13. Tips and Tricks for Getting Rid of Head Lice

See video for verbal presentation on treating head lice:

One summer several years ago, my three long-haired daughters and I acquired a nasty case of head lice. For weeks I vigorously scratched my head, wondering if I might have lice, but my husband and coworkers (all of whom are doctors) didn’t see any nits. Eventually, when the infestation got bad enough, I noticed the nits myself–stuck to the gray roots of my hair–while looking in the mirror. Once the diagnosis was confirmed, our family got to work treating the infestation, but we seemed to be fighting a losing battle. Despite sterilizing hairbrushes and applying over-the-counter medications like Nix and Rid multiple times (not to mention expensive prescription medications such as Sklice), we couldn’t get rid of them. The nasty little buggers kept reappearing. I was ready to shave everyone’s head, which was starting to seem like the easiest option for definitively banishing lice. Then something miraculous happened. We spoke to a wise, long-haired auntie who once had lice in her household, and she shared a fantastic secret.

“The answer is olive oil,” she revealed. “It works every time.”

We followed her instructions, and lo and behold, no more lice!

What just happened, I wondered? Why did olive oil work, when everything else failed?

The biggest barrier to eradicating head lice is the eggs (nits), which are unaffected by most over-the-counter lice medications. Because Nix and Rid only kill hatched lice, but not the nits, eggs will survive treatment with these agents. Ever heard the term nit picking? To completely cure a case of head lice, a person would need to pick off every single nit from the hair, and there could be thousands of nits. Believe me, it’s nearly impossible to remove every nit from a child’s head, even with a good lice comb. Similar to Nix and Rid, the prescription medication Ulesfia does not kill nits. What about Sklice, another prescription medication? Though Sklice is marketed as being ovicidal, it doesn’t kill 100% of the eggs; some bugs can survive to perpetuate the life cycle. Other treatments, such as “shrink wrapping” the head with Cetaphil, may be more effective for killing eggs and hatched lice simultaneously (see below).

The variable lifecycle of head lice makes eradicating infestations challenging. Nits take about six to nine days to hatch and approximately seven days to mature into egg-laying adults. Notice I used the words “about” and “approximately.” Some nits hatch late, at eight days, and others become adults early, in six. This means that if you follow the instructions with OTC treatments and repeat an application of medication exactly seven days after the first treatment, some nits have yet to hatch and will survive the second treatment; whereas some adults will have laid eggs the day before you applied the medication. A week later those little buggers will be hatching. Because the life cycle of a louse isn’t exact, applying a pesticide and repeating it one time exactly seven days later won’t kill all of them. The only solution is to keep repeating treatments until the life cycle is 100% interrupted. However, it isn’t healthy to continually douse a child’s head with pesticide night after night.

Which brings us back to the wise auntie’s solution. Olive oil is a natural, non-toxic remedy that works by plugging the spiracles (air holes) of a louse. When the oil fills up the spiracles, the bugs suffocate and die. While some lice are currently resistant to the chemicals in Nix and Rid, none of them can survive olive oil. Though a bit messy, olive oil can safely be used once every four days for two to three weeks. By repeating the application frequently over time, the oil catches any lice that hatch late or mature early. Truth be told, lice can be cured with olive oil alone, a much less expensive endeavor than buying OTC medications or shelling out money for Sklice (Sklice was $40 a bottle with my insurance, which adds up quickly for four heads of hair!). Would mayonnaise or other oily substances work just as well? Maybe, but my family has yet to try these experiments. Hopefully we never will!

What is the best way to apply olive oil? Empty a used plastic condiment bottle with a long applicator tip (like mustard), and fill it with the cheapest brand of olive oil you can find at the supermarket. Before bedtime, have your kids lay on the floor with their heads over a thick towel. Coat their scalps in oil and work it through the hair. Upon completion, wrap their heads in Saran wrap, followed by a shower cap or thin towel. Be sure to wipe away excess oil from their foreheads to prevent it from dripping into the eyes (olive oil stings and temporarily blurs vision). Cover their pillows in towels to absorb excess oil, which unfortunately will stain bedsheets and clothes. In the morning, wash the oil out of the hair with a strong shampoo or dishwashing detergent. Repeat the process every four days for two to three weeks, and your family will be liberated from head lice, I promise. If you want to start with Nix, Rid, Ulesfia, or Sklice, and then follow up with olive oil, that’s fine; but disrupting the life cycle with continued olive oil applications is critical to avoiding a prolonged infestation.

If you like the idea of using a “natural” remedy for treating head lice, but you aren’t keen on applying olive oil repeatedly, Cetaphil Gentle Skin Cleanser can also be used to suffocate head lice.  In a nutshell, the cleanser is applied to the hair and a blow dryer is used to “shrink wrap” the lotion over the scalp at bedtime. Eight hours later, the lotion can be washed off the head. If done correctly, this method has a > 90% chance of eradicating head lice (see link below for detailed instructions).

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