By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

DOCTOR MAY HELP WITH DAUGHTER’S HEAD LICE; DON’T WORRY ABOUT DOG

Question: My daughter came home from camp with head lice. I have treated her once and now she has them again. What can I do to keep her from getting them a third time? Also, I am concerned that our dog may get them as well.

Answer: Head lice are quite common, particularly among school-aged children and other groups where there is frequent physical contact. Your daughter’s situation sounds typical. She and her camping buddies probably slept close to each other in a tent or cabin, and in waking hours they likely engaged in activities like arm wrestling, pillow fighting, etc., that involve close physical contact. They also might have shared items such as hats, combs, brushes and barrettes.

Next, let me give you some general information on head lice before I answer your questions more directly. Adult lice are visible as very small specks or dots on the scalp. In fact, they are so small that you’ll probably find using a magnifying glass makes them easier to see. These tiny insects bite the scalp to feed. This produces local skin irritation that is usually noticed as itching, red areas rather than as pain.

In addition to biting, the adult lice lay eggs, called nits, which are attached to hair shafts. The nits take about one month to hatch and another two to three weeks to mature into adults. These new adults then continue their life cycle on that individual, or they may be spread to someone else.

Now, with that background, let me answer your question more directly. It can be difficult to tell if your child has lice a second time or if the first treatment didn’t eradicate the lice completely. Not only does the hair and scalp need to be treated when someone has head lice, the clothing and living area must be cleaned as well. Other family members need to be checked for lice and treated if they have it.

When the infested person is treated, you need to wash the clothing they have worn for the previous 48 hours as well the bed linens. When clothing and bedding are washed, it needs to be in hot water and dried in the drier at high heat as well. Clothing that is not washable, should be sent out to the dry cleaners. Stuffed animals and things that can’t be washed or dry cleaned should be sealed in an air tight bag for two weeks to kill all of the lice. Be sure to clean all of the combs and brushes in rubbing alcohol. Overstuffed furniture and carpeting should be vacuumed.

There are several things that can lead to treatment failure. Many people wash the hair with regular shampoo too soon after treatment. You should not re-shampoo the hair for at least two days after the treatment. This will give it time to work. Also, if you don’t use enough of the medicated shampoo, you will get a treatment failure.

Another problem that some people have is that they don’t do an adequate job of combing out the nits. The common over-the-counter medicated shampoo, Rid, only kills the live lice, and the eggs (nits) have to be combed out. Nix, also available without a prescription, does kill nits.

Finally, there are lice that have become resistant to the common treatments. If that is the case, you’ll need to consult your doctor. He or she may prescribe different lice-killing medications and possibly oral antibiotics. As for the dog, they don’t get head lice, so they can’t get it or give it to you.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.