Lice Aren’t Nice!
A Head Lice Treatment and Prevention Booklet

Dear Parents:
We understand that head lice is a difficult and frustrating problem for you and your family.
It is important to remember to:

• Be kind to yourself and your children.
• Reassure your children that they are loved and they are not the cause of this common problem.

Best Wishes!
The Lice Aren’t Nice Community Coalition

When a person in your family gets head lice, your life can get a little crazy. Crazier than it is right now!

But the more you know about lice prevention and treatment, the better off you and everyone else will be!

The purpose of this booklet is to provide you with the most current information about head lice. It has been gathered by the Lice Aren’t Nice Community Coalition (LANCC) and was reviewed by the Snohomish Health District.

Because information about head lice treatments changes over time, the following recommendations have been based on treatments the LANCC found to be the most effective for the majority of our community at this time. There are no guarantees that these treatments will be 100% effective; data from clinical trials are not available for all treatment options in this booklet.

The LANCC does not assume responsibility for the outcome of your treatment.

An adult louse is about the size of a sesame seed.

When a female louse finds its way onto the head of a person, she starts laying eggs, or nits, along with a glue that firmly attaches the nits to the hair close to the scalp. An adult female can deposit 6 to 8 nits in 2 days!

In a week or so, the nits hatch, and the newborn lice take their first meal of blood from the person’s head.

It takes about 10 days for a newborn louse to become an adult.

Once an adult, the female louse can start laying eggs. This means it only takes 16 days for an egg (nit) to become a female louse capable of laying more eggs!

Adult lice live for 9-10 days, making the total life-span of a louse from egg to adult about 25 days.

Perform weekly head checks to look for lice and nits. Lice and nits are very small, so use a bright light and/or a magnifying glass when checking for them. Outdoor light is best.

• Avoid sharing personal items such as hats, coats, brushes, combs, hair accessories (barrettes or scrunchies), and pillows.
• If your child is scratching his/her head more than usual, this is a warning sign. Check for lice and nits!
• Keep long hair in a braid or ponytail.
• Everyone in your home needs to take part in head checks as a part of their weekly personal hygiene routine.
• Encourage your school, child care, youth groups and PTAs to have lice prevention and treatment training every year.

Some people confuse nits with dandruff. Here are a few pointers to help you identify nits:

• Nits are hard to remove from your hair.
• Nits feel like little grains of sand stuck to the hair, so you may feel them before you see them!
• Dandruff can be easily flicked away with your finger. NITS CAN’T!
• Nits are tiny and yellowish-white, and sometimes gray. Dandruff is larger and white.

A thorough head check is very important in the prevention and control of head lice. It takes more than a quick look at someone’s head to see lice and/or nits. It takes time, patience, and good lighting. Here are three tips for a successful head check.

What you will need (for each person):

• One sheet or large towel
• Two towels or hair dryer
• A sink to wash hair in
• One regular tooth comb
• Hair clips
• One nit comb (LiceMeister™ or LiceOut™ comb)
• Tissue (paper towels or toilet paper)
• Good lighting (a magnifying glass if you have one)

There is a wide variety of lice treatments available. Current research and community feedback suggest that some lice have become resistant to common pesticides used in treatment. In response to this, several pesticide-free treatments have been developed. Based on research and reports by school nurses, the LANCC have found the following treatments to be effective:

1. Nit loosening process
2. LiceOut™
3. Oil based treatments
4. HairClean 1-2-3™

White vinegar can be used to loosen the nits from the hair before you begin nit picking. Soak the hair with white vinegar and then apply a damp towel that has also been soaked in the same solution. Leave the towel on the hair for 30 to 60 minutes, then begin to pick the nits.

Oil based products such as olive oil or mayonnaise make it difficult for lice to breathe. If you saturate the hair with an oil based product and leave it on the hair for more than 30 minutes, this will cause the lice to slow down. This process makes removing live lice and nits much easier. Here is how to use oil based treatments:

• Olive oil or mayonnaise (do not use homemade mayonnaise, low/no fat mayonnaise, or salad dressing.)
• Shower cap or plastic wrap
• Hair dryer
• Special nit removing comb
• Regular baby shampoo or regular shampoo without: conditioner, detangler, cream rinse or oils
• Sink to wash hair in

1. Cover the infested head completely with olive oil or mayonnaise.
2. Place a shower cap over the hair or wrap the hair with plastic wrap.
3. With the cap on, briefly blow dry the hair. The heat will help kill the lice.
4. Leave the cap on for at least 30 minutes, up to 2 hours.
5. Using a special nit removing comb, like the LiceOut™ comb or the LiceMeister™ comb, remove the lice and nits. Read the step on how to pick nits.
6. Shampoo the hair. It may take more than one shampooing to remove all of the mayonnaise/oil.
7. Use the special nit removing comb to remove any remaining nits. Continue to remove nits twice a day for two weeks.

This is a natural head and hair hygiene treatment that is pesticide-free. It contains coconut oil, anise oil, and ylang ylang oil. It has been used effectively in Israel to kill lice. A research team from the University of Miami found HairClean 1-2-3™ to be an effective non-toxic product for the treatment of head lice. Always follow the instructions on any lice treatment product. To find out where you can buy HairClean 1-2-3™ see the product information below.

There are head lice treatment products called pesticides that may kill lice on contact. Pesticides are toxic products, which, if used improperly, may cause side effects. Always carefully follow the instructions on any head lice treatment product!

There are currently 3 types of head lice pesticides:
1. Pyrethrums
2. Permethrins
3. Lindane

Case reports suggest that head lice are becoming increasingly resistant to pesticide products. Using several different products does not increase effectiveness but may only increase side effects. Even if you choose to use a pesticide product, you must continue to pick the nits twice a day for two weeks!

These pesticides usually kill lice on contact but have no long-lasting effect on lice that may hatch later

Pyrethrum Shampoos
Rid®
A- 200®
Clear®
R&C®

Pyrethrum Cream Rinse
Pronto®
End Lice®

These pesticides usually kill lice on contact and may continue to kill lice and newborn lice for 7-10 days.

Permethrin cream rinses:
Nix® - 1% permethrin
Elimite™ (prescription only) - 5% permethrin

• Permethrins are the treatment of choice by the Center for Disease Control (CDC), although they report that treatment failure is common.
• Always carefully follow the instructions on any head lice treatment product.
• Do not shampoo the head for at least 24 hours after treatment.
• Do not reapply any pesticide product for at least seven days after the first pesticide treatment. Using treatment products more frequently than recommended can cause serious side effects. Remember, these are pesticides!
• Use only a baby shampoo or a regular shampoo without conditioner for 2 weeks after the lice treatment. Do not use hair coloring, mousse, gel or hair spray for at least 2 weeks after lice treatment. (See below for product information.)
• When using Nix®, use the entire 2 ounce bottle on the infested head. If the person has extremely short hair, only use half the bottle. If the person has long hair, use one and a half to two bottles of Nix®.

Lindane is a shampoo that is available only by a prescription. Over use or misuse of this product can be toxic to the brain and nervous system. Lice are not as easily killed by Lindane as they use to be, according to Washington State Department of Ecology Publication #97-423, Integrated Pest Management in School Project. Always carefully follow the instructions on any head lice treatment product.

Both the American Head Lice Information Center and the National Pediculosis Association discourage the use of Lindane to treat head lice for anyone due to its high toxicity and potentially serious side effects.

Off the head, adult lice usually cannot survive for more than a day or two. Nits off the hair will die within hours of hatching if they can’t find a meal. So, there is no point in cleaning every nook and cranny.

Pets do not carry human head lice. They do not need any special cleaning.

Evidence shows that lice sprays are not effective in killing lice or nits. They only put poisons into the air. Save your money and avoid buying lice sprays.

• Bath towels
• Coats
• Hats and scarves
• Washable rugs
• Sheets, blankets, and pillow cases

Wash items using very hot water or dry items in the dryer using high heat for 30 minutes. The heat will help kill the lice and nits.

• Brushes, combs, and special nit loosening combs
• Barrettes, other hair holders
• Detachable foam pads inside bike and sport helmets

To sanitize these items, soak the item in 1/4 cup bleach to 1 quart cold water for one hour.

• Rugs and carpets
• Car seats
• Chairs and couches
• Pillows from a couch or bed (wash the pillowcases)
• Bed mattresses
• Stuffed animals in contact with head and neck

Items exposed to lice, such as stuffed animals, can be placed in a plastic bag and closed tightly for two weeks. During these two weeks the lice and nits will not have food (blood) and will die.

The Lice Aren’t Nice Community Coalition does not endorse or promote any of the products mentioned. Details are provided for your information only!

The Lice Aren’t Nice Community Coalition (LANCC) is a group of concerned parents, educators, health professionals, day care providers, and social service agencies working together to educate the community about the prevention and treatment of head lice infestation in Snohomish County.

The goal of the LANCC is to ensure cooperation about head lice treatment and prevention among all those individuals and institutions who are affected by head lice infestation.

If you would like more information about the Lice Aren’t Nice Community Coalition, or to join the coalition in their fight against head lice in Snohomish County, please contact us at (425)339-5230.

For persons with disabilities, this document is available on request in other formats. Please call 1-800-525-0127 (TDD relay 1-800-833-6388).