With fall here, kids are firmly entrenched in their school work, putting their heads together over their assignments and projects—literally. And while this may be good for sharing ideas, sometimes kids share more than just their creativity. Head lice outbreaks typically occur as kids transmit the pests through close contact.

“It is difficult to completely get rid of head lice because when children are exposed for the first time, they often don’t have any itching for the first two to six weeks, leaving a lot of time for lice to spread before parents are able to treat them,” says Dr. Kara Mayes of Mercy Clinic Family Medicine.

“Lice cannot jump or fly, they only crawl. They are usually transmitted by close contact with the head of an infested individual,” Mayes notes, adding, “Hair length or frequency of hair brushing does not make a difference in lice prevention. Children should be taught not to share combs, brushes and hats.”

Making the situation even more difficult is the fact that some lice have developed resistance to the pesticides and medications used to eradicate them, adds Dr. Jennifer Foersterling of SSM Medical Group Pediatrics. Although she agrees that sharing personal items should be discouraged, “direct head-to-head contact is the most common source. Watch your children hug each friend they meet and this will become more evident.”

If a child complains of an itchy scalp, parents should look for the pests, which are about the size and shape of sesame seeds. They are most visible behind the ears and at the nape of the neck. Nits, the unhatched eggs laid by adult lice, adhere to the hair shaft and look like tiny yellow or white spots.

“If parents see live lice on their child’s head, they can treat with over-the-counter lice treatments. The one that is recommended to try first is permethrin (Nix),” Mayes says. “Parents should follow all of the directions on the package and repeat the treatment in seven to 10 days if live lice are still seen.”

Foersterling adds that parents should contact their child's physician if the treatment does not seem to eradicate the infestation. “Remember that the parent must use the comb with the kit to remove all nits. It is also important to wash bedding on hot, vacuum upholstered furniture, wash coats, combs and brushes, and check all family members for infestation.”

Most important, both Mayes and Foersterling remind parents that lice are not a sign of poor family hygiene. “Do not panic,” Foersterling says. “Lice are a nuisance; they are not a health threat, and there is likely nothing you could have done to prevent the infestation.” 

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