Head lice are tiny, crawling insects that live in the hair on your head. The most common symptom is itching, especially in the back of your head and neck and near your ears. Special medicated shampoos that contain a substance called pyrethrins are available to kill lice.
Head lice are tiny, crawling insects that live in the hair on a person’s head. The lice feed on blood sucked from your scalp and lay eggs (called nits) that firmly attach to the hair exposed at your skin’s surface (hair shafts). An infestation of head lice is pediculosis.
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Head lice can affect anyone but occur most often among children between the ages of 3 to 11 years old, along with their families. Children are more at risk, as they make head-to-head contact with other children when playing together and may share items that have contact with their hair.
Head lice infestations are common, affecting an estimated 6 million to 12 million people each year. Lice are most common among school-age children who are more likely to have close contact with each other or share combs, brushes, hats and other objects that touch the hair.
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The most common symptom of head lice is itching, especially on the back of your head and neck and near your ears — areas where lice are more likely to live.
Symptoms of head lice include:
Head lice are most active at night, which can disrupt sleep.
Frequent itching can break the skin on your head, which can lead to an infection.
A person gets head lice because the insects crawl from person to person by direct contact or by sharing items — including combs, brushes and hats — with another person who has head lice. Poor hygiene doesn’t cause head lice.
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Head lice can’t fly or jump, so they spread by crawling from person to person during close contact. Although rare, head lice can spread through personal items like towels, sheets, hairbrushes or hats.
Animals and pets can’t get or spread head lice to humans.
A diagnosis of head lice is made by visual inspection. If you look closely at your child’s hair on their scalp, you may be able to see the tiny white nits attached to the hair shafts. Nits resemble dandruff but aren’t as easy to brush or shake off the hair. Adult lice can move around quickly and are difficult to see.
You can check for lice at home if you suspect your child has head lice by running a fine-toothed comb or a special head lice comb slowly through your child’s hair to locate nits or head lice.
Treatment for head lice includes using over-the-counter medicated or prescription shampoos, lotions or creams that eliminate head lice. Over-the-counter medicated shampoos contain a substance called pyrethrin or permethrin that kill lice and nits.
Lice and nits attach to the strands of your hair and can be hard to remove unless you use a fine-toothed comb to loosen them. After using a comb or brush, soak the comb in hot water for 10 minutes.
Make sure you follow the directions on over-the-counter medicines. The treatment is only successful if you follow the instructions on how to apply the treatment, how long you should leave it in your hair and how often you should repeat the treatment.
Over the years, some lice (called “super lice”) evolved so that the over-the-counter treatments don’t effectively kill the lice. Powerful prescription drugs are available that can eliminate super lice with one dose.
Talk with your healthcare provider if the first treatment for your head lice isn’t working. They’ll make a recommendation if treatment for super lice is necessary.
Follow these steps to get rid of head lice with an over-the-counter medicated or prescription shampoo:
It takes several treatments to completely remove lice and nits from your hair. It could take up to three weeks to get rid of all lice and nits.
Make sure all members of your household check and receive treatment for head lice if one member of your household has head lice, as lice easily spread from person to person.
The best prevention is to not share combs, brushes, towels or hats with others and to avoid physical contact with someone who has lice. It also helps to examine and treat all members of your household who have contact with a person with lice.
Take time to teach your children about head lice and advise them to:
If someone in your household has head lice, you can prevent the spread of head lice by:
Head lice is a temporary irritation that effectively goes away with treatment of a medicated shampoo, lotion or cream. It may take several treatments to completely get rid of head lice, so be sure to follow instructions on the treatment’s packaging or as advised by your healthcare provider.
Head lice can’t spread disease, but they can make your scalp itchy. Frequent itching could break the skin on your scalp, which could lead to infections. If your child has lice and can’t stop scratching, contact your healthcare provider for additional treatment options to prevent them from damaging the skin on their scalp.
With effective treatment, head lice will completely go away after two to three weeks. The duration is dependent on how many lice made a home in your hair. Make sure you follow the instructions on your medicated shampoo, lotion or cream to get rid of lice quickly. Lice can live up to 30 days or longer on your head if left untreated.
Children who have head lice don’t have to stay home from school. But as head lice spread from close contact, it’s important to tell the school, daycare center or your child’s babysitter if your child has head lice. Remind your child to avoid making head-to-head contact with other children during playtime.
Other parents must be made aware of a confirmed head lice case so that they can check and treat their children as needed.
Symptoms of head lice can create disturbances in your sleep pattern and cause excessive itching and discomfort. Treat head lice at the first sign with over-the-counter medicated shampoo, lotion or cream and follow the instructions to make sure it’s effective. If you notice your head lice get worse and don’t go away with over-the-counter treatment, talk with your healthcare provider about stronger prescription treatment.
Lice don’t always go away after one treatment and it could take a couple of weeks to completely get rid of them. Following the treatment’s instructions leads to the best outcome.
Call your health care provider if over-the-counter treatments fail to work or if there are signs of an infection. Signs of infection include:
There isn’t any scientific evidence that at-home remedies, like using salt or other food products like olive oil or mayonnaise, get rid of head lice. The only recommended treatment for head lice is over-the-counter medicated or prescription shampoos, lotions or creams.
No, infestation with head lice doesn’t occur because someone has poor hygiene. Head lice spread from person to person during close contact or from sharing items that touch a person’s hair who has head lice. Anyone can get head lice regardless of hygiene.
A note from Cleveland Clinic
Hearing that your child has head lice can be a stressful experience. As children are in close contact with each other in school and daycare, head lice easily spread. It also means that there’s a chance other members of your household could get head lice as well. Make sure you follow the treatment as recommended by the instructions on the treatment product or from your healthcare provider and educate your family on head lice to prevent others from getting and spreading it. Following instructions and repeating treatment as necessary eliminates head lice quickly and effectively.
Last reviewed on 05/24/2022.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy