Misery-free treatment of a child’s lice infestation

“Coercion is absolutely NOT necessary to treat a head lice infestation. It was not even true 30 years ago, in the days of the nasty nit comb and stinky skin-peeling shampoo.”
– Sarah Fitz-Claridge

Parents sometimes make mistaken negative assumptions like this:

“Obviously coercion was necessary when my children had head lice. No one likes using the shampoo and nit comb but it had to be done.”

Coercion is absolutely not necessary to treat a lice infestation. It was not even true 30 years ago, in the days of the nasty nit comb and stinky skin-peeling shampoo.

Remembering all too clearly my own experience of the school nurse scraping my head raw with a sharp nit comb that sheared my hair and painfully pulled hair out, and then the harsh chemical stinky shampoo that took yet more skin off, I would never dream of putting any child of mine through that trauma. (And nor would I leave a child suffering the infestation either!)

To avoid my children going through such misery, when my first child was very young, I took the time to find an extremely smooth, non-hair-shearing round-toothed nit comb, that we used to use regularly just to check. (It was a blue Boots one, but this was decades ago.) Using a nit comb only hurts if someone else is doing it. Even youngish children can learn how to comb their hair thoroughly. You can also add a drop or two of tea tree oil and lavender when rinsing hair after a wash, to try to discourage them. These days I would consult AIs for brilliant preventive measures and solutions. (See below.)

What makes the difference between lice treatment and nit combing being coercive or not at all coercive, is whether the child is in control of what is happening, or in effect being forced by the parent. Think about how you yourself would feel if your own bodily integrity were violated by someone with the strength to force you. That turns what could be a perfectly noncoercive treatment into a traumatic experience. We can do so much better than that!

When one family I knew had an infestation, their noncoercive solution involved copious amounts of mayonnaise and a lot of laughter and mess (and a nit comb) and vinegar.

Another family came up with a simple easy noncoercive solution when their child got lice. With a shaved head the daughter’s favourite dystopian sci-fi outfit would look particularly good, and she did not want lice in her hair, so she loved her parents’ suggestion of having her head shaved. A couple of weeks later the family went shooting, and the daughter was thrilled with the photos taken of her shooting. Her by then crew-cut-length hair made the photos look like movie stills.

In neither of the two cases of noncoercive lice treatments I mentioned did the parents even think of coercing the children, any more than I would appreciate someone taking it upon themselves to coerce me if I ever got lice again. Coercion only seems like the obvious/only answer if you already find it acceptable to treat people that way. Those who do not, find more creative solutions that do not involve any coercion.

As is so often the case in life, how you are viewing the situation can make all the difference in the world to your experience of it. The same is true for children. My friends’ shaved head solution reminds me of a brain tumour survivor I saw on television once, who instead of hiding her bald head and extreme surgical scar (I think she mentioned staples!), started dressing to make it part of her look, for a fun change in appearance (a very dramatic change for her). She told the story of how a stranger with piercings and tattoos had asked her, “Who did your head? It’s so rad.” And she had responded, “Oh, Dr [so-and-so]. Highly recommended.”

“My daughter would hate to have her long hair shaved off!”

Would she? Are you sure about that? Sometimes parents are more attached to the long hair than the child. Hair does grow back. Sometimes a dramatic change can be very interesting and fun, as in the above examples. Or maybe she would like to find a long hair wig to wear while it grows back? Or a hat? My niece has a long black hair wig she loves.

If, when you suggest shaving your daughter’s head, you are communicating through every pore of your being that she is going to find it a terrible trauma rather than an adventure or an interesting change or a fun experiment, then obviously she is going to believe you and hate the idea. (That applies to everything, not just head lice.) It all depends how you view these things. Bring fun and problem-solving curiosity and creativity to bear, not doom and gloom this is going to traumatise you for life. In cases of children not wanting their heads shaved, ask a doctor about Grok’s ideas below. Some of these modern treatments seem worlds ahead of what was available 30 years ago. Definitely no coercion ‘necessary’.

If your child is attached to her long hair (having very long hair myself I understand!), how about turning the shampoo/lotion treatment into a luxurious spa day for her, complete with candles and lovely scents and meditative spa music, and a special spa towelling robe. And while the anti-lice shampoo or lotion is doing its work, she gets a shoulder massage and a mani-pedi, and an enjoyable conversation about whatever interests her. Explore her ideas and opinions about things. The conversation has to be real, not fake, to be enjoyable. When I start asking children I meet their opinions about things, their whole being lights up. And so does mine! People are so fascinating, irrespective of age. The time you spend waiting for the head lice treatment to do its work might turn out to be a special time full of love and connection, in which you and your child have the most interesting, enjoyable conversation you have ever had, and you learn things about your child that amaze and inspire you.

Sometimes a bit of thinking ahead helps, like taking the time to keep looking until you find a smooth round-toothed nit comb instead of waiting until a child actually has nits and only then buying a nit comb, which turns out to be horribly sharp and hair shearing, but now you feel a sense of urgency to use it anyway, despite the pain and misery it causes. (Or indeed, your child is at the mercy of the school nurse, like I was.) If you think a child would hate to have their head shaved but might love a spa day, make sure you have everything you need for such a spa day before there is any need for it, don’t wait until the child has head lice to start trying to buy what you need for it.

Another thing you can do is to ask your doctor to prescribe any prescription-only treatment lotion or shampoo now, for you to have on hand just in case a child does get head lice. You can then do a patch test now, to check that your child is not allergic to it, so that there is no such delay needed if/when there are head lice to treat.

Better still, talk with your children now, about head lice, and about how to prevent them, about the treatments, and about what they each might like in the event that they were to get head lice themselves. You might be surprised by their ideas, and although of course what they want might change in the event that it actually happens to them (which would change how you proceed, obviously), you can at least be prepared with whatever knowledge you have.

If you live in America or another country in which there are ‘super lice’, I would also keep enough insect-killing smoke bombs to treat each room in your home twice, or know where to rent (and how to use) an ozone pump should the worst occur and you need to delouse your entire home in addition to your heads. Admittedly, I may be a bit paranoid about bugs.

Here follows some information Grok provided about head lice treatments. But do your own research and be sure to consult a medical doctor. Neither Grok nor I are doctors, so in no way rely on this:

Spinosad Topical Suspension (Natroba)
- Innovation: Derived from soil bacteria, this FDA-approved treatment kills both lice and eggs in a single application, often eliminating the need for nit combing.
- Success: Highly effective for children 6 months and older, with minimal retreatment needed due to its ovicidal properties.
- Child-Friendly: Apply to dry hair, rinse after 10 minutes.
- Pediatric Dermatology Insight: Safe for sensitive scalps, with low irritation risk.
Ivermectin Lotion (Sklice)
- Innovation: A single-application lotion that kills lice and prevents nymph survival, approved for ages 6 months and up.
- Success: Effective against resistant “super lice,” with no nit combing required, simplifying the process.
- Child-Friendly: Short application time (10 minutes) and no combing needed. A “quick fix”. No prescription needed in USA.
- Pediatric Dermatology Insight: Minimal skin irritation, ideal for children with sensitive skin.
Dimethicone-Based Treatments (e.g., Nyda, Hedrin)
- Innovation: Non-insecticidal silicone oil that suffocates lice by blocking their respiratory system, bypassing chemical resistance.
- Success: High efficacy (up to 97% lice mortality), safe for repeated use, and no risk of pesticide resistance.
- Child-Friendly: Apply like a conditioner, leave on for 8 hours (e.g., overnight), and rinse. Use a fun sleep cap to make it playful.
- Pediatric Dermatology Insight: Non-irritating, suitable for eczema-prone scalps.
Ozonated Olive Oil Lotion
- Innovation: A natural remedy using ozonated olive oil to suffocate lice, studied for efficacy in 2022.
- Success: Outperformed permethrin shampoo in a small trial, with fewer treatments needed. [It was quite a small study though.]
- Child-Friendly: Feels like a hair conditioner; make it a “spa day” with fun scents.
- Pediatric Dermatology Insight: Hydrates scalp, reducing dryness from traditional treatments.

Key Insights and Considerations

Pediatric Dermatology: Treatments like spinosad and dimethicone are favoured for their efficacy and low irritation, critical for children’s sensitive scalps. Always rinse pediculicides over a sink with warm water to limit skin exposure, and avoid overuse to prevent dryness or resistance.
Resistance Challenges: “Super lice” resistant to pyrethrins and permethrin necessitate newer treatments like ivermectin or dimethicone, especially in North America.
Safety: Always check product labels for age restrictions (e.g., malathion not for under 6; pyrethrins not for chrysanthemum allergies). Consult a medical doctor.

See also:

Sarah Fitz-Claridge, 2025, Taking Children Seriously FAQ: ‘Misery-free treatment of a child’s lice infestation’, https://takingchildrenseriously.com/misery-free-treatment-of-a-childs-lice-infestation