Dermatology • Mar 14, 2015

Mutant Bugs: The new LICE

It’s back to school time! Excitement and anxiety are common emotions for children and parents alike. But the reasons for these emotions are very different between us and our kids. Experienced parents often fear the large masses of children hugging, sharing lunch items, sharing bathrooms, coughing and, well, just sharing germs, viruses, bacteria, and of course everyone’s creepy favorite: lice.

Has your child had lice? You aren’t alone. It is the second most commonly transmitted infection among school children. Only the common cold gets passed around more than these little buggers. Your head probably just got a little itchy reading that…

“Head lice,” “Pediculus humanus capitis,” “the head louse” are all names for a specific human loving parasite found throughout the world and in all economic groups. Lice infestation is diagnosed by visual inspection of the hair for live insects and their eggs. Lice are irritating, but they are not dangerous.

In recent days, these age-old creatures have become newsworthy once again as yet another research study has detected increased resistance to some of the most popular anti-lice treatments. Treatments such as Nix and Rid utilize a chemical called Permethrin. Pyrethrin is another similar chemical also found in over the counter treatments. These OTC treatments have been used for many years and have good safety profiles for ages down to two months. They are cheap and easily accessible at most pharmacies. But in ways similar to how bacteria become resistant to antibiotics, lice can inherit resistance to Permethrin and other chemicals over time.

Is this really front page material? Well, no, probably not. Butterflies and lightening bugs aside, most Americans really don’t like bugs in their home, on their skin, on their kids’ skin, or pretty much anywhere ever. So, tell me that I may get these terrible lice and you may not be able to kill them, I will watch your news in fear that mutant lice are taking over the world.

They aren’t. Really, they aren’t. Again, they are annoying, not dangerous. Resistant lice are not different in any other way from any other boring head lice.

So now what? Permethrin and similar treatments remain the 1st line choice along with combing techniques which mechanically remove these bugs from the hair. Experts recommend repeating the treatment at 7-10 days. The second treatment greatly increases the chance that you got them all.

What else do you have to do? Re-infestation is common either from friends or household contacts.

  • Treat all bedmates even if you haven’t seen any sign of infestation, and examine everyone in your house for signs of lice.
  • Treat all affected people on the same day if possible.
  • Wash all linens towels etc in hot water or dry in a hot dryer.  
  • Vacuum soft furniture used by affected individuals.
  • Since lice can only live for ~1-2 days off the scalp, sealing any stuffed toys, special pillows, etc. in a plastic bag for 48 hours should prevent any lice from escaping and causing problems.

If you have done all of these things and you still can’t get these bugs out of your house or classroom you may have encountered resistant lice. In this case your pediatrician can prescribe one of a handful of prescription medications still known to be effective in combating the lice. Before running to your doctor though, try the simple over-the-counter method. You will likely save time, co-pays, prescription fees, and still be successful.

Can’t stand the thought of getting anywhere near these tiny foes? You can find a nit picking or lice eradication service in your area. They will often come to your home and do the dirty work and combing for you. They aren’t cheap, but if you really need someone to help, assistance is available at a price.

Lice happen like life happens. You aren’t a bad parent and you don’t have dirty kids. It just is what it is. Annoying.