Lice | When to see a doctor

Head Lice treatment

April 26, 2022

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Do you need to see a doctor for lice?



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 oftentimes it can be cleared effectively on your own.  

Most cases I see as a Dermatologist are either treatment-resistant cases, cases that involve spread amongst numerous family members that result in difficulty getting ahead of it, or recurrent cases.



 



What is the treatment for lice?

 

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 use 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 on 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!

 

Do natural/home treatments work, or is medication necessary?



I believe that home remedies and treatments for lice 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?

 

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 summer camps and the beginning of the school year.  Lice are 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 (50 degrees C) with or without detergent OR drying for 40 minutes or sealing clothes or laundry off for 2 weeks can often help kill the lice in any clothing or linens.

  

 

Options to kill lice from fabrics

  • Machine wash with or without detergent at 50 degrees C.
  • Drying for 40 minutes.
  • Sealing for 2 weeks can often help kill the lice in any clothing or linens.













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