5 Reasons Your Kids Keep Getting Head Lice

The Basics All Parents Should Know

Young boy scratching head
Don't panic when your kids have lice. Instead, treat your kids with a lice shampoo, comb out nits with a head lice comb, and clean any recently used clothing and bedding. Elysee Shen/Getty Images

Although we keep hearing stories about mutant head lice, resistant head lice, or uncontrollable head lice, it is important to remember that head lice "have been companions of the human species since antiquity."

It is perhaps even more important to keep in mind that although they cause "a high level of anxiety among parents of school-aged children," head lice infestations are benign and are "associated with limited morbidity."

So don't get panicked over lice. Even if your kids have had them multiple times, you can safely get rid of them and keep them away.

Still, it is a frustrating problem to deal with.

Here are five reasons why your kids might be getting head lice over and over again.

Don't Ask, Don't Tell Head Lice Policies

When my own daughter had lice, the first thing I did after treating her was to email her school nurse and let her know. Although school-wide head lice screening programs aren't usually effective, it might be helpful if the school is aware of an outbreak in a particular classroom. That might prompt them to check other students in the class, or at least check those students who are most likely to have had direct head-to-head contact with the child that has head lice. This could be especially important if there are multiple reports from the same classroom.

Too often, though, parents get stressed out when a child is found to have live lice or nits.

Believing that it is a sign of poor hygiene or neglect (it isn't), they often do their best to treat the lice and don't tell anyone. Or they visit their pediatrician after the third or fourth episode and don't know why their lice treatments haven't been working.

Your child got lice from someone else.

Unfortunately, if that person isn't treated properly, then there is a good chance that your child will get lice again.

Since it isn't always easy to notice a head lice infestation at first, a child might have them for weeks or months before he or she is treated, spreading them to others.

If you are still embarrassed, even understanding that lice infestations occur among all social classes, rich and poor, just say that you heard that lice was going around and urge parents to check their kids.

Too Much Sharing

Teaching your kids to share is good, but it can go too far.

Sharing your germs, whether in the form of a virus, bacteria, parasite, or insect, like head lice, is definitely a sign of oversharing.

But while it is easy to tell kids to wash their hands and cover their coughs to avoid spreading cold and flu bugs, how do they keep from getting and spreading lice?

To understand how to prevent head lice infestations, you should first understand that:

  • lice move around by crawling—they can't jump, hop, or fly
  • lice will quickly die if they wander off of our scalp, perhaps surviving up to a or two day at most, as they need to frequently feed
  • nits, their eggs, are firmly attached to our hairs and need to be fairly close to our scalp to hatch

Knowing all of that about lice, it should now be obvious that it actually isn't that easy to get lice.

While we often blame sharing hats, combs, brushes, helmets, and even headphones, etc., for spreading lice, it is likely that direct head-to-head contact is the usual method by which they spread.

It is probably a good idea to avoid sharing these items, in addition to not throwing hats and jackets in a pile at recess or after school and avoiding the use of a community hat or costume box in the classroom, etc.

Still, there have been studies that:

  • did not find any lice on hats of kids with active lice infestations
  • did not find any association between sharing combs and brushes and getting lice
  • did not find any association between sharing wall hooks or lockers and getting lice
  • did not find lice or nits on the floor of schools

So instead of focusing on sharing, teaching younger kids to try and avoid direct head-to-head (hair-to-hair) contact, especially if head lice are a problem in their school or community, might be a better way to avoid lice.

Their Friends Do Have Cooties

Where do kids get head lice?

Parents typically blame other kids at school when their kids get lice, but some lice experts think that kids are more likely to get lice from:

  • friends at sleepovers and slumber parties
  • teammates at sports activities
  • at overnight camps
  • family members at home

As we very often see lice outbreaks occur among students at multiple schools in a community, it makes sense that they are getting and spreading them outside of school.

With that in mind, it also makes sense to be sure to check your child's head for lice before and after sending your child to a sleepover, camp, or practice, etc.

Ignoring Head Lice Symptoms

Although head lice don't cause any diseases, having lice can cause symptoms.

Identifying head lice symptoms as quickly as possible can help to get a child treated early and help prevent spreading the lice to others.

Of course, the most common symptoms of head lice is itching. Surprisingly, the itch isn't caused by the lice biting and feeding but is instead an allergic reaction to their saliva. Unfortunately, it can take up to four to six weeks for this reaction to develop, which can mean that your child has had and has been spreading lice for quite a while already.

Other signs and symptoms can include sores from scratching, finding nits (lice eggs) on your child's hair, and actually seeing live lice crawling around. Lice are quick, though, so even if your child has a significant infestation, it can take a while to spot a live louse.

The take home message though is that you shouldn't ignore head lice symptoms. Don't dismiss itching as a sign of a dry scalp without giving your child's head a thorough check.

On the other hand, lice is often misdiagnosed when parents find hair casts, dandruff, and nits that are more than a quarter inch away from the scalp and no live lice (not an active infestation), etc. Without seeing live lice, your child typically shouldn't be diagnosed and treated for lice.

Misinformation About Head Lice

Myths and misinformation may be helping your kids get head lice over and over again, too, and definitely help keep stress levels up.

This misinformation might include that:

  • kids with short hair are less likely to get head lice (they aren't)
  • special shampoos and conditioners can keep your kids from getting head lice (they don't)
  • nits are always a sign that your child has an active head lice infestation (they aren't)
  • no-nit policies help keep lice out of schools (they don't)
  • home remedies can prevent and treat lice (there is no evidence that they do)
  • it is easy to manually remove live lice to treat an infestation (it can be done, but since the average child has at least 10 lice scurrying around, it certainly isn't easy)
  • you have to remove all of the nits (you don't necessarily since the recommended retreatment in nine days should kill hatching nits, but removing nits does make it easier to spot new nits and to know the infestation is truly gone)
  • you should call your pediatrician for a prescription lice treatment (you should use OTC lice medications, like Rid or Nix first, but only when you are sure your child has an active lice infestation and not just nits)

Even the traditional advice that you have to disinfect your whole house after someone has lice isn't really true. In fact, one study only found live lice on 4 percent of pillowcases of people with active lice infestations.

Instead of spending lots of extra time cleaning your entire house, you can simply clean the things that your child's head likely had contact with, including clothing, sheets, hats, brushes, and pillow cases, etc. You should also vacuum carpeting, rugs, and furniture that your child had recently (within the last 48 hours) sat or lain on.

Getting lice is a routine childhood problem. Panicking about them shouldn't be. And even if your child has a case that is hard to get rid of, your pediatrician can help with treatment advice, including a prescription for a newer lice medication, such as Ovide, Ulesfia, Natroba, or Sklice.

Sources:

American Academy of Pediatrics Clinical Report on Head Lice. Pediatrics Vol. 135 No. 5 May 1, 2015. pp. e1355-e1365.

Burkhart CN. The route of head lice transmission needs enlightenment for proper epidemiologic evaluations. Int J Dermatol. 39: 878±879.

Speare R. Hard data needed on head lice transmission. Int J Dermatol. 2000 Nov;39(11):877-8.

Speare R. Head lice are not found on floors in primary school classrooms, Aust N Z J Public Health. 2002;26(3):208-11.

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