Head Lice
What Are Head Lice?
Head lice are small sesame seed sized insects that live on the scalp and feed on small amounts of blood to survive. Head lice lay eggs (called nits) on hair shafts close to the scalp. These nits look like tiny white or yellowish dots and can be mistaken for dandruff. Nits contain a sticky substance which helps it stay attached to hair, making it difficult to remove.
How does Head Lice Spread?
Direct Head-to-Head Contact
This is the most common way lice spread, especially among children who play closely together.
Sharing Personal Items
Although not as common, lice can spread when sharing items such as combs, brushes, hats, headphones, and hair accessories.
Symptoms of Head Lice
Itching
The most common symptom, itching typically starts behind the ears and back of the neck. It takes a number of weeks before the scalp becomes sensitive to the lice saliva, causing irritation and itching.
Visible Lice or Nits
Small white or yellowish nits stuck to hair shafts close to the scalp, and sometimes live lice crawling on the scalp.
Treating Lice in Children (Without Medications)
Wet Combing:
Wet the hair and use a fine-toothed nit comb to comb out lice and nits. After each pass with the comb, wipe the comb with a wet paper towel. Repeat this process every 3-4 days for at least two weeks.
Treating Lice in Children (With Over-the-Counter Medications)
Permethrin based product (lotion, shampoo, hair mousse)
Permethrin lotion can be used in children greater than or equal to 2 months of age.
Permethrin shampoo & hair mousse can be used in children greater than or equal to 2 years of age.
How It Works: Permethrin kills live parasites (head lice, pubic lice, scabies), but does not kill lice eggs (nits). Repeat treatment is often needed after 7-10 days to kill newly hatched lice.
How to Use: Wash hair with normal shampoo (without conditioner) and rinse with water. Towel dry hair and apply enough permethrin product to cover the scalp (don’t forget to apply behind the ears and at the base of the neck). Leave on hair for 10 minutes before rinsing out with water and remove any remaining nits.
This can be repeated in 7-10 days if live lice or nits are still seen on your child’s scalp.
Ivermectin (lotion)
Can be used in children greater than or equal to 6 months of age.
How it works: Ivermectin lotion kills live head lice but does not kill lice eggs (nits). Ivermectin will prevent newly hatched lice from living, so only 1 application is needed.
How to Use: Apply enough ivermectin lotion (up to 1 tube) to completely cover dry hair and scalp. Rinse off after 10 minutes. Throw away remaining ivermectin lotion.
Cleaning and Disinfecting
Wash bedding, hats, and clothing in hot water and dry them on high heat. Vacuum furniture, carpets, and car seats to remove any fallen lice or hairs with nits.
If there are items that can’t be washed, seal them in a plastic bag for 2 weeks or they can be dry cleaned.