Discovering lice can be unsettling, whether it’s on yourself or a family member. These tiny parasites, while not dangerous, can cause significant itching and discomfort. Understanding how to identify and effectively eliminate lice is crucial for a quick and stress-free resolution. This guide provides a comprehensive approach to getting rid of lice, covering everything from diagnosis to treatment and prevention, ensuring you have the knowledge and tools to tackle this common issue head-on.
Diagnosing Lice Infestation
Accurate diagnosis is the first step in effectively getting rid of lice. A healthcare provider can confirm a lice infestation through a physical examination. They may use a magnifying lens or a Wood’s lamp, a specialized light that makes nits appear pale blue, to aid in detection. Here’s what they look for to diagnose different types of lice:
Head Lice Diagnosis
Head lice are typically diagnosed by identifying live lice or nits in the hair. A healthcare provider will look for:
- Live Lice: Finding a live nymph (young louse) or adult louse on the scalp or hair is a definitive sign of head lice.
- Nits: The presence of nits attached to hair shafts within a quarter of an inch (about 6 millimeters) from the scalp also indicates head lice. Nits are lice eggs and are often mistaken for dandruff, but unlike dandruff, they are firmly attached to the hair.
Body Lice Diagnosis
Body lice infestations are diagnosed by examining clothing and bedding, as these lice primarily live in fabric and move to the skin to feed. Diagnosis involves:
- Eggs or Crawling Lice in Clothing: Healthcare providers look for lice eggs or crawling lice in the seams of clothing or on bedding.
- Lice on Skin: While body lice live in clothing, they can be seen on the skin, especially when they crawl there to feed.
Pubic Lice Diagnosis
Pubic lice, also known as crabs, are diagnosed by visual examination of the pubic area and other areas with coarse hair. Diagnosis is confirmed by:
- Moving Lice or Nits in Pubic Hair: Identifying moving lice or nits attached to hairs in the pubic region, or other coarse hair areas like chest hair, eyebrows, or eyelashes, confirms pubic lice.
Effective Lice Treatment Methods
Once diagnosed, prompt treatment is essential to get rid of lice and prevent further spread. Treatment options vary depending on the type of lice and may include nonprescription and prescription medications, as well as home care measures.
Head Lice Treatment Options
Treating head lice often involves medicated shampoos and lotions, along with thorough combing and environmental cleaning.
Nonprescription Treatments for Head Lice
Over-the-counter (OTC) treatments are often the first line of defense against head lice. These typically contain:
- Permethrin Lotion 1% (Nix): Shampoos containing permethrin are a common initial treatment. Permethrin is a synthetic pyrethroid, similar to natural pyrethrins derived from chrysanthemum flowers, and is toxic to lice. It is crucial to follow the product instructions carefully for effective use.
- Ivermectin Lotion 0.5% (Sklice): This lotion is another nonprescription option containing ivermectin, which is also toxic to lice. It’s approved for adults and children six months and older. A single application to dry hair for 10 minutes, followed by rinsing, is usually sufficient. However, repeat treatments should only be done after consulting a healthcare provider due to potential side effects such as eye irritation, dandruff, dry skin, or scalp burning.
It’s important to note that lice in some areas have developed resistance to OTC treatments. If nonprescription options are ineffective, a healthcare provider can prescribe stronger treatments.
Prescription Medications for Head Lice
When OTC treatments fail or for more severe cases, prescription medications are available:
- Oral Ivermectin (Stromectol): Prescription oral ivermectin tablets are effective for treating head lice, usually requiring two doses taken eight days apart. This oral medication is typically reserved for cases where topical treatments have not been successful. It’s suitable for children weighing at least 33 pounds (15 kilograms). Potential side effects include nausea and vomiting.
- Topical Malathion Lotion 0.5% (Ovide): Malathion is a prescription lotion applied to the hair and scalp. It’s important to note that malathion is flammable due to its high alcohol content, so it should be kept away from heat sources like hair dryers or cigarettes. Consult a healthcare provider before using if pregnant or breastfeeding, and it is generally not recommended for children under two years old.
- Topical Spinosad Suspension 0.9% (Natroba): Spinosad is a newer prescription treatment applied to dry hair and scalp for 10 minutes before rinsing. Often, a single treatment is enough, but it can be repeated after seven days if live lice are still present. Possible side effects include eye and skin redness or irritation. Spinosad is not recommended for children younger than four years old.
Body Lice Treatment
Getting rid of body lice requires a combination of personal hygiene and environmental control.
- Hygiene: Start by bathing thoroughly with soap and water.
- Topical Treatment: After bathing, apply permethrin 1% lotion (Nix) to the affected areas before bed and shower in the morning. Repeat this application nine days later.
- Environmental Control: Wash all clothing and bedding in hot, soapy water (at least 130°F or 54°C) and dry them on high heat for at least 20 minutes. Vacuum floors and furniture thoroughly. Items that cannot be washed should be sealed in airtight bags for two weeks to kill lice and nits.
Pubic Lice Treatment
Treatment for pubic lice is similar to head lice, utilizing both nonprescription and prescription options.
- Nonprescription and Prescription Treatments: Many of the same OTC and prescription treatments used for head lice are effective against pubic lice. Always follow package instructions carefully. For lice or nits on eyebrows or eyelashes, consult a healthcare provider for safe removal methods.
Self-Care Strategies for Lice Removal
Regardless of the chosen treatment method, self-care steps are critical to effectively get rid of lice and prevent re-infestation.
- Check and Treat Household Members: Examine all household members for lice and nits and treat anyone who shows signs of infestation to prevent re-infestation.
- Use Medicated Lotions and Shampoos: Follow the instructions on nonprescription or prescription lice treatments carefully, and repeat treatment as directed, usually around 9 to 10 days after the first application, to kill any newly hatched lice. Always check age recommendations before using these products on children.
- Wet Combing: Use a fine-toothed nit comb on wet hair to physically remove lice and nits. Repeat this process every 3 to 4 days for at least two weeks, even after using medicated treatments, to ensure all lice and nits are removed. This method is particularly recommended as a first-line treatment for infants under two months old.
- Wash Items Thoroughly: Wash all bedding, clothing, hats, and stuffed animals in hot, soapy water (at least 130°F or 54°C) and dry on high heat for at least 20 minutes to kill lice and nits.
- Seal Unwashable Items: For items that cannot be washed, seal them in airtight bags for two weeks. This deprives lice of a food source and ensures they die.
- Vacuum Regularly: Vacuum floors and furniture thoroughly to remove any stray lice or hairs with attached nits.
- Clean Combs and Brushes: Soak combs and brushes in very hot, soapy water (at least 130°F or 54°C) or rubbing alcohol for at least one hour to disinfect them.
It’s important to remember that household pets are not a concern in lice infestations, as lice prefer human hosts and do not typically infest pets.
Exploring Alternative Lice Remedies
While many home remedies are suggested for treating head lice, their effectiveness is not scientifically proven.
- Home Remedies: Substances like mayonnaise or olive oil are sometimes used to suffocate lice, but there is limited evidence to support their efficacy. These methods can also be messy and are not consistently reliable.
- Professional Hot Air Treatment: A more effective alternative treatment is a specialized machine that uses controlled hot air to dehydrate and kill lice and their eggs. This treatment is available at professional lice treatment centers and requires trained operators. It is different from using a regular hair dryer, which can be too hot and cause burns. The professional machine uses a cooler air temperature but with a much higher flow rate to dehydrate the lice effectively.
Preparing for a Doctor’s Appointment for Lice
In many cases, lice can be effectively treated at home with OTC remedies and diligent self-care. However, if these methods are unsuccessful, or if you have any concerns, consulting a healthcare provider is advisable.
What to Do Before Your Appointment
To make the most of your appointment, preparation is key:
- Symptom Journal: Write down all symptoms you are experiencing, even if they seem unrelated to lice, as this can provide a comprehensive picture for your healthcare provider.
- Exposure History: Note down when you might have been exposed to lice, who else might be affected, and what household items could be contaminated.
- Medication List: Prepare a list of all medications, vitamins, and supplements you are currently taking.
- Questions to Ask: Write down questions you have for your healthcare provider. Prioritize your questions to ensure you address the most important concerns first.
Questions to ask your doctor might include:
- What is the best treatment for lice in my specific situation?
- Are there generic alternatives to prescribed medications?
- How often and how safely can I use the recommended treatment?
- What is the best way to get rid of lice from my household items?
- Who else needs to be informed about this condition (e.g., school, daycare)?
- What steps should I take to prevent future infestations and avoid spreading lice to others?
- Are there any informational brochures or websites you recommend?
- Is a follow-up appointment necessary?
Don’t hesitate to ask additional questions during your appointment as they arise or if anything is unclear.
What to Expect During Your Doctor’s Visit
Your healthcare provider will likely ask you several questions to understand your situation better:
- When did your symptoms start?
- How do you think you were exposed to lice?
- Who else might have been exposed?
- How severe are your symptoms?
Self-Care in the Meantime
While waiting for or between doctor’s appointments, take these steps:
- Avoid Sharing Personal Items: Refrain from sharing personal items like hats, combs, brushes, bedding, towels, and clothing to prevent spreading lice.
- Continue Self-Care: Continue bathing regularly and following self-care measures, including washing potentially contaminated items in hot water.
- Avoid Sexual Activity (for Pubic Lice): If you suspect or know you have pubic lice, avoid sexual activity until you and your partners have been fully treated to prevent transmission.
By following these guidelines, you can effectively get rid of lice and prevent future infestations, restoring comfort and peace of mind.
