Buy the nit comb before you need the nit comb

Get a metal nit comb and put it in the bathroom closet today, while nobody in your house is itching. The fine-toothed steel kind, not the plastic freebie taped to the box of shampoo. That plastic comb is decoration. The steel one is the entire treatment.

Because the call comes on a Tuesday. School nurse, 2:40 p.m., cheerful voice, bad news. And the single biggest factor in whether that night goes smoothly is whether you have to make a pharmacy run at 9 p.m. with a kid crying in the back seat.

Lice first, because lice are the one everybody handles wrong

Head lice don't jump and they don't fly. They crawl, and they move by head-to-head contact, which is why they run through second grade and sleepovers and cousins at Thanksgiving. They're not a verdict on your housekeeping. They actually prefer clean hair. They don't carry disease. Off a human head they die within a day or two, because they need to feed and they need the warmth.

Write that down somewhere, because the panic is what costs you the evening.

The eggs are what matter. Nits glued within about a quarter inch of the scalp are the live ones. Further out on the shaft, they've usually already hatched or died, which is why a kid can "still have nits" weeks after the problem is over and you're combing out debris like an archaeologist.

The over-the-counter treatments, permethrin and pyrethrin, kill live lice well and eggs poorly. That's why the box tells you to repeat in about a week. Resistance to those active ingredients is real and regional, so if you treat correctly twice and you're still finding crawling lice, that's a call to your pediatrician or a conversation with your pharmacist about prescription options. Don't keep dumping the same bottle on the kid's head.

The comb-out is the job

Mechanical removal is what finishes it. Plan on forty-five minutes the first night.

Set up where the light is good. A headlamp helps more than you'd think. Soak the hair in cheap conditioner, which slows the lice down and lets the comb pull. Section the hair with clips into pieces about an inch wide. Comb each section from the scalp all the way out, and wipe the comb on a white paper towel after every single pass so you can see what you're getting.

Then do it again every three or four days for two weeks. That schedule isn't arbitrary. It covers the hatch cycle, so anything that emerges gets combed out before it's old enough to lay.

Things you can skip: the house. Don't bomb it, don't spray the furniture, don't bag every stuffed animal in the playroom for a month. Wash the bedding and the clothes and the jackets the kid used in the last two days in hot water, dry them on high heat, run the combs and clips through hot soapy water, vacuum the couch and the car seat and be done. Anything you can't wash can sit in a sealed bag for two weeks and come out fine.

And don't shave a kid's head as punishment for a bug. If a boy wants the buzz because it makes the combing stop, sure, take him to the clippers. That's his call, not a penalty.

Pinworms are the 2 a.m. one

Different animal. A child wakes up scratching, usually a couple hours after bedtime, because that's when the female worm lays eggs around the bottom. Miserable, extremely common in elementary school, and almost never dangerous.

The confirmation trick is tape. First thing in the morning, before the bath and before anybody washes, press a strip of clear tape against the skin, stick it to a plastic bag, and bring it to your doctor. Eggs show up under the microscope. Plenty of pediatricians will treat on symptoms alone, but the tape saves you an argument with yourself about whether you imagined it.

Treatment is a medication, often pyrantel pamoate over the counter or a prescription, dosed by weight, with a second dose about two weeks later because the first one doesn't touch the eggs. Ask your pediatrician or pharmacist about the whole household, because the usual advice is to treat everyone under the roof at the same time. Half-treating a family is how you get a reinfection in March and a rerun of the same week.

The eggs survive on surfaces for two to three weeks. So for those two weeks: morning showers instead of evening baths, fingernails cut short, hands washed like you mean it before meals, underwear and pajamas and sheets changed and washed often. Don't shake the bedding out. Bundle it and carry it to the machine.

The rest of the greatest hits

Ringworm isn't a worm. It's a fungus, it makes a ring with a clearer center, and antifungal cream from the pharmacy usually handles it. Scalp ringworm doesn't respond to cream and needs the doctor.

Impetigo is the honey-crusted sore around the nose and mouth, it's bacterial, it's contagious, and it wants prescription ointment or antibiotics.

Hand, foot and mouth is a virus, it looks alarming, and it's mostly a fluids-and-patience situation. Watch that the kid keeps drinking, because the mouth sores are what stop them.

Molluscum is the crop of small pearly bumps that shows up, hangs around for a year, and then leaves on its own.

Scabies deserves its own respect. Intense nighttime itching, often between the fingers or at the wrists, and it needs a real diagnosis and a prescription treatment for the whole household.

Call the doctor for spreading redness, red streaking away from a sore, fever with a rash, swelling, real pain, or a kid who won't drink. And if you're guessing, stop guessing. A photo and a phone call to the nurse line costs you nothing.

Now the marriage part

There's a moment, usually around 10 p.m., when one of you says "where did she even get this" in a tone that means "what were you not watching."

Kill that instinct. It's a bug. Bugs go where children are. There's no detective work worth doing and no blame worth assigning, and the hour you spend litigating it's an hour you're not combing.

Split it instead. One parent combs and talks the kid through it. The other parent strips beds, runs the hot wash, makes food, and handles the other children who have decided this is the perfect night to need something. Trade who combs on the second and third rounds, because the neck cramp is real and because the kid should see both of you doing it. If it lands on the mother every time by default, the default is broken.

Then send the email. Tell the school, tell the sleepover host, tell the cousin's family. Somebody will be embarrassed. Send it anyway, because the parents who stay quiet are the reason it's back in six weeks.

Keep the kit in a shoebox: steel comb, clips, a bottle of conditioner you don't care about, a white towel, a headlamp, clear tape. Total cost is less than one panicked pharmacy run and one canceled Saturday.

The louse has no opinion of your parenting. It just found a warm head and took the invitation.