Head Lice

How to Get Rid of Head Lice

“Mommy, my head itches!” Not the words you want to hear from your child, because it usually means one thing- head lice.

The American Academy of Pediatrics recently released a statement that children with head lice do not need to be kept home from school which understandably has many parents worried. Here are answers to some of the most commonly asked questions about head lice.

What are head lice?
Head lice are tiny, 6-legged insects about this long (-). They are either grayish-white or red, if they are filled with blood. They do not have wings, so they get around by jumping quickly from one surface to the next which can make them difficult to find and catch.

When someone has head lice, what you typically see are nits, or tiny yellowish-white lice eggs. Nits can look a lot like dandruff and are usually found close to the scalp, at the back of the neck or behind the ears.

How can my child get lice?
Lice are passed from child to child by sharing hats, scarves, combs, brushes, or helmets, or from clothing that has the nits or lice on it. One big thing to note, lice are not a sign of bad hygiene. Lice actually prefer clean hair as it is easier to attach their eggs to.

How do I treat lice?
Lice can be treated at home with an over-the-counter treatment such as RID or NIX. Wash your child’s hair with a conditioner free shampoo and towel dry prior to using these treatments.  For step-by-step instructions on how to use NIX, check out our Helping Hand.

These treatments are best used in conjunction with white vinegar, as it helps to loosen nits from the scalp.

Once the first treatment is complete, be sure to follow these steps to ensure the lice do not return:

  • If you see live lice 10 days or more after the first treatment, a second treatment may be needed.
  • Check the hair and scalp of all family members every day by combing the hair until no live lice or nits are found for 10 days.
  • Don’t use hair conditioner for 10 days.
  • Head lice can live away from the human body for 2-3 days, and nits (eggs) can take 1-2 weeks to hatch.  To avoid spreading these lice, be sure to wash all items you can (clothing, bedding, etc.) in hot water and dry on high heat for at least 30 minutes. Non-washable items (pillows, stuffed animals, etc.) can be put in the dryer for at least 30 minutes or sealed in a plastic bag for 2 weeks.

When does my child need to see a doctor?
You typically do not need to see a doctor if you have head lice. However, if you notice any of the following, please consult your provider or report to an urgent care or emergency department immediately:

  • Your child still has lice after 2 treatments
  • Open, oozing sores on scalp
  • Fever and/or enlarged lymph nodes in the neck

How do I prevent head lice?

  • Teach your child to “Never Share What Touches the Hair.” Never share combs, brushes, hats, scarves, hair accessories, helmets, pillows, etc.
  • Check your child’s hair often during the school year, especially when the school tells parents there is a lice problem.
  • Have your child bathe or shower every day. Shampoo the hair 2 or 3 times a week.
Mike Patrick, MD
Dr. Mike is an emergency medicine physician at Nationwide Children’s and host of PediaCast, our pediatric podcast for moms and dads. Each week, PediaCast covers news parents can use, answers listener questions, and delivers interviews with pediatric experts on a variety of topics. Dr Mike is also an Assistant Professor of Pediatrics at The Ohio State University College of Medicine, where he serves as a faculty advisor for medical students. On the home front, he is married with two kids: a college-aged daughter and a son in high school. Prior to working in the emergency department, Dr Mike spent 10 years in a busy private practice, a time he says most prepared him for the practical advice he shares on PediaCast. Dr Mike also has an interest in roller skating. He learned to walk with skates on his feet, and his first job (age 10) was as a disc jockey at his hometown roller skating rink. He has also worked as a DJ at two radio stations, experiences which further prepared him to host our podcast!

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