This is a great question because of just how common lice can be. The vast majority of cases of lice are likely managed by school nurses or pediatricians simply because of the way it is usually diagnosed. Many times it is caught during lice checks or because someone in their class or friend group has it.
There are so many over the counter remedies for it that often times it can be cleared effectively on your own. Most cases I see are either treatment resistant cases, cases that involve spread amongst numerous family member that results in difficulty getting ahead of it, or recurrent cases. Over the counter there are shampoos that contain Pyrethrum. This tends to kill the ‘live’ lice but not the nits or unhatched eggs. It will likely be necessary to repeat treatment in 10 to 14 days to ensure that any lice from eggs that hatch are treated before they have a chance to lay eggs again. There are also topical lotions that contain Permethrin or Benzyl Alcohol that work the same way. There are a number of home remedies that focus on ’suffocating’ the lice. Petroleum jelly, olive oil, mayonnaise. These are safe to do and need to be repeated in a week. Some sources recommend blow drying hair to help kill the lice through heat. This is safe and reasonable to try with one big precaution. High heat to hair if tried should be done alone and not when the other lice treatments are in the scalp. Many of these lice treatments are highly flammable and applying a heat source can pose a high risk. If you are struggling to control it, we do have a number of prescription options that are focused on just treating both the active or live lice AND their eggs. This can have a higher chance of being more definitive as it breaks the life cycle of the lice quickly!
I strongly believe that home remedies and treatments must work because lice is relatively common and yet it doesn’t consume my practice! I definitely find there are clearly times of the year when I see a surge in cases however many over the counter and home remedies work well.
How can lice be prevented? I just mentioned the other day that one of the times of year I tend to see a spike in lice cases is towards the end of the summer and early in the school year. Many are linked to camps and the beginning of the school year. However, the precautions we are taking for COVID should not only prevent COVID but also lice! Lice is spread through direct contact. Hair to hair contact sharing pillows and brushes, hats and hair clips, etc are the key ways to spread the lice. Machine washing in hot water or sealing clothes or laundry off for 2 weeks can often help kill the lice in any clothing or linens.