“How could this happen? I’m constantly cleaning!” This is a typical response I get when I tell a family their child has lice.

Cadiz Headshot

Oneith O. Cadiz, M.D., is assistant professor of clinical pediatrics at the University of Miami Health System.

Photo provided to the Miami Herald

It is a common misconception that head lice are a sign of poor hygiene. All children are potential targets of these tiny stubborn insects that live on people’s skin and in their hair, feeding on human blood and laying eggs or nits. Besides being vile creatures, they can cause itching or scalp irritation, but are otherwise relatively benign.

The first inclination is to run to the pharmacy to buy one of a number of medicated creams or liquid treatments, but over time head lice have gotten smart. We have been treating them with over-the-counter preparations for so long that most of the cases in South Florida are now resistant. Therefore, when these treatments don’t work, distressed parents rush their child to the doctor’s office for prescription lotions or pills also aimed at killing the live lice and preventing them from laying more eggs. However, there is also a viable solution that can be found in your kitchen pantry or bathroom cabinet. Recent research has studied the efficacy and safety of natural oils and over-the-counter emollients to smother these unwelcome pests.

With so many options, where should parents start? You’d be surprised to learn that the most effective management dates back to the time of ancient Egyptians. According to research, the only two 100 percent effective methods for treating lice are thorough wet combing and shaving the head. But don’t panic. Below are a suggested treatment regimen and some prevention tips when shaving the head just isn’t an option.


▪ Use a special fine-toothed comb to carefully comb out the eggs and lice from the hair. Wet the hair and add an emollient, such as hair conditioner or natural oils. The combing session should take 15 to 30 minutes, depending on how long and thick the hair is. Comb before and after topical treatments are applied and continue every three to four days for at least two weeks.

▪ Use a store-bought or prescription lotion on the hair that kills lice. Be sure to follow all directions on the label. These treatments often need to be repeated one to two weeks after the first treatment to kill any surviving lice.

▪ Studies have examined alternative methods of treating lice with oils and other materials (including olive oil, tea tree oil, mayonnaise and petroleum jelly) that are applied to the hair, and then allowed to dry, with the goal of suffocating lice.

▪ Wash clothes, bedding, and towels in hot water and dry them on the hottest setting.

▪ Boil combs, brushes and hair accessories.

▪ Vacuum carpets and furniture.

▪ Put items that cannot be washed into a sealed plastic bag for at least two weeks. The lice will not be able to feed and will eventually die.

▪ All of the adults and children in the home should be checked for lice and treated if necessary. It is important to find and treat lice quickly to avoid spreading them to others.

▪ If you can’t get rid of the lice by doing these things, see your doctor. He or she might prescribe a stronger lotion or a pill.


Some over-the-counter products claim to prevent lice. A few small studies have shown that “natural” ingredients in some of these products (plant oils such as rosemary, citronella, eucalyptus, tea tree and lemon grass) may work to repel lice, but there is no scientific evidence supporting the safety or true efficacy of these products. Therefore these “natural” repellants are not regulated and may have significant side effects for some children.

Lice cannot fly or jump. They are spread by direct person-to-person contact or by sharing clothes and personal items. To prevent the spread of lice:

▪ Avoid head-to-head contact with classmates during play and other activities.

▪ Do not share personal belongings such as hats, scarves, coats, combs, brushes, hair accessories and headphones.

▪ Avoid shared spaces where hats and clothing from more than one student are hung on a common hook or kept in a locker.

▪ According to the American Academy of Pediatrics, a healthy child should not be kept home from school because of lice. However, some schools have different policies.

If your child is affected by these miniscule beasts, stay calm. Although head lice can be unpleasant, they cause no serious or long-term health problems, and effective treatment options are available. Call your doctor before using any treatments on infants or during pregnancy or breastfeeding.

Oneith O. Cadiz, M.D., is assistant professor of clinical pediatrics at the University of Miami Health System.


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