The bane of many parents, the head louse is a tiny,
wingless parasitic insect that lives among human hairs and feeds on
extremely small amounts of blood drawn from the scalp. Although
they may sound gross, lice (the plural of louse) are a very common
problem, especially for kids ages 3 years to 12 years (girls more
often than boys).
Lice aren't dangerous and they don't spread disease, but
they are contagious and can just be downright annoying. Their bites
may cause a child's scalp to become itchy and inflamed, and
persistent scratching may lead to skin irritation and even
Signs of Head Lice
Though very small, lice can be seen by the naked eye. What you
or your doctor might see by thoroughly examining your child's
Lice eggs (called nits).
These look like tiny yellow, tan, or brown dots before they hatch.
After hatching, the remaining shell looks white or clear. Lice lay
nits on hair shafts close to the skin's surface, where the
temperature is perfect for keeping warm until they hatch. Nits look
sort of like dandruff, only they can't be removed by brushing
or shaking them off. Unless the infestation is heavy, it's more
common to see nits in a child's hair than it is to see live
lice crawling on the scalp. Lice eggs hatch within 1 to 2 weeks
after they're laid.
Adult lice and nymphs (baby lice).
The adult louse is no bigger than a sesame seed and is
grayish-white or tan. Nymphs are smaller and become adult lice
about 1 to 2 weeks after they hatch. Most lice feed on blood
several times a day, but they can survive up to 2 days off the
With lice bites come itching and scratching. However, the
itching may not always start right away - that depends on how
sensitive your child's skin is to the lice. It can sometimes
take weeks for kids with lice to start scratching. They may
complain, though, of things moving around on or tickling their
Small, red bumps or sores from scratching.
For some kids, the irritation is mild; for others, a more
bothersome rash may develop. Excessive scratching can lead to a
bacterial infection (the skin would become red and tender and may
have crusting and oozing along with swollen lymph glands). If your
doctor thinks this is the case, he or she may treat the infection
with an oral antibiotic.
You may be able to see the lice or nits by parting your
child's hair into small sections and checking for lice and nits
on the scalp, behind the ears, and around the nape of the neck
(it's rare for them to be found on eyelashes or eyebrows). A
magnifying glass and bright light may help. But it can be tough to
find a nymph or adult louse - often, there aren't many of them
and they're able to move fast.
Call your doctor if your child is constantly scratching his or
her head or complains of an itchy scalp that won't go away. The
doctor should be able to tell you if your child is infested with
lice and needs to be treated.
Also be sure to check with your child's school nurse or
childcare center director to see if other kids have recently been
treated for lice. If you discover that your child does, indeed,
have lice or nits, contact the staff at the school and childcare
center to let them know.
Are Lice Contagious?
Lice are highly contagious and can spread quickly from person to
person, especially in group settings (schools, childcare centers,
slumber parties, sports activities, and camps).
Though they can't fly or jump, these tiny parasites have
specially adapted claws that allow them to crawl and cling firmly
to hair. They spread mainly through head-to-head contact, but
sharing clothing, bed linens, combs, brushes, and hats can also
help pass them along. Kids are most prone to catching lice because
they tend to have close physical contact with each other and often
share personal items.
And you may wonder if Fido or Fluffy may be catching the pests
and passing them on to your family. But rest assured that pets
catch head lice and pass them on to people or the other way
Your doctor can recommend a medicated shampoo, cream rinse, or
lotion to kill the lice. These may be over-the-counter (OTC) or
prescription medications, depending on what treatments have already
been tried. Medicated lice treatments usually kill the lice and
nits, but it may take a few days for the itching to stop.
It's important to follow the directions exactly because
these products are insecticides. Applying too much medication or
too frequently can increase the risk of causing harm. Following the
directions on the product label is also important to ensure that
the treatment works properly.
Treatment may be unsuccessful if the medication is not used
correctly or if the lice are resistant to the medication. After
treatment, your doctor may suggest combing out the nits with a
fine-tooth comb and also may recommend repeating treatment in 7 to
10 days to kill any newly hatched nits.
If your child is 2 years old or under, you should
use medicated lice treatments. You'll need to remove the nits
and lice by hand.
To remove lice and nits by hand, use a fine-tooth comb on your
child's wet, conditioned hair every 3 to 4 days for 2 weeks
after the last live louse was seen. Wetting the hair beforehand is
recommended because it temporarily immobilizes the lice and the
conditioner makes it easier to get a comb through the hair. Wet
combing is also an alternative to pesticide treatments in older
children. Though petroleum jelly, mayonnaise, or olive oil are
sometimes used in an attempt to suffocate head lice, these
treatments have not been proven to be effective.
Keep in mind that head lice don't survive long once they
fall off a person. So it's unnecessary to spend a great deal of
time and money trying to rid the house of lice.
Here are some simple ways to get rid of the lice and
their eggs, and help prevent a lice reinfestation:
- Wash all bed linens and clothing that's been recently
worn by anyone in your home who's infested in very hot water
(130Âº Fahrenheit, 54.4Âº Celsius), then put them in the hot cycle
of the dryer for at least 20 minutes.
- Dry clean any clothing that isn't machine washable.
- Have bed linens, clothing, and stuffed animals and plush toys
that can't be washed dry-cleaned. Or, put them in airtight
bags for 2 weeks.
- Vacuum carpets and any upholstered furniture (in your home or
- Soak hair-care items like combs, barrettes, hair ties or
bands, headbands, and brushes in rubbing alcohol or medicated
shampoo for 1 hour. You can also wash them in hot water or just
throw them away.
Because lice are easily passed from person to person in the same
house, bedmates and infested family members will also need
treatment to prevent the lice from coming back.
In your efforts to get rid of the bugs, there are some things
do. Some don'ts of head lice treatment include:
use a hair dryer on your child's hair after applying any of
the currently available scalp treatments because some contain
use a cream rinse or shampoo/conditioner combination before
applying lice medication.
wash your child's hair for 1 to 2 days after using a
use sprays or hire a pest control company to try to get rid of
the lice, as they can be harmful.
use the same medication more than three times on one person. If
it doesn't seem to be working, your doctor may recommend
use more than one head lice medication at a time.
Having head lice is
a sign of uncleanliness or poor hygiene. The pesky little bugs can
be a problem for kids of all ages and socioeconomic levels, no
matter how often they do - or don't - clean their hair or
help to prevent kids from getting lice - or from becoming
reinfested with lice - by taking the following precautions:
- Tell kids to try to avoid head-to-head contact at school (in
gym, on the playground, or during sports) and while playing at
home with other children.
- Tell kids not to share combs, brushes, hats, scarves,
bandanas, ribbons, barrettes, hair ties or bands, towels,
helmets, or other personal care items with anyone else, whether
they may have lice or not.
- Tell kids not to lie on bedding, pillows, and carpets that
have recently been used by someone with lice.
- Every 3 or 4 days, examine members of your household who have
had close contact with a person who has lice. Then, treat those
who are found to have lice or nits close to the scalp.
Will They Ever Be Gone?
As many parents know firsthand, lice infestation can be a
persistent nuisance, especially in group settings. If you feel like
you're following every recommendation and your child still has
lice, it may be because:
- there are still some nits left behind
- your child is still being exposed to someone with lice
- the treatment you're using isn't effective
There's no doubt that they can be hard bugs to get rid of.
If your child still has lice for 2 weeks after you started
treatment or if your child's scalp looks infected, call your
No matter how long the problem lasts, be sure to emphasize to
your child that although having lice can certainly be very
embarrassing, anyone can get them. It's important for kids to
understand that they haven't done anything wrong and that
having lice doesn't make them dirty. And reassure them that as
aggravating as getting rid of the annoying insects can be, there
light at the end of the tunnel.
Be patient and follow the treatments and preventative tips as
directed by your doctor for keeping the bugs at bay, and you'll
be well on your way to keeping your family lice-free.
Mary L. Gavin, MD
Date reviewed: September 2008
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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