1.   Check ALL family members for nits/lice.  Medicated lice shampoos and creams should only be used if lice/nits are found.

2.   Follow directions on a medicated lice shampoo/creams.  Consult your doctor if you have any questions regarding product safety, age appropriateness and pregnancy.   Although important, completing this step alone will almost assuredly guarantee that lice will return as many nits (eggs) are not killed by medicated lice shampoo/creams.

3.   Next, begin the nit comb out procedure by removing all hair tangles.  Using the tail of a rat-tail comb, section the hair into 4 quadrants as shown below.  Crisp part-lines are essential.   Clip or ponytail each section separately.  For easier combing, add several teaspoons of conditioner to a spray bottle of water.  Spray generously on the hair prior to combing and as needed to facilitate the passage of the lice comb through the hair.         

                                     

4.  Start with the bottom right quadrant (1) and comb out “around the world” in a clock wise fashion starting at the very edge of the part-line.  Comb around all of the outer edges of quadrant 1 in a circular “around the world” pattern. This will ensure you comb all hair surfaces.     

5.   Next, sub-section bottom right quadrant (1) into “lice comb width” sub-sections.  Use clips and ponytails to keep the sections divided.  Remember, crisp parts are the key!

          Left Lower    Right Lower   

                        

1. Go “around the world” on this “lice comb width” sub-section “a” ; wipe the comb on a white piece of tissue, paper towel, toilet paper or clean the comb by repeatedly tapping its teeth on the bottom of a white bowl filled with water.  (note: in water, eggs generally float and lice sink to the bottom). 
2. Continue going “around the world”, on the sub-section “a”, until you get no cream-tan-brown-black specks on a white piece of tissue, paper towel, or toilet paper or in the bowl of water. 
3. Go “around the world” one additional time.

1. If no cream-tan-brown-black specks, move on to the next “lice comb width” sub-section “b” in Quadrant 1.  
2. If cream-tan-brown-black specks are present, go “around the world” again.
3. Continue until you have 2 “around the worlds” that are clean (without specks).
4. Continue in the same manner until you complete all subsections c, d, e, f etc. in Quadrant 1.

Continuing Treatment Regime

DAYS 2, 3, 5, 6, 7, 9, 10, 12, 18

Repeat steps 3 and 4 above.  

Repeat step 5 above if lice and nits are found.

 

DAYS 4, 14, and 21

Repeat steps 3, 4, 9, 10 and 11 above.

Repeat step 5 above if lice and nits are found.

Days 8 

Repeat steps 1-10 above

Weekly after day 21

       Repeat steps 9 and 10 above

*****If done correctly, a thorough comb out will take at least 30-60 minutes on a person who does not have a close haircut.  The longer the hair, the longer the comb out.  Heavy infestations may take as long as 4-5 hours.*****

Additional Lice Care Steps

1.   Boil combs and brushes for 10 minutes.   Caution they will be hot.  Replace any combs and brushes that cannot withstand boiling.

2.   Wash soiled linens, sheets, and blankets.  Place in a hot dryer for 30 minutes.  Place clean bedding on beds before use.

3.   Any non-washable cloth items (stuffed animals/non-washable materials) should be placed in a sealed plastic bag for 4 days.

4.   Vacuum or lint roll all carpets, mattresses, car seats, car interior, fabric furniture, and throw pillows.

5.   Wash all jackets, sweaters, hats, and other clothing that have come in contact with infected persons in the last 2-3 days.

6.   Notify individuals that have had head-to-head contact with the infected person(s) ie) teammates, sleepovers, best friends, parties.

 

LICE FACTS:

• A parent should always be proactive and check their child’s head weekly while in school.   The average infestation has been in place for 4-6 weeks before being identified.  
• Many lice are becoming resistant to over-the-counter medicated shampoos.  
• Head lice can be very frustrating to deal with.  The key to their eradication is to remove the lice AND NITS, via combing, from EVERYONE in the home, the FIRST time they are found.  If you fail to do this step, they will inevitably return.   This is especially frustrating in shared custody situations.  Once gone from your home, using weekly dimethicone oil or olive oil treatments will effectively manage these situations.
• Lice shampoos alone will not eradicate lice due to medication resistance .  You must remove the nits.  
• Remember the hours of work you put into lice removal when first discovered, will save you days, weeks and months of lice work and frustration in the future!!!
• Head lice are only spread from prolonged direct, head-to-head (hair-to-hair) contact.   Friend selfies, sleepovers, sharing hats and helmets, bedtime story telling, snuggling and playtime hair-to-hair contact are common culprits.  Your child will not get head lice from sitting beside someone in the classroom unless there is hair-to-hair contact.  
• Head Lice do not live off a human host greater than 48 hours.
• Head Lice do not live on pets.
• Head lice do not jump, hop or fly.  They crawl from hair shaft to hair shaft using their front claws, much like a monkey swings vine to vine.  
• Head lice have no preference for clean or dirty hair.  They only care that it is a human host upon which to feed.  
• Nits cannot be brushed off a hair shaft.  They are glued and have to be picked or pulled from the hair shaft.

 

HELP, I did all these steps and we still have LICE!!!!  What is next!!!!!

 

Your next step should be to:

1.  Ask your school nurse for guidance and demonstrations.

2.  Talk with your doctor about other treatment options or consider seeking professional lice removal.

 

 

 

 Your Family Schedule to Lice Freedom!

Day 1	Thoroughly inspect the hair of all family members Apply medicated Shampoo/Cream for those with nits/lice Meticulously comb through child’s hair with a nit comb Apply Dimethicone/Olive Oil for all family members (with or without lice/nits) Clean Home
Day 2	Child returns to school Comb through child’s hair with a nit comb
Day 3	Comb through child’s hair with a nit comb
Day 4	Comb through child’s hair with a nit comb Apply Dimethicone/Olive Oil for at least 60 minutes
Day 5	Comb through child’s hair with a nit comb
Day 6	Comb through child’s hair with a nit comb
Day 7	Comb through child’s hair with a nit comb
Day 8	Thoroughly inspection the hair of all family members Apply Medicated Lice Shampoo/Cream for those with nits/lice Comb through child’s hair with a nit comb Apply Dimethicone/Olive Oil for all family members (with or without lice/nits)
Day 9	Comb through child’s hair with a nit comb
Day 10	Comb through child’s hair with a nit comb
Day 11	Comb through child’s hair with a nit comb May Stop daily comb out if no lice/nits are found.  Otherwise continue comb outs as scheduled below.     When in doubt, keep combing!
Day 12	Comb through child’s hair with a nit comb
Day 14	Comb through child’s hair with a nit comb Apply Dimethicone/Olive Oil for at least 60 minutes
Day 18	Comb through child’s hair with a nit comb
Day 21	Comb through child’s hair with a nit comb Apply Dimethicone/Olive Oil for at least 60 minutes
Weekly Thereafter	Head inspection Apply Dimethicone/Olive Oil as a preventative, if you choose