Treating Head Lice

The start of a new school year can be an exciting time for children, but it is also the time when problems with head lice begin. According to the CDC, “anyone who comes in close contact (especially head-to-head contact) with someone who has head lice is at greatest risk of getting it”.

What Are Head Lice?

Head lice are small, gray or reddish brown insects that live mainly on the scalp and neck hairs of people. (Called parasites, these insects need a host – a person’s scalp in this case – to live.) Head lice are tiny, about the size of a sesame seed, and usually take three forms on the hair, the egg (also called a nit), the nymph and the adult.

Head lice don’t fly or hop, but the adults can crawl fast, making them hard to spot and causing them to spread if they come in contact with another child’s head. So besides the initial problem of being infected with head lice, many schools will not allow an infested child in the classroom until the head lice are gone.

Why Are They a Problem?

Head lice bite the scalp, causing it to itch and the person infested to scratch. These bites can become infected. Also, the lice will crawl around in a person’s hair and lay their eggs (nits). Lice eggs are small, oval-shaped or yellowish-white and attach to the hair shaft.

One louse can lay up to 100 nits that hatch in 7-10 days and take another 7-10 days to develop into adults. If the nits are allowed to hatch, the infestation can go on and on and spread to others. Therefore, to effectively end the problem, it is important to remove all the nits

How Do I Know It’s Head Lice?

Here are some signs to look for if you suspect your child has head lice:

  • Is your child scratching his head a lot?
  • Does his scalp have red or crusty scabs?
  • Do you see small white or yellowish dots or spots attached to the child’s hair shafts?
  • Do you see any bugs crawling in his hair?

Getting Rid of Head Lice

Once you are sure the problem is head lice, what do you do? Previously, experts recommended washing all bed clothing (sheets, blankets, pillowcases) and street clothes, and vacuuming all areas inhabited by the infested person. However, research suggests that since head lice don’t survive long off the scalp, this extra cleaning isn’t necessary. There are several ways to get rid of head lice:

  • Use an over-the-counter chemical shampoo or gel made especially for head lice. Follow the directions carefully. (Some researchers have said head lice have developed a resistance to these types of shampoos. However, others believe chemical shampoos fail because people do not follow the directions. For example, do not use a cream rinse or a combination shampoo/ conditioner before using lice medicine and don’t rewash hair for 1-2 days after treatment.) Remember anti-lice shampoos do not kill the nits, so you often have to treat the child a second time to kill any newly hatched lice. That’s why the next step is important.
  • Carefully remove nits by combing them out of your child’s hair using a fine-toothed nit comb. Your child’s hair should be wet when you do this. (This method is said to work alone without using any chemical shampoo; however, you must be diligent to remove all the nits and you may have to do this several times over the course of several days or weeks.)
  • Coat your child’s dry hair with Cetaphil, an over-the-counter face cleanser, and then blow-dry the hair. This technique, developed by a California doctor, kills lice by suffocating them – the cleanser forms a seal over the hair, like cellophane. Leave on for 8 hours. Then wash and comb hair with a regular fine-toothed comb.
  • If none of these methods work, or if your child has an especially stubborn infestation, you may have to get a prescription from your healthcare provider for a stronger treatment.
    If you think your child has head lice, but don’t actually see any live lice, consult your healthcare provider for a definitive diagnosis.
    A good place to get information on identification, treatment and other issues regarding head lice is at


CDC. (2005). Treating head lice infestation. Retrieved June 6, 2006 from the World Wide Web: treating.htm
Consumer Reports (2006, April 5). Treating head lice safely. Retrieved June 6, 2006 from the World Wide Web:https://www.consumerreports. org/mg/treatment-centers/child-health/head-lice/free-highlights/manage-yourhealth/ head_lice.htm?resultPageIndex=1&resultIndex=1 Iannelli, V. (2006). Head lice treatment for kids. Your guide to pediatrics.
Retrieved June 6, 2006 from the World Wide Web: conditions/a/head_lice.htm
National Pediculosis Association. (2006).

Compiled by Gail O. Guterl, ADVANCE editor.

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