by Becky L. Spivey, M.Ed.
Ew! Ick! Oh, no! Head lice… here we go… get out the special shampoo and nit comb! Head
lice are definitely a nuisance, and they can be a nightmare. But… look at the bright side. Lice
doesn’t cause illness or disease, and the condition is easily treatable at home. Plus, they’ll keep
the neighborhood children out of your house for a day or two! ☺
What exactly are head lice?
Head lice are tiny, pale gray insects about the size of a sesame seed (2–3 mm long). One “lice”
is a louse, and it only takes two to quickly infest the scalp. Lice are highly contagious and can
spread quickly from person to person, especially among preschool- and elementary school–
aged children and in group settings like childcare centers, slumber parties, sports activities,
and camps. Head lice must feed on tiny amounts of blood from your scalp, or they cannot survive but day or
two. Lice can lay up to 10 eggs a day. Newly hatched eggs reach adulthood in 12 days and begin laying their
own eggs. If left untreated, this cycle can repeat every three weeks.
The eggs and their shell casings are “nits” and are easily visible with the naked eye. A sticky substance secreted
when the lice lay the eggs attaches the yellowish or white tiny ovals (about 0.8 x 0.3 mm) on the hair shafts near
the roots and holds them firmly in place. After the eggs hatch, the empty nits remain, and the new lice begin
Who gets head lice?
NOW HEAR THIS! Anyone can get head lice! Head lice do NOT discriminate! Race, nationality, or social status
doesn’t matter. It doesn’t matter how clean your hair or home may be or where children and families live, play,
or work. Everyone is susceptible. According to the National Pediculosis Association, African-Americans (due to
the difference in hair texture) are less likely to contract lice than their counterparts, but they can still get them.
How do lice spread?
Head lice are crawling insects and spread through close, personal contact and the sharing of items such as
combs, brushes, hats, sleeping bags, etc. Advise your children against sharing hair tools and clothing. Lice cannot
jump, hop, or fly.
What are the symptoms of head lice?
The most common symptom when suspecting head lice is itching and scratching behind the ears and at the
back of the neck. You might observe your child mindlessly scratching his head, so take this opportunity to
check. It may take up to 4 weeks after lice get on the scalp for the itching to begin, and the itching can last for
weeks, even after treatment. However, an itchy scalp also may be due to eczema, dandruff, or an allergy to hair
How do you check for head lice?
According to the American Academy of Pediatrics (AAP), regular checks for head lice are a good way to spot lice
before they have time to multiply and infest your child’s scalp.
- Seat your child in a brightly lit room.
Part the hair with a comb and look at your child’s scalp. Start at the bottom of the neck and work your
way up and along the sides. The easiest place to find them is at the hairline at the back of the neck or
behind the ears.
Look for crawling lice and nits. Lice avoid light and move quickly. Nits look like small white or yellowbrown
specks attached to the hair near the scalp. Nits look somewhat like dandruff, dirt particles, or hair
spray droplets. The difference is that nits stick to the hair shaft and can’t be moved, while dandruff, dirt,
or other particles will move easily.
What do I do if I find lice?
Check with your child’s doctor or your local pharmacist first before beginning any head lice treatment. The most
effective way to treat head lice is with medicinal shampoos specifically for treating lice. They are available at
pharmacies, larger grocery stores, and discount department stores. Only use head lice medicines/shampoos when it is certain that your child has head lice.
Follow directions carefully. Only adults should apply the lice shampoo to the child’s hair. After applying the
shampoo, there is normally a wait time of around 10 minutes. After waiting, rinse the hair as directed and use
a very fine-toothed comb (referred to as a nit comb, included in the treatment kit) to comb out the remaining
lice or nits. Comb through your child’s hair in small sections. After each comb-through, wipe the comb on a wet
paper towel. Examine the scalp, comb, and paper towel carefully.
Check with your child’s doctor before beginning a second or third treatment. A second treatment is
recommended 10 days after the first treatment and, in some cases, a third treatment may be needed 10 days
after the second.
- Do not use medicinal shampoos on a child 2 years or younger without a doctor’s recommendation.
For children 2 months old or younger consult your physician. They might recommend the “comb-out
method.” The “comb-out method” (trying to remove lice from damp, untreated hair using a finetoothed
comb) often fails, but this is one of the recommended treatments for children age two and
under. Home remedies like applying petroleum jelly, mayonnaise, tub margarine, herbal oils, or olive oil
to the scalp are not scientifically proven to work.
Store the shampoo/treatment kit in a locked cabinet, out of sight and reach of children during the
- Head lice medicines and shampoos usually last for one treatment period. Throw out what is left.
- Never use dangerous kerosene-based chemicals or medicines made for use on animals!
What else do I need to know about treating head lice?
Don’t throw away anything belonging to your child. However, if the child used the items within 3 days before
you found the head lice, you need to wash all clothes, towels, hats, and bed linens in the hottest water possible
for the particular fabric and dry them on high heat. Dry-clean or seal items you cannot wash in a plastic bag for
at least 2 weeks (pillows, stuffed animals, etc.). Do not spray dangerous chemicals or pesticides in your home.
If your child has head lice, all other household members and close contacts should be checked and treated if
necessary. If your child had friends over just before you discovered the head lice, please let the other parents
know that their child may have been exposed.
What about “no-nit” policies?
Some schools have “no-nit” policies stating that students who still have nits in their hair cannot return to school.
Some schools will admit students after one treatment. The American Academy of Pediatrics and the National
Association of School Nurses discourage such policies and believe a child should not miss school because of head
lice. Check with your child’s school nurse or daycare provider about policies concerning lice.