‘Super’ Lice Are Coming for Your Kids

Hold onto your scalps, America. Super lice are upon us.

The time for panic is not yet at hand, however. Planning for mass head-shavings or the wearing of plutonium hats is probably premature.

As has been widely reported recently, a study from Southern Illinois University in Edwardsville (SIUE) found that lice in over 25 states have become resistant to the active ingredient in most over-the-counter treatments. These hardy specimens can survive treatment with chemicals called pyrethroids, which is found in commonly used products like Nix and Rid.

Super lice are just regular lice, but harder to kill. Studies have yet to detect any with uncanny strength or the ability to manipulate the weather. You can put down the clippers.

The study, which was published last year in the Journal of Medical Entomology, was funded by a subsidiary of Sanofi, a pharmaceutical company that manufactures a prescription lice treatment. Any time a drug company underwrites a study that indicates a need for its products, it should make readers somewhat more skeptical of the findings.

However, in this case I have little suspicion that the findings aren’t true. (In case it needs saying, I have never taken a dime from Sanofi, nor any other pharmaceutical company for that matter.) Drug-resistant lice have been a growing problem for years, and my patients complain to me about it all the time.

When parents call me at their wit’s end after continuing to find lice despite repeated applications of over-the-counter products, I give them several pieces of advice. First of all, it’s important to make sure you’re using the product correctly, as even bugs that are still susceptible to treatment can survive if they’re not exposed to the chemical long enough. A second treatment is often needed to kill nits, which are the tiny white eggs lice leave attached to hair shafts close to the scalp.

Nits themselves can be a problem for children, even if they’ve been appropriately treated. School nurses appear to have a superpower of their own and seem able to spot them across crowded playgrounds, and many schools have “no nit” policies that forbid children from returning if any remain in the hair, even though complete removal of nits is not necessary for treatment of lice and the American Academy of Pediatrics recommends against them. There’s a reason “nitpicking” has become synonymous with punctilious attention to tiny details, as the process of removing the little devils (either with a special comb or by hand) can be very time-consuming and tedious. Some people offer the service professionally, and I’ve recommended local providers when parents can no longer stand the thought of staring at the back of their kid’s head for another minute.

In situations when parents swear they have used and re-used over-the-counter treatments with scrupulous attention to the directions and still the lice persist, my next recommendation is to apply the skin cleanser Cetaphil to the hair and blow it dry. The instructions for doing it properly must be followed to the letter, but if done correctly it coats the pests and suffocates them. In my experience it is highly effective, and I rarely need to resort to other methods.

What is not necessary is a frenzy of cleaning and bagging everything. Lice can survive for no more than a day or two at most off the body, so a bonfire of all your linens is not required. Recently used sheets should be washed and machine-dried, and personal items like coats that can’t be washed can be bagged for two weeks, which is long enough for any nits that might happen to be attached to die.

I can count on one hand the number of times I’ve actually had to prescribe medication for lice treatment, but there are a few options should all alternatives fail. If, as the SIUE indicates, resistance to over-the-counter treatments is on the rise, I may find my rates of prescribing increasing a bit, though I’ll stick with the Cetaphil treatment as my first line of attack.

But annoying as lice may be, even the super variety is pretty run of the mill and won’t do any lasting harm. Nobody needs to invest in kryptonite shampoo.