Lice will not
go away without proper treatment. Treatment should begin as soon as symptoms of
lice are noticed or when live lice and eggs (nits) are seen on the person's
body or in clothing. Specific treatment depends on the type of lice
- Head lice and
pubic lice are killed with
over-the-counter or prescription medicines applied to
the skin or scalp, and sometimes with a prescription pill. The
most common way to treat lice is to use medicated creams, lotions, or shampoos
that kill lice. Some people use a comb to
remove head lice and their eggs in addition to or instead of using medicine. In Britain, where lice have become
resistant to medicated lotions and shampoos, one study found that using
fine-toothed combs with a conditioner (wet-combing) helped get rid of head lice.1
- Body lice , which live and lay eggs in the seams of
clothing, are destroyed by washing clothing in hot water [130°F (54.4°C) or higher] for 5 minutes or
more. This will usually kill adult lice and prevent eggs from hatching. Body
lice are only present on the skin when they feed and will usually go away if you bathe daily and wear clean clothes.
Children with head lice can return to school or
day care after their first treatment. Some schools have a "no nits" policy in which the child can go back to school or day care only after eggs have
been removed. "No nits" policies are discouraged by medical experts. Most doctors agree that a child should be allowed to return
to class after proper treatment and should be urged to avoid close head-to-head
contact with other students. Confidentiality should be maintained so as not to
embarrass a child who has head lice.
Itching may continue even
after all lice are destroyed. This happens because of a lingering
allergic reaction to their bites. Over-the-counter
cortisone (corticosteroid) creams or calamine lotion may help.
For severe itching,
antihistamine medicines (such as Benadryl) or
stronger, prescription-strength corticosteroid creams may be needed. Don't give
antihistamines to your child unless you've checked with the doctor first. And
don't use cortisone cream for longer than 7 days without talking with your
doctor. Do not use the cream on children younger than age 2 unless your doctor
tells you to. And don't use it in the rectal or vaginal area in children
younger than age 12 unless you've checked with the doctor first.
What to think about
Who should be treated?
- Household members and anyone who has been
in close contact with a lice-infested person should be checked for signs of
lice. If they have itching and skin sores that are commonly seen with lice
infestations or if lice or eggs are found on their bodies, treatment is
- Anyone who has shared a bed with a person who has lice
should be treated, whether they have symptoms or not.
- If you still see live lice on a household member 7 to 10 days after he or she had the first treatment, it's best for that person to have a second treatment. Sometimes the first treatment doesn't work.
- People who have pubic lice are encouraged to tell their sex partners so that they can also be
treated. It is also a good idea to see a doctor to be tested for
sexually transmitted infections.
Treatment is not likely to work if:
- You don't use the medicine as directed.
- You stay in contact with other people who have lice but who did not get treated.
- Lice become resistant to the medicines and don't die. This occurs in some locations more than others. Talk to your doctor if you think a lice medicine isn't working as expected.
John Pope, MD - Pediatrics
Susan C. Kim, MD - Pediatrics
August 30, 2012
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