• Dharma Nemani

Meet my mom friend: Jessica Nemani, pediatrician



Jess is my SIL and yes, I message her a couple of times a month asking about a random rash, fever, my cough, cold, headache, among a wide array of other ailments. You know how it is when you have a Doc in the fam. We’re so grateful to have her medical expertise a quick call away so who better to answer all my pressing lice-related questions. Thank you, Jess! 😘


So you find out someone in your kid's school has lice. What are your immediate next steps?

You can check for head lice or nits by parting the hair in several spots. You can use a magnifying glass and a bright light to help spot them. Because head lice can move fast it may be easier to spot the nits. Nits can look like dandruff, but you can identify them by picking up a strand of hair close to the scalp and pulling your fingernail across the area where you suspect a nit. Dandruff will come off easily, but nits will stay firmly attached to the hair.

Editor’s note: I just threw up a little.


Hair lice versus nits: Is one stage better than the other?

If just transmitted, the first thing you’d see are adult lice. Later stages you’ll see nits. As time continues, itching worsens and you’ll see both nits and adult lice. Nits like to congregate on the hair at the scalp, especially where the head meets the neck. Nits are not viable unless next to the scalp. The ones stuck to the hair more than 1/4 inch away from the scalp are empty casings or will eventually die. Eggs are stuck to the hair and are not transmitted to other people, only the crawling lice can be transmitted.


Should your kid NOT have lice / nits, what should you do?

Lice is only spread through direct hair to hair contact. Lice do not jump like fleas. Less commonly lice can be spread from clothing or hats/helmets. It is advised not to share beds or clothing with those known to have lice until treatment is completed.


Should your kid HAVE lice / nits, what should be done? I’ve heard of soaking your hair in neem oil or mayonnaise?

If you definitely find lice, you can call your pediatrician or treat yourself.


Gels, oils, etc are used with hopes of suffocating the lice. This in theory would work but lice last a long time and would need complete suffocation for likely longer than just applying overnight. Worth a first go though if you want to avoid pesticides!

First, the lice need to be killed as soon as possible. Usually, if done correctly, the child is no longer contagious effective immediately as the crawling lice are killed. Sometimes, nits remain but those are not contagious until hatched and so can be further wiped out at the next treatment a week or two later.


Options for treatment:

- There are over the counter (OTC) creams/shampoos that can be applied overnight then combed through the hair using a nit comb found at pharmacies (or flea combs work). However, with the misdiagnosis of lice and overuse of these creams, many states now have lice that are entirely resistant to all OTC creams. The creams are insecticides, and so unfortunately not a "natural" remedy, and over applying is not recommended.


- Some creams are prescription only. Some of these are safer and shown to be more effective, but can be pricey.


- All of these require combing out the lice, which, in the end is likely what is most effective in eliminating the lice. That said, for those who want a completely natural remedy without any medications can simply try wet combing. This how to do it:

--- Coat your child’s hair and scalp with conditioner or a safe lubricant such as olive oil. Use a wide-tooth comb to separate hair into sections.

--- Follow with a metal nit or flea comb, concentrating on the area close to the scalp. After each comb-through, wipe the comb on a paper towel and inspect for lice.

--- Continue combing until no lice are found; a single session can take 15 to 60 minutes, depending on the length and thickness of hair.

--- Repeat every three to four days for several weeks.


Becoming more popular now are "Lice Clinics". you can go to their office, some are mobile and will come to your house, and they spend the hours combing all the lice and applying organic products to the hair. They have a guarantee of eliminating the lice in just a couple hours and will check the whole family and treat as needed. Though these clinics save you a lot of time and energy- especially if you have multiple kids to comb-they can be expensive and usually not covered by insurance.


Anything parents can do to proactively prevent hair lice?

Actually, lice prefer clean hair over “dirty” hair. I’m not proposing parents not wash their children to prevent lice, but do want to make the point that personal hygiene or overall household cleanliness does not determine who does or does not get head lice.

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