Head Lice

Head lice are tiny, parasitic insects that can live in your hair. They bite your skin to suck your blood and attach their eggs (called nits) to your hair, close to your scalp. All this can make your head itchy.

Head lice are most common in young kids. But don’t worry; head lice have nothing to do with your kids’ hygiene. Like germs, they just spread more easily in people who spend a lot of time close together.

While most of us just think of them as “bugs,” you might hear an infestation of head lice called pediculosis.

Symptoms of head lice

Symptoms of head lice include:

• Itching (most common)
• Feeling like something in your hair is moving
• Small bumps or sores from scratching
• Difficulty sleeping, as head lice are most active at night

What do head lice look like?

Adult lice are gray or tan with three pairs of legs that look like claws. They’re smaller than a sesame seed. As lice move quickly, you’re more likely to find eggs than lice themselves.

Head lice eggs are white, yellowish, tan or brown. You can find them close to your scalp. They’re tiny and might look like dandruff, but they don’t come off easily if you pull on them. You can use a nit comb and conditioner to pull them out.

How do you get head lice?

Head lice usually spread from person to person by direct contact. But they may also spread by sharing items that touch your head (like combs, brushes and hats). Lice are most common in kids ages 3 to 12, as they’re usually in frequent, close contact with each other.

Lice don’t have wings, but they’ll crawl between people and live in warm areas of your body, like on your head. Adult lice lay eggs near your scalp and glue them to your hair. Five to 10 days later, the lice hatch. Over the next nine to 12 days, they’ll bite you several times to take a meal. They’ll grow into adults and lay more eggs, starting the cycle over again.

Complications of head lice

Head lice are mostly harmless and don’t carry diseases. But the itching might make your child scratch their head a lot. This can break the skin and lead to bacterial infections.

How can you tell if you have head lice?

You can check for lice by running a fine-toothed comb or a special head lice comb slowly through your child’s wet hair. Inspect the comb for lice and their eggs after each time you pull it through. Lice are most commonly found at the back of your head and neck, and near your ears.

If you think your child might have lice but you can’t confirm it, ask their healthcare provider or school nurse for help.

How do you get rid of head lice?

The best way to treat lice is with an over-the-counter or prescription shampoo, lotion or cream that kills them. Follow the directions on how to apply it and how often to use it. Note that some treatments shouldn’t be used on babies.

Talk to your child’s healthcare provider if you’re unsure which is best to use or if the first treatment you try isn’t working. Lice are becoming resistant to treatment. It may take a combination of treatments to get rid of them completely.

Some lice treatment options include:

• Benzyl alcohol lotion (Ulesfia™)
• Ivermectin lotion (Sklice®)
• Permethrin lotion (Nix®)
• Pyrethrin and piperonyl butoxide shampoo (RID®, A-200™)
• Spinosad topical suspension (Natroba®)

Another technique is to apply hand lotion or conditioner to your child’s wet hair for two minutes, then comb the lotion or conditioner out with a fine-toothed comb. Repeat every few days for two to three weeks after you last saw a live louse. These and other home remedies might work best when combined with medicated shampoo, cream or lotion treatment.

Getting rid of lice in your home

Get rid of lice on clothing, bedding and personal items by:

• Washing clothing and bedding in hot water and drying them on high heat. Anything you can’t wash should be dry-cleaned or stored in a sealed plastic bag for two weeks.
• Washing combs and brushes in very hot water after using them. You can also coat them in a lice-killing shampoo, cream or lotion for 15 minutes and rinse off.
• Vacuuming areas of your home, including furniture, that could’ve come in contact with lice.

When should I see my healthcare provider?

Call your child’s healthcare provider if treatments aren’t working or if your child has signs of an infection. These include:

• Fever
• Sores that won’t heal or are pus-filled
• Pain or tenderness on their head
• Redness or swelling on their scalp

Can you prevent head lice?

You and your child can prevent spreading lice by:

• Avoiding head-to-head contact with others
• Not sharing combs, brushes, hats or pillows with others
• Checking others in your household for lice and treating them if necessary to prevent further spread
• Washing clothes and bed linens and vacuuming your home thoroughly if someone in the household has had lice

How long does head lice last?

With effective treatment, head lice can go away after two to three weeks. Sometimes, you might have to try a different kind of treatment if the first doesn’t work.

If your child can’t stop scratching, contact their healthcare provider. They might be able to give you additional treatment options to prevent them from damaging their scalp.

When can my child go back to school after having head lice?

Kids usually don’t have to stay home from school if they have head lice. But it’s important to tell their school, daycare or babysitter about it. Remind your child to avoid making head-to-head contact with other kids during playtime. The school may let other parents know so that they can check and treat their kids.

How long can head lice live off the host?

Adult head lice can live without a host for only a day or two. Eggs can survive about 10 days.

Do head lice live on pillows?

Yes. While head lice don’t live long, they can spread from person to person if you share a pillow.