Fort Worth, Texas,
09:30 PM

4 Ways To Fight Against Super Lice

Doc Smitty’s plan for treating bugs resistant to most over-the-counter treatments.

Thanks to Senate Bill 1566, you will now know if someone in your child’s classroom has head lice.

The bill requires school nurses to notify parents within 48 hours if their child or a classmate has been identified to have head lice.

Along with then notice, you will receive recommendations from the Centers for Disease Control and Prevention on recommendations to treat and prevent head lice.

Easy enough, right? I guess this blog is over.

But wait. What’s that?

Look in your child’s hair. It’s a bird. It’s a plane. No, it’s SUPER LICE!

These bugs are especially annoying because they can't be killed by most over-the-counter treatments.

Every year we see news reports about the super lice being more resistant to traditional treatments and it always leaves me scratching my head (sorry). Not just because it sounds super gross, but because we have known about this for a while and we can take care of it.

A study released by the American Chemical Society meeting had news sites buzzing with information about lice that are developing resistance to the most commonly used treatment for lice.

Fortunately, this doesn’t mean these lice are faster than a speeding bullet, more powerful than a locomotive or able to leap across large classrooms in a single bound. Remember, lice can’t even jump.

The study looked at genetic mutations found in the lice that make them resistant to permethrin, the most common over-the-counter medication for lice. This isn’t exactly news, reports of lice resistance to permethrin have been around since the 1990s. This is just the first time that investigators have looked at large samples of lice from across the country. The researchers found these mutations in lice from 30 states, including Texas.

In my recent experience, I have recommended head lice treatment for at least 10 children in the last two months and have not had to change to a stronger treatment. The AAP has recommended that parents in high resistance areas call their pediatrician for stronger treatments, but I think we are too early to determine if we are in a high resistance area at this point.

How do we treat these “super lice?”

Here is my 4-step kryptonite:

1.Start treatment immediately after your discover lice.

2.Follow the directions closely (the length of time the product is to stay on, nit-combing and a follow-up dose).

3.Have a professional reassess soon after treatment.

4.Call your doctor if active lice remain. If it is the super lice strain this is most likely the route you will have to go. Remember, we said that over-the-counter products won't be able to stop super lice. But your friendly neighborhood pediatrician can. Just doing our job folks.

Get to know Justin Smith, M.D.

Justin Smith, M.D., is a pediatrician in Trophy Club  and the Medical Advisor for Digital Health for Cook Children's in Fort Worth, Texas. He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles. Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” open now. Click to learn more. To make an appointment, call 817-347-8100.

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