How to Treat Head Lice in China

Not too long ago, my friend (we’ll call her Mindy) discovered that her youngest child had head lice. If he had it, his brother had it too, and she probably did as well. I — I mean my friend, of course — had never had head lice before, and started down the research tunnel immediately. Here is what Mindy learned from friends, her husband’s rational research, and her own freaked out internet searches.

Set aside time to sit and comb through their hair. Thoroughly. Mindy did this two to three times a day depending on her work schedule. What a fun way to spend a lunch break…
There are lots of conflicting ideas on what works. Suffocate the lice with conditioner and head wraps. Wash everything at high temperatures. No, it’s actually about the drying cycle. As with anything parenting-related, do all your research and then figure out what works with your own methodologies.
You can’t get lice treatment quickly in China. We get into that more below, but your best bet is to ask a friend if they have any left while you order some from Taobao. If you have a friend who works at an embassy, any embassy, you will have more luck than my friend Mindy did. For reference, the Taobao order arrived four weeks after being placed.
It sucks to tell your school, but if you have younger kids, do it. Within 24 hours, our — I mean, Mindy’s — school had checked all the appropriate classrooms, emailed the entire school on the update, and said that three to four days after starting treatment, they could arrange for the school nurses to check the children’s hair and see if they could start school again. This was good: Mindy likes gameplans.
Nits can’t jump from animals to humans. This is the second question most people ask, and it simply isn’t possible. Yay.
There’s nothing to do but hunker down and get ready to comb. Mindy found it astonishing how not gross it was to comb through your kids’ hair and pick out eggs and bugs who were sucking the blood from their scalp once you approached it as a triumph for every nit picked. Mindy is a good nitpicker when it comes to editing, so why not her kids’ hair?

Mindy was also astonished at every pharmacy’s blank look when she asked if they have head lice or nit treatment. “Do you have to shave their heads?” is something she heard once a day. So we asked our friend at Beijing United Family Hospital to shed some light on the mysteries of head lice in Beijing, and China as a whole.

Here is Dr. Charlotte Zhang from BJU about her expertise on the subject.

Is head lice common in Beijing?

Dr. Charlotte Zhang (CZ): No, it is uncommon in Beijing, but occasionally are occasional breakouts in some schools.

If a child was found to have nits or head lice, what would your doctors prescribe or suggest?

CZ: The patient should be bathed thoroughly. Infested clothing and bed linen should be heat washed (temperature should reach at least 149°F [65℃]), dry cleaned, or discarded. Ironing clothing with particular attention to the seams will also kill lice on fabrics

Are chemical treatments available here?

CZ: There are some medications available in China, including 4% dimethicone lotion or some TCM medications containing radix stemonae/Ocimum gratissimum or sulfur ointment.

Are there nonchemical treatments you’d suggest?

CZ: Wet combing — the mechanical removal of lice by wet combing is an alternative treatment for patients who are too young for pediculicide (a chemical insecticide used in head lice medications) treatment or who desire to avoid pediculicide therapy. The time and care required to perform wet combing and the need for multiple sessions are deterrents for some patients. [Instead] a lubricant such as a hair conditioner is applied to the hair prior to the following steps, which are also used for the dry-combing method.

The hair is brushed or combed to remove tangles.
A fine-toothed comb is inserted near the crown until it gently touches the scalp, after which it is drawn firmly down and examined for lice after each stroke.
The entire head is combed systematically at least twice.

Other physical methods

Hair removal: Shaving hair is anecdotally reported as a method of eradicating head louse infestation .

Electric comb: A comb that uses an electric current generated by an AA battery to electrocute lice is marketed for the treatment of head lice.

Heated air: An unblinded study reported louse eradication with high-volume heated air blown at the scalp for 30 minutes. Few patients overall received the high-volume heated air treatments, and patients younger than age six were excluded.

Any preventative measures you should take?

CZ: Household members should be examined and treated if infested (live lice or nits within one cm of the scalp detected); bedmates should be treated prophylactically.

Louse survival off the scalp beyond 48 hours is unlikely. It is reasonable to recommend washing clothing and linen used by the infested person during the two days prior to therapy in hot water and/or drying the items on a high-heat dryer cycle. Temperatures should reach at least 130°F (54℃). Items that cannot be washed may be dry-cleaned or stored in a sealed plastic bag for two weeks, although this often may not be necessary. Vacuuming of furniture and carpeting on which the infested person sat or lay down has also been suggested; of note, the risk of transmission from these sites is low. Spraying the home with a pediculicide is not recommended.