Head Lice

How do you know if your child has head lice?

Head lice are small grey insects about ¼ in long. They live only on human scalps. (There are other kinds of lice that prefer other hairy locations). They move very quickly and are very difficult to spot. They attach their eggs, known as “nits” to a single strand of hair. Nits are straw colored and about 1mm long. That’s about the size of a comma on this page. You generally find nits within ½ in of the scalp near the nape of the neck. Look for nits by having you child bend forward with their head in their lap; then part and search near the roots of the hair at the hairline of the neck. Sometimes you will notice redness and scratch marks (excoriations) on the neck. The lice bite the skin there causing some kids to be itchy.

What should I do if my child is exposed to someone with lice?

Lice cannot fly or jump. They only crawl. They are not usually motivated to leave the warm scalp they inhabit. That being said, they do end up one way or another on someone else’s head. If your child has been in contact with another child with lice, keep a look out for nits in your child’s hair. Preteating with medications does not seem to be helpful. Keeping long hair neatly tied back, teaching your children not to share combs, brushes, hair accessories or hats will help limit the transfer of lice from one head to another.

What do I do when I find nits on my child?

Do not panic! Dealing with lice is inconvenient. They are not a health hazard. There are many products available over the counter at your pharmacy to take care of the lice. The nits must be removed by hand.

What is the best product to use to kill lice?

The products available over the counter to kill lice are insecticides. They kill lice and kill the nits (the egss won’t hatch). These products do not loosen the dead nit from the hair shaft. The most widely used products contain Permethrin or Pyrethrin. They may come as shampoos, cream rinses or mousses. READ AND FOLLOW THE PACKAGE DIRECTIONS VERY CAREFULLY ! Some products are applied to dry hair and other products to wet hair. The time the product must remain on the hair varies. (Your regular cream rinse may coat the nit and affect how the product penetrates. Wash the hair with a plain shampoo to remove any cream rinse residue before applying the lice-control product. Dry if necessary before product application). The product is usually repeated in 7 to 10 days to catch any immature lice that might have hatched after the first application.

How do I know the lice are gone?

Since it is hard to find live lice on a scalp, often the only sign of their persistence is the appearance of new nits. That means you have to be very dedicated to removing the old nits after the application of a lice control product.

How do I get rid of the nits?

Getting rid of nits is time-consuming and tedious. Each nit must be pulled off the hair shaft. Specially designed fine toothed metal combs may help isolate the hairs, others prefer to pull the nits off with their fingers. There are nit removal aids available from your pharmacy. These are supposed to loosen the adhesive binding the nit to the hair shaft, making the nit easier to pull off. Vinegar may also loosen the adhesive. You still have to pull each nit off the shaft.

Why bother nit-picking?

There are some lice populations whose nits seem resistant to the lice-control products mentioned above. The lice are gone, but the nits still hatch and your child is infested again. If you remove the nits, that problem is solved. Getting rid of the nits also lets you quickly assess if new nits appear indicating recurrent lice infestation. Many pediatricians feel being overly aggressive with nit removal is unwarranted as the nits usually do die with treatment. However, Harford County Schools do support a No Nit Policy for a child to return to school.

When is my child no longer capable of sharing lice?

Immediately after treatment with one of the above mentioned lice-control products (pediculocides), the lice are dead.