Although head lice are a nuisance, they do not transmit disease. Don’t panic!  Lice are a common childhood occurrence and are usually spread directly by the head-to-head contact, common during children’s play.  Lice can neither hop nor fly but are very fast crawlers. Anyone can get lice, regardless of cleanliness, but they cannot live on pets. Lice are much less frequently spread by insects that have crawled onto clothing or belongings.  Lice rarely survive longer than 24 hours off a person since they cannot feed. 

Signs of Lice

Itching is a common symptom of head lice.  The bites of head lice cause small sores/scabs on the scalp.

Hair inspection:

Look for crawling bugs found on the head, or lice eggs (nits) within ¼ to ½ inch of the scalp. Lice are difficult to spot because of their small size (2mm) & quickness.  They are tan to grayish-white in color and will move quickly away from light.  Nits are much easier to locate and are white to gray in color.  They are oval, about the size of a poppy seed, and are firmly attached to the hair shaft by a glue-like substance. Do not confuse nits with dandruff or hairspray which will brush away easily. Look closely behind the ears and at the nape of the neck as this is the most common location for lice.

Treatment of Lice

• Apply lice medicine (pediculicide) & follow the directions exactly. If your child has extra-long hair you may need to use a second bottle.  Do not re-wash the hair for 1 – 2 days after treatment.
• Comb out the hair using a metal comb with very close teeth. Utilize the best light source possible & section off the hair. Place the teeth of the comb as close to the scalp as possible & gently pull comb through the hair from the roots to the ends. Wipe comb with a tissue to remove any bugs or nits. Try to find a quiet and/or distracting activity for the child during this time-consuming process.  Comb and comb and comb!  You may also pull nits out with your fingernails. There are enzyme products available to loosen the nit glue. Some also advocate a vinegar hair rinse or use of an oil.
• Use of a hair dryer and/or hair straightener is helpful since lice are stunned or killed at temperatures of about 120-140 degrees.
• Check & Recheck: Check the scalp & hair daily for at least 2 weeks for the presence of lice or nits that are within ½ inch of the scalp.  The lice shampoo cannot penetrate the hard nit shell and viable nits may hatch within one week. Nit removal is a tedious process, but it is the most important step in getting rid of lice. 
• Machine-wash all clothing & bed linens used and/or worn two days prior to treatment. Use the hot water (130 degrees) cycle and dry clothing on high heat for at least 20 minutes.
• Store all items that cannot be washed in a plastic bag & seal for 2 weeks.
• Vacuum the floor & furniture.
• Check household contacts for lice & nits every 2 to 3 days.
• Prescription drugs are available to treat head lice. If you do not find success with the above measures, contact your healthcare provider.

Helpful website with additional resources: https://www.cdc.gov/parasites/lice/head/index.html