Lauren Ehrler

The Des Moines Register

As children head back to school, a study suggests that "super lice" have spread to at least 48 states.

But health officials say the news is no reason to panic.

Research published in a March edition of the Journal of Medical Entomology shows that head lice in a majority of states have grown resistant to the over-the-counter medications doctors often recommend to treat the irritating insects. Lice in Alaska and West Virginia weren't analyzed.

However, these lice aren't worse than your average louse, which survives by feeding on human blood, said Dr. Patricia Quinlisk, medical director for the Iowa Department of Health.

“These lice are no different than regular lice. They’ve just become resistant to some medications used to treat them," she said.

Drug-resistant super lice a peskier nit to pick

Quinlisk already is familiar with the so-called super lice. She said she's seen them in Iowa for decades.

So what can a parent do, other than nit pick by hand?

Step 1: Begin with over-the-counter medication

If your child contracts lice, over-the-counter topical treatments such shampoos containing permethrin and pyrethrin are the best course of action to start, Quinlisk said.

"Talk to your local physician or pharmacist," she said. "They usually have a good idea of what works from community to community" based on feedback from clients.

Step 2: Follow the regimen closely

When medications don't work initially, it is usually because parents aren't following the treatment correctly, Quinlisk said.

"You can find (a product) that works as long as you use it correctly," she said.

Super lice: What you need to know

Many parents don't realize that they have to treat the lice twice: First, kill the lice present with the insecticide shampoo. Then, nine days later, use the anti-lice shampoo again to kill any bugs that have hatched since the first wash.

In between, combining regular shampoo with conditioner and combing with a nit comb, a special fine-toothed comb that can remove the tiny lice eggs laid on the hair shaft close to the scalp, is imperative.

It's a 14-day treatment regimen in the brochure at the end of this story.

Step 3: Check into multiple products

If you've been diligent and your child still has lice, switch to a product with a different insecticide.

"Your lice might be resistant to Product A. That's when you try Product B," Quinlisk said. "I don't think I've ever heard of a lice resistant to every product on the market."

Hard to kill super lice are resistant to many chemicals

Over-the-counter topical treatments are the official public health recommendation.

If you still can't seem to get rid of the infestation, talk to a doctor about a prescription lotions. A prescription pill called Stromectal, which contains the same chemical that prevents heartworms in dogs, is available but has been shown to have side effects in some children.

Step 4: Take steps to prevent future infestations

If your children don't have lice now, teach them proper prevention.

“Teach your children not share hats, not to share combs," Quinlisk said. "You can play with your friends. Just don’t put your heads together.”

All lice move by crawling. They can't hop like fleas or fly like mosquitoes.

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If your child does get lice, don't keep the student home from school while treatment is ongoing, Quinlisk said. The bugs may make a child's head feel itchy, but head lice aren't dangerous and don't carry any diseases.

Humans can get three types of lice — head, body and pubic lice — but they're all different from one another and live on different areas of the body, according to the federal Centers for Disease Control and Prevention. Only body lice spread disease.

Follow Lauren Ehrler on Twitter: @lmehrler