Every parent dreads it – the school note informing you that your child or a classmate has head lice.
The Centers for Disease Control and Prevention (CDC) estimates that 6 million to 12 million cases of head lice infestation occur each year in the U.S. among children ages 3 to 11. If the estimate’s range seems rough, it is because social stigma and the false belief that head lice are associated with poor hygiene generally mean infestations are under-reported.
The good news and bad news about lice
Small, stubborn and particularly unpleasant, head lice are tiny parasites that live in the hair and feed on blood from the scalp. These disagreeable and hard-to-see bugs can also be found in eyebrows and eyelashes.
The good news is that unlike body lice, head lice do not carry or spread diseases. They do, however, cause intense itching, and can live up to 30 days on a human. Their eggs, called nits, can live for more than two weeks.
Head lice are spread easily among school children and are common in overcrowded living conditions. Lice are picked up by head-to-head contact with a person who has lice; by one’s head touching the clothing or bedding of someone who is infected; or by sharing hats, towels, brushes, or combs of someone who has had lice.
Telltale signs of head lice include an itchy scalp; small, red bumps on the scalp, neck and shoulders that sometimes crust and ooze; and nits, which look like tiny white specks, at the base of each hair and that are difficult to remove.
To determine if your child has lice or nits, the American Academy of Dermatology (AAD) recommends that you sit your child under a bright light and separate his or her hair into sections, parting the hair down to the scalp. Search each section for nits or live lice. Nits will look like tiny seeds or dandruff attached to the hair. One way to distinguish lice or nits from dandruff is that they cannot be easily removed. Lice and nits are commonly found in the hair behind the ears and around the nape of the neck.
What to do if a family member has lice
Head lice do not go away on their own so treatment is necessary. There are many products available – both over-the-counter and prescription – for treating lice.
Paradi Mirmirani, MD, assistant clinical professor of dermatology at the University of California, San Francisco, offers these tips for treating lice:
- Use a shampoo or lotion that is specifically formulated to kill lice. It is important to follow package directions, but usually this treatment involves leaving the product in the hair for a few minutes before rinsing it out.
- Once the hair is rinsed, use a fine-toothed comb on still-wet hair.
- To give the medication a chance to work, avoid shampooing again for a few days. Note that because these products are generally more effective in killing lice than nits, your product may suggest repeating the treatment in seven to 10 days to kill any nits that may have hatched since the initial treatment.
- Comb wet hair once a day for several weeks to remove lice and nits.
- To ensure that lice do not spread to others in your household, use hot water (130 F) to wash any clothes, towels, linens, blankets or anything else the infected person’s head may have touched, and dry on a high heat setting. Clothing and articles that cannot be washed can be dry cleaned or sealed in a plastic bag for two weeks.
- Vacuum your carpets and furniture, but avoid lice-killing sprays, which can cause more harm than the lice.
- Remind your family to avoid sharing hats, scarves, combs and brushes.
In the past year new prescription treatments for lice have emerged that appear to be especially effective. If over-the-counter remedies do not work, Mirmirani suggests you see your healthcare provider for advice on further treatment.