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Head Lice Removal - Best Practices

How to Eliminate Lice:

Here are four basic steps you can work on to eliminate lice:

1. Stop the spread by eliminating all possible methods of transmission.

2. Kill the lice that are already living.

3. Remove the nits (unhatched lice eggs). Repeatedly.

4. Prevent reinfestation.

We will elaborate.

Step 1 - Stop the spread by eliminating methods of transmission.

An Explanation: Lice are transmitted by physical contact. They can live for a short time on hats, combs, sheets, furniture, and stuffed toys. Quarantine all of these items and handle them as follows.

  • Hats and sheets: Launder using hot water and a hot dryer cycle.
  • Combs: Hot water soak (over 130 degrees)
  • Toys: Place in a plastic bag, seal it (a trash bag works fine). Do not disturb for 14 days (lice and their eggs won't live that long).
  • Furniture: Use a spray and then cover with a sheet. Launder the sheet often.

Step 2 - Kill the lice that are already living.

Use an over the counter lice shampoo. We sell a bunch of them. Unless you have had trouble in the past with them, we recommend a pyrethrum or permethrin based shampoo. If you think you are dealing with lice that is resistant to these methods you can try one of the natural products. Either way, don't miss steps 3 and 4.

Step 3 - Remove the nits (nit picking).

This is the most important and sometimes most overlooked step. Lice lay eggs. Lice lay lots of eggs, up to 10 per day. These eggs last for about 1 week. If they are left behind to hatch, you will be reinfested and back to step #1.

Carefully (get a magnifying glass if you have to) go over every hair on your childs head with a (pardon the pun) fine toothed comb. Our favorite is the lice meister because it is by far the best one available. A plastic comb won't last through this grueling ordeal. Comb through every single hair and remove all of the nits (they are usually located within an inch of the scalp). The nits are very small and can be difficult to spot. Make sure you get them all. The process is easier if you wet your childs hair first. There are some products on the market that act as nit looseners. These make the nits easier to remove but you still have to comb and comb.

Repeat this nit-picking procedure daily (yes daily) for two weeks.

Step 4 - Prevent Reinfestation.

Make sure your child doesn't become reinfested. Start by explaining to them where the lice come from. Warn them not to swap hats or hair brushes with other children. If your childrens school nurse isn't aware of the situation let him or her know that your child had problems with lice. Inspect any of your other children repeatedly to ensure they don't experience the same problems. Lastly, keep picking those nits.

Good Luck.


Parents: September 2000, "Bug Off", Pg. 83-85.

Time: September 25, 2000, "The Nit Detector", pg. 104

Consumer Reports: February 1998, "Parents Scratching Their Heads", pg. 62-3

Time: January 12, 1998, "A Lousy Nitpicking Epidemic", pg. 73-4

Good Housekeeping: July, 1999, "Send Pests Packing", pg. 150

John Hopkins Family Health Book, 2000, Harper Collins, pg. 1305-6, 861, 1106, 1305