The head louse is a very small insect (2-4 mm-long) and well-adapted to spending its life among the hairs on human scalps.

Sending your children off to the first day of school comes with plenty of concerns.  Will they enjoy their new teachers?  Will they make good friends?  But one concern often overlooked in the rush of the new school year is head lice.

Now the last thing anyone should stress over when it comes to schools is head lice.  But with a new school year, reports of head lice always go up.  And according to a new paper delivered at the American Chemical Society and reported this week in Smithsonian.com, this year’s head lice are running with a tougher crowd.

In the paper Texas is among 25 states shown to have head louse populations that are resistant to the most commonly used head louse shampoo treatments, including pyrethrins and the pyrethroid insecticide permethrin.  In fact, most states (104 out of 109 samples) tested so far have lice that are resistant to these over-the-counter (OTC) louse treatment options.

Researcher Kyong Sup Yoon, at Southern Illinois University-Edwardsville, is lead author of the study. He points out that “Just one louse that manages to survive a pyrethroid treatment can live for up to a month and lay five eggs a day. Multiply that by an elementary school, a community, and soon you’ve got plenty of resistant lice.”

Not to panic.

There are almost as many home remedies for head lice as there are worried moms; but even resistant lice can be successfully treated with OTC products with careful attention to head inspection and combing after treatment.  Using two methods (insecticide plus mechanical control in this instance) is almost always better than one method when it comes to controlling pests.

In addition, new treatment options are now available through your doctor.  These products include ivermectin (Sklice®), spinosad (Natroba™), and benzyl alcohol (Ulesfia®).  These products will likely be more expensive, you you might want to try the OTC route + combing first.  But it’s always good to have options.

I remember the battle I had with my daughter and head lice several years back.  It took three treatments and repeated sessions with the comb to exterminate the cunning creatures.  At least we didn’t have to resort to the barber shears.

So send those little people off to school with a smile.  Chances are they will have a great year.  But in case they come home some night with unwanted friends, be prepared.  For more information about head lice, see our free publication on human lice.  If you are a doctor or nurse looking for treatment options for head lice, check out this recent paper from the American Academy of Pediatrics on head lice guidance for the clinician.