Head Lice Slideshow: What Parents Should Know

Reviewed by Kathy Empen, MD on Friday, October 28, 2011

Head Lice: What Parents Should Know

Spotting a tiny, white speck in your child's hair is enough to make many parents panic. Sure, head lice score high on the yuck factor, but they usually aren't harmful. Here, you'll find all the information you need to get a lice infestation under control.

What Are Head Lice?

Head lice are tiny six-legged insects that cling to the scalp and neck and feed on human blood. Each louse is about the size of a sesame seed and can be hard to spot. Lice eggs, called nits, are glued onto hairs near the scalp and can be even more difficult to see.

Who Gets Head Lice?

Head lice are most common in young children attending day care, preschool, or elementary school. Children of this age often play together closely and with more hair-to-hair contact, and may share brushes, hats, hair clips, and the like. Adults who live with children also have a higher risk of exposure to head lice.

How Head Lice Spread

Lice usually spread through direct head-to-head contact that allows the pests to crawl from one person's hair into another's. Lice can also survive for a short period on clothing or other personal items, so a shared hairbrush can help a louse find a new host. Lice cannot jump or fly from one person to another.

How to Spot Head Lice

Although lice and their nits are small, they are visible to the naked eye. Head lice can be white, brown, or dark gray. They are most often found in the hair at the back of the neck or behind the ears. The nits are round or oval specks that are tightly glued to hairs near the scalp. If you try to slide the nits off, they won't budge. Recent research suggests combing through wet hair is an ideal way to spot an infestation.

Symptoms of Head Lice

Spotting a live louse or nymph (juvenile louse) is often the only sign of an infestation. The presence of nits alone doesn't confirm an infestation. In many children, head lice don't cause any discomfort. When symptoms do occur, the most common problem is itching that may start weeks or even months after the lice move in.

Head Lice Allergies

The itching associated with lice is caused by an allergic reaction to the bug bites. Frequent scratching may lead to sores or raw skin on the scalp. Although uncommon, sores related to scratching can become infected by skin bacteria. Call a doctor promptly if the skin becomes red, swollen, or painful; or the lymph nodes in the neck become tender. These are signs of a skin infection.

If You Suspect Head Lice

Head lice will not go away on their own. If you suspect your child has an infestation, there are several steps you should take right away. Call your health care provider to confirm the diagnosis. Notify your child's day care provider or school so other students can be checked. Examine all other members of the household for signs of lice. Finally, treat everyone who's infected at the same time.

Ridding Hair of Lice

You can find lice-killing treatments over the counter. They are made from extracts of chrysanthemums or a synthetic version that is similar. Both are considered safe. These products kill live lice but not nits. Follow instructions on the label carefully regarding how long the medication should be left on the hair and how it should be washed off. Do not rewash the hair for 1-2 days afterward. A second treatment is recommended 9 to 10 days later. If two treatments don't do the job, see your doctor for more potent medication.

Ridding Your Home of Lice

Although lice don't survive long on bedding, it's best to wash the sheets of anyone being treated for lice. Clothing worn in the past 48 hours should also be washed in hot water. While parents are sometimes told to clean and quarantine all of a child's stuffed animals, experts say this is not necessary. If your child sleeps with a favorite plush toy, pop it in the hot dryer for 20 minutes. That should kill any creepy-crawlies.

Home Remedies for Head Lice

Some parents claim mayonnaise, white vinegar, or tea tree oil are effective natural remedies for head lice. Mayonnaise is said to smother lice if it's applied thickly and kept on overnight under a shower cap. Vinegar is rumored to dissolve the glue that keeps nits stuck to the hair. While there is no scientific evidence to support these home remedies, pediatricians say there's no harm in trying them, but don't use them as primary treatment.

Fine-Toothed Combs

An addition to topical head lice treatments is the fine-toothed comb. This comb has teeth fine enough to pull out lice and their nits. It worked for the ancient Egyptians -- nit combs have been found in their tombs. The drawback is that it takes time and patience to comb every last nit out of a child's hair. But if you can do it properly, you may be able to avoid using medicated shampoos. However, it may be more effective to comb the hair after treating with a medicated shampoo to get rid of any stragglers.

Head Lice Myths

Head lice are not a scourge of the lower classes, nor a sign of poor hygiene. They affect children across all levels of income, social class, and cleanliness. The bugs can survive underwater for up to six hours, so kids who bathe regularly are just as vulnerable. The good news is lice are not carriers of any disease.

Head Lice at School

According to the most recent report from the American Academy of Pediatrics, a healthy child should not be restricted from school because of lice. They recommend that a child remain in class but avoid head contact with others. After treatment, dead eggs may remain in a child's hair until they are removed. Some schools have a "no nits" policy, meaning the eggs must be removed before the child returns to class. The American Academy of Pediatrics discourages this policy. Removing nits after treatment is not necessary to prevent spread.

Guarding Against Head Lice

If you have young children, there's unfortunately very little you can do to ward off head lice. Kids will be kids, and when they put their heads together or share hair bows, lice get a ticket to ride. Your best defense is to examine your child's hair and scalp regularly so you can catch an infestation early. Prompt treatment will help prevent the bugs from spreading to the rest of the family.