend topical medicines that contain the active ingredients spinosad, a naturally derived long-lasting insecticide, ivermectin, a lotion that paralyzes a louse and only requires one application, or benzyl alcohol, a substance that asphyxiates up to 75 percent of living lice after one 10 minute application.

- Professional head lice removal services: Removal services rid the hair of lice in one hour to hour-and-a-half treatment by manually combing. A protein based enzyme solution will be used to help soften the glue that keeps eggs attached the scalp. Treatments typically range from about $100-200 depending on gender and length and thickness of hair. Most services will come with a month guarantee to do another treatment if lice are not entirely gone.

4. Alert Other Parents. Though Warner says lice is more prevalent, it’s losing its stigma of uncleanliness or neglect. The best way to prevent lice from being spread back to your child is to make sure everyone knows the facts of how its spreads and who might be at risk. Alerting the classroom teacher, sending out a Facebook message, or calling the parents of your children’s friends ensures they can take early action to deal with lice.

5. Send Your Child to School. The APA states that if a child is found with head lice during the day, they can—and should—finish out the school day. If discovered in the morning or after school, book a treatment in the afternoon or the next morning and return to school. To keep your child from being stigmatized in school settings, again, wet comb with a fine toothed comb to eliminate cemented eggs and nits. “Schools are stopping targeting a child as dirty or to be avoided,” Devore says, “The privacy and dignity of every child should be honored.

6. Lightly Clean the House. Research shows that lice die in about 24 hours without a human host. But Warner says after an infection is found, wash pillowcases, stuffed animals, headbands, clothes, hats—anything that could have been touched by hair in the past 48 hours—in hot water (140 to 160 degrees) and then put in the dryer for at least 20 minutes at a high heat setting.

For anything that cannot be machine washed, Devore says to put it in a plastic bag in the garage (or a similar, uncarpeted space) for 72 hours. Vacuuming the floors can help, but other surfaces do not need to be touched.