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How to Avoid the Nit Picking?

Any thoughts on treatment of head lice? We had a persistent case last summer. Our pediatrician recommended Rid. I followed the directions to the letter, but the lice seem to be resistant. Only manual removal of lice and nits worked. If this happens again, do you know of an easier method?

These tiny flat parasites are about the size of a sesame seed, and move from person to person through combs, hats, and personal contact. With kids back in school, this is likely to become a problem in your household. If you take a close look at the scalp with a magnifying glass, you can see little grayish-white eggs, or nits, attached to the hair shafts. You rarely see the adult lice themselves.

Preparations like Rid and Kwell work to kill lice, but they are definitely toxic to people, too. The conventional treatment is 1 percent lindane (sold as Kwell) in a shampoo, cream, or lotion applied once a day for two days. Then you can comb the eggs out of the hair, row by row, using a fine-toothed comb. Lotions made with 0.5 percent malathion can also work. But both of these can be irritating and are flammable. Lindane is a cousin of DDT, and can harm the nervous system.

Organisms resistant to these treatments are increasing, and recurrence is common. It may be that you were seeing reinfection, or that enough of the eggs survived to make a comeback. Sometimes it's necessary to go back at the nits after they hatch (in about 10 days). Also, you have to get rid of or properly clean all sources of the lice: combs, hats, clothing, rugs, even chair coverings (cleaning includes vacuuming, laundering, steam pressing, or dry cleaning).

The Food and Drug Administration recently approved a safer, more effective, and more pleasant product, which is 1 percent permethrin cream rinse. Sold over the counter as Nix, that would be one to look into. Permethrin is a synthetic pyrethrin, which is a natural insecticide that comes from a compound in a chrysanthemum relative. Or you can use a pyrethrin-based insecticide itself.

For a still safer treatment, I would consider Neem. Neem, derived from a tree in India, is sold in garden shops as a pesticide. You'll find it with organic gardening supplies in stores that carry them. Another treatment people have found helpful is an herbal recipe consisting of 2 ounces of vegetable oil, 20 drops of tea tree oil, and 10 drops each of the following essential oils: rosemary, lavendar, and lemon. Do a skin test on the inside of the elbow first, and wait several hours to make sure the strong oils don't irritate the skin. Leave the mixture on the infected head under a towel for an hour, then shampoo. You'll probably have to repeat this at least once to get rid of the next batch of hatched lice.

If you use any of these treatments, make sure your child's eyes are covered and that you apply the pesticide only to the head and neck.

Lice are awful for children because the itching is so severe. The easiest way to deal with the bugs is to avoid getting them, if at all possible (and sometimes it's difficult). Make sure your children don't share pillows, hats, combs, or hairbrushes with others. If there's an infestation at school, change the bedsheets often. Wash them in hot water and dry them in the dryer. Wash combs and brushes, and soak them in hot water for 10 minutes. Check your children for head lice at least once a week, looking for nits behind the ears and above the neck.

Lice have really made a major comeback in schools these days, so you have to stay on the lookout.


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