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Pediculus humanus capitus, or head lice, often become a parenting nightmare when they are discovered on a school-aged child. Old wives' tales that associate head lice infestation with poor hygiene or lack of household cleanliness add an unnecessary social stigma to the disorder. In truth, head lice are parasitic insects spreading readily from one human to another through direct skin contact. Children of preschool- and elementary-school age tend to be affected more because of their close contact during playtime and at school. The National Pediculosis Association estimates about 12 million cases of head lice are discovered each year.
What are head lice?
Head lice are wingless parasites that live on the scalp. These parasites need to feed on human blood in order to survive. Head lice cannot live on family pets nor can they survive for periods longer than 2 days once they fall off a person. Adults can live up to 30 days on someone's head; eggs take about a week to hatch. Lice are unable to fly or jump from one person to another; however, they can crawl. The most common way for lice to spread is from head-to head-contact. They may also get from one person to another by sharing combs, brushes, hats, towels, sleeping bags or bed linens with an infected person.
How will I know if my child has head lice?
The most common symptom associated with head lice is itching of the scalp. When head lice puncture the skin to draw blood for survival, their saliva causes itching and may result in a skin rash. If you notice that your child is frequently scratching his or her head, check for lice. At times, children can become infected and not complain of itching. If the school notifies you of an outbreak of head lice, check your child often, even if you don't see any noticeable symptoms. Use a bright light, and a magnifying glass if you have one.
It can be difficult to spot head lice since they move quickly and shy away from bright light. Begin by inspecting the scalp and hair. Look for small white or yellowish-brown specks that are attached to the hair (the "nits" or eggs). Dandruff can sometimes be confused with lice, but dandruff is easily removed by flicking, whereby lice and their eggs are not as easily dislodged.
What is the treatment for head lice?
If someone in your family has head lice, the most important thing is to use head lice medication to kill the lice on the person and other family members. Wash clothing and bedding that was used 2 days before treatment by the person who has lice. Other recommendations from the Centers for Disease Control and Prevention include:
- Use an over-the-counter or prescription medication approved by your health care provider or school nurse. Follow all instructions about how to use the medicine. Note: Do not use creme rinse or combination shampoo/conditioner before using lice medicine. Don't wash hair for 1 to 2 days after applying medicine.
IMPORTANT: Medications for head lice should not be used on children under age 2 and should not be applied by pregnant women. For children under age 2, use a nit comb. If this doesn't work, contact your health care provider for recommendations.
- After treatment, check hair and comb with a nit comb (usually included in lice medication package) every 2 to 3 days to remove nits and lice. Continue checking for 2 to 3 weeks to be sure they are all gone.
- Machine wash all clothing and bedding with hot water and dry on high for at least 20 minutes. Dry clean clothing that is not washable.
- Store all clothing, stuffed animals, comforters that can't be washed or dry cleaned in a sealed plastic bag for 2 weeks.
- Soak combs and brushes in rubbing alcohol or Lysol for 1 hour or wash with soap and hot water.
- Vacuum the floor and furniture where the person with lice usually sits and lays.
Note: Head lice to not live long once they fall off the person so don't spend a lot of time or money on cleaning.
Should I alert school officials if I find head lice on my child?
Yes. The only way to be certain that head lice will not persist is to adequately treat anyone who has them. If you discover head lice on your child, chances are good that someone else in the classroom is also affected. If you alert school officials, the school nurse can screen for head lice in the classroom and also alert parents to check their children on a regular basis. Remember that head lice do not imply unsanitary living conditions. You are doing your child, his or her classmates and the teacher a disservice if embarrassment keeps you from sharing information about head lice.
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External Sources
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Centers for Disease Control and Prevention
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National Pediculosis Association
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This article was reviewed and updated June 2007.
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