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Lice (Head): Brief Version

What are head lice?

Head lice live only on human beings. They can be spread quickly by using the hat, comb, or brush of an infected person. The nits (eggs) normally hatch into lice within 1 week. Your child probably has lice if:

  • The nits (white eggs) are firmly attached to hairs. Unlike dandruff, nits can't be shaken off.
  • There are gray bugs (lice) in the hair about 1/16 inch long. They move quickly and are difficult to see.
  • Your child's scalp itches and has a rash.

How can I take care of my child?

  • Anti-lice shampoo. Buy an anti-lice shampoo or rinse. Follow the directions on the package exactly. Most products must be used on dry hair. Pour about 2 ounces of the anti-lice shampoo into the hair. Add a little warm water to work up a lather. Scrub the hair and scalp for 10 minutes. Rinse the hair thoroughly. The shampoo kills the lice and most of the nits. Repeat the shampoo again in 9 days.

    Don’t use hair conditioner. It will keep the anti-lice shampoo from working.

  • Removing dead nits. You don’t need to remove dead nits. Only live lice can cause lice in other children. But removing nits keeps other people from thinking your child still has live lice. Remove the nits by combing the hair with a fine-tooth comb or pulling them out one by one.
  • Cleaning the house. Lice can't live more than 24 hours off the human body. Nits can live for 2 weeks. Vacuum your child's room. Soak combs and brushes 1 hour in a solution made from the anti-lice shampoo. Wash your child's sheets and pillowcases in hot water. Put things that can't be washed (hats or coats) in plastic bags for 2 weeks (until the nits are dead).
  • Contagiousness. Check the heads of everyone living in your home. Treat anyone who has scalp rashes, sores, or itching. Also treat anyone who sleeps in the same bed with your child. Your child can return to school after the first treatment with the shampoo.

Call your child's doctor during office hours if:

  • The rash and itching are not gone 1 week after treatment.
  • The sores start to spread or look infected.
  • The lice and nits return.
  • You have other questions or concerns.
Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of Pediatrics Books.
Pediatric Advisor 2019.4 published by Change Healthcare.
Last modified: 2016-06-01
Last reviewed: 2018-07-13
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2018 Barton D. Schmitt, MD FAAP. All rights reserved.
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