Anything but LICE!

Okay, so now you've checked, found some nits or lice, finished crying, poured a much larger glass of wine (or started a pot of coffee), and want to know what to do because denial and sobbing don't seem to be helping:

What you Need to get Started

1. It really isn't that bad.  Try to stay calm.  It is a lot of work and monotonous but you will survive.  Pull on big girl panties, put everyone in Good Will clothes, find a couple of old towels, and get to work.  Call, text, or message me if you need support.
2. First off, get rid of the lice.  It is a good practice to keep lice products in the house just in case but honestly, olive oil lice treatment works as well as anything.  I'm not big on pesticides and the oil slows and suffocates the lice and more importantly makes the nits easily slip right off the hair with the nit comb.  There are plenty of sites online that talk about various methods; one doesn't need to go au-natuale but it works for us.*
3. Put a old towel around shoulders.  Saturate the hair in olive oil (or other lice remover/killer).  Comb the olive oil through with a wide comb to make sure it is really in there and to get out the knots. 
4. Put a plastic bag or shower cap over the head and move to the next family member.  Personally, if we find one nit / louse, I just put the olive oil on all of us (not the same if you use pesticides; use pesticides sparingly).  Since olive oil is so harmless and actually helps your hair, it isn't bad to do every now and again even just to be safe. The oil needs to stay on for a couple of hours.
5. While heads are wrapped and marinating: remove all sheets, blankets, mattress pads, coats, etc.  Everything needs to be washed in hot water and put in the dryer on hot.  
6. Pack all stuffed animals and pillows that can't be washed into garbage bags.  They need to stay in there for 2 weeks, the incubation period of nits/eggs. This step is not to suffocate the nits/lice as much as to keep attractants and crap to a minimum.
7. Vacuum everything really well: couches, beds, floors, pillows, cushions, chairs, the car, backpacks, etc. The goal being to vacuum up any unhatched nits or a random unattached louse.
8. By this point, you will be tired but ready to nit comb the first person.  Start with the individual with the shortest hair.  It will go quicker and there will be fewer nits; it will also give the others more time to soak. 
9. Find a well lit spot, not over carpet.  It should be someplace very easy to clean later.  Get a chair that is at a comfortable height to avoid bending too far.  If you can put a TV in front of them, even better.
10. Take a small metal nit comb and go through every little bit of hair in very small groups. Go multiple directions.  Pay special attention to above the ears and the nape of the neck. Wipe the nit comb on a paper towel (I personally prefer a paper towel to a bowl of water) to get off the nits after each swipe (Figure 2.b - they will look like little black specks).
11. Continue through the whole head a couple of times until the nit comb is repeatedly coming out clean.  If it is a bad case, this will take awhile.
12. Wash the hair REALLY well with dish soap to cut the oil and then wash with shampoo.  I blow dry the hair afterwards.
13. Repeat steps 6-11 on each person.  Save the worst for last.  You will be really good at it by that point and it will go faster.
14. Soak all combs in rubbing alcohol for at least an hour when you are done.
15. Put clean sheets on the beds.  Some people keep their pillows in a garbage bag with a case over it.  When we had the Infestation of 2009, we did that.  If there are only 2 bugs, that is over-kill.
16. Neurotically check for lice multiple times a day.  If even one nit is found, redo the olive oil treatment, rewash, and vacuum everything (honestly, I redo the olive oil every couple of days on anyone who had a nit the previous time, just to be safe).

Figure 2b - Little Black Specks are Nits

A Couple of Other Things:

No need to be too stressed or over-whelmed.  I've seen remarkable women reduced to tears over lice.  It is a lot of work but not awful.  We've had the roto-virus and that is way worse and spreads like wild-fire.  This is simply a really thorough house cleaning  (and to be honest, I kinda like the stuff all packed up).  If there isn't time to get to a certain room, just don't let anyone into that room until it is done.  The first time, the playroom was off limits for a couple of days until I could get to it.  I know several families who literally just locked the playroom for 2 weeks and everyone stayed in a couple of rooms until the risk was over.  Focus on the rooms that must get done.  Take your time.  This isn't a race to exhaustion.

Please don't be embarrassed or feel like you need to keep it a secret because of the crazy stigma associated with lice.  Lots of people get lice and you will need the moral support of friends and family.  Diligently fix the problem so that it doesn't spread, don't be ashamed for having it.  Keeping lice a secret is actually what is helping it continue to spread.  I'm not sure why it seems so different from strep throat or the flu.  Clean people get lice just like healthy people get viruses. 

After the house is clean and the nits are at bay, some dreaded phone calls / emails need to be made (I go the email route as I'm too tired to make phone calls).  It is never fun to tell people that they may also have lice because their child was with your child.  Let school** or church know, chances are if one child has lice others have it as well and until everyone resolves it, the problem will just keep coming home.  It is a courtesy from one parent to another.

Clear The Oracle.  Cancel playdates, carpools, and don't feel the need to rush back to school and work. Eradicating lice takes a lot of energy and is a big deal.  It will take time to resolve.   A couple of days off will be good for everyone.  My DS speaks of Lice 2009 as the "glory days".  We all stayed home for 3 days and watched TV and played video games but everyone felt great.  It doesn't NEED to take 3 days; it is possible to have a clean head in one night and return to life as normal the next day, but that seems really ambitious, even on a light case.

I hope that the louse was caught quickly and the clean-up is fast and easy, but if not, Stay Strong my DF.  Imagine the virtual mom stripes earned from this battle!  It is the Everest of Parenthood.  It isn't glamorous.  It is exhausting and over-whelming but at the same time heroic.  If you need a Sherpa to hold the nit comb, bring an emergency bottle of wine, or check your head (even the mere mention of lice makes me super itchy) -- I'm here for you.

*To clarify:  I'll be honest, Medical Professionals often seem to recommend pesticides and frown on the natural alternatives.  The olive oil doesn't necessarily kill the lice or nits (it is supposed to eventually suffocate them), it just makes it really easy to pull them out of the hair (way easier than anything else I've tried and I've tried a ton of stuff).  In 2009, I first killed the lice with a natural lice killer (followed the instructions on the bottle) and did the nit comb, THEN I used the olive oil.  This time, with only a few, I just did the olive oil a couple of times.   The olive oil is so easy that I can actually nit comb my own hair (this time nobody but our DD had any), and it is fast .  If it is a bad case, I recommend first a natural lice killer (or pesticide), then the same night, olive oil to get out whatever was missed the first time.  Don't count on the lice killer to work, you NEED to hand pull out all of the nits.  If the lice killer isn't totally effective, that is how you breed the super bug.  The egg or bug survived the chemicals and is now stronger than ever and you need to start all over.  It is better to take your time at the beginning than repeat this over and over.

**Common practice is that the school will send home a letter to everyone in your child's class, alerting other parents to be on guard for lice and giving general information (our school is small so even sent out a school wide email).  The nurse will also check your child before they can return to class.  The nurse will recheck again in 2 weeks.  I usually redo the olive oil treatment at least once a week for 3 weeks even if she appears clear, just to be safe.  Especially because it can reoccur.