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Head Lice: What Parents Should Know

Spotting a tiny, white speck in your child's hair is enough to make many parents panic. Sure, head lice score high on the yuck factor, but they usually don't cause serious disease. Here you'll find all the information you need to get a lice infestation under control.

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What Are Head Lice?

Head lice are tiny six-legged insects that cling to the scalp and neck and feed on human blood. Each louse is about the size of a sesame seed and can be hard to spot. Lice eggs, called nits, are glued onto hairs near the scalp and can be even harder to see.

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Who Gets Head Lice?

Head lice are most common in young children who go to day care, preschool, or elementary school. Children of this age often play together closely and with more hair-to-hair contact, and they may share brushes, hats, hair clips, and the like. Adults who live with children also have a higher risk of getting head lice.

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How Head Lice Spread

Lice usually spread through direct head-to-head contact that allows the pests to crawl from one person's hair into another's. Lice can also survive for a short period on clothing or other personal items, so a shared hairbrush can help a louse find a new host. Lice cannot jump or fly from one person to another.

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How to Spot Head Lice

Although lice and their nits are small, they are visible to the naked eye. Head lice can be white, brown, or dark gray. They are most often found in the hair at the back of the neck or behind the ears. The nits are round or oval specks that are tightly glued to hairs near the scalp. If you try to slide the nits off, they won't budge. Research suggests combing through wet hair is an ideal way to spot an infestation.

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Symptoms of Head Lice

Spotting a live louse or nymph (a young louse) is often the only sign of an infestation. Seeing nits alone doesn't confirm an infestation. In many children, head lice don't cause any discomfort. When symptoms do happen, the most common problem is itching that may start weeks or even months after the lice move in.

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Head Lice Allergies

The itching from lice is caused by an allergic reaction to the bug bites. A lot of scratching may lead to sores or raw skin on the scalp. It's not common, but sores from scratching can become infected. Call a doctor quickly if the skin becomes red, swollen, or painful or the lymph nodes in the neck become tender. These may be signs of a skin infection.

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If You Suspect Head Lice

Head lice will not go away on their own. If you suspect your child has an infestation, there are several steps you should take right away. Call your doctor to confirm the diagnosis. Notify your child's day care or school so other students can be checked. Examine all other members of the household for signs of lice. Finally, treat everyone who's infected at the same time.

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Getting Rid of Lice

You can find lice-killing treatments over the counter. They are made from extracts of chrysanthemums or a synthetic version that is similar. They are considered safe, but they may not be recommended for young children. Sometimes lice are resistant to these. Speak to your doctor about whether the lice in your area are resistant to these drugs. No matter what you treat with, follow instructions on the label carefully for how long the medication should be left on the hair and how it should be washed off. A second treatment may be needed 9 to 10 days later.

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Ridding Your Home of Lice

Although lice don't survive long when not on a human, it's best to wash the bedding of anyone being treated for lice. Clothing worn in the past 48 hours should also be washed in hot water. While parents are sometimes told to clean and quarantine all of a child's stuffed animals, experts say this is not necessary. If your child sleeps with a favorite plush toy, put it in a hot dryer for 30 minutes. That should kill any creepy-crawlies.

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Home Remedies for Head Lice

Some parents claim mayonnaise, white vinegar, or tea tree oil are effective natural remedies for head lice. Mayonnaise is said to smother lice, but check with your doctor first. Vinegar is rumored to dissolve the glue that keeps nits stuck to the hair. There is no scientific evidence to support these home remedies, and pediatricians say you should not rely on them as your main treatment.

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Fine-Toothed Combs

Fine-toothed combs are another way to get rid of lice. This comb has teeth fine enough to pull out lice and their nits. It worked for the ancient Egyptians -- nit combs have been found in their tombs. The drawback is that it takes time and patience to comb every last nit out of a child's hair. It is more effective to comb the hair after treating with a medicated shampoo to get rid of any stragglers.

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Head Lice Myths

Head lice are not a scourge of the lower classes, nor a sign of poor hygiene. They affect children across all levels of income, social class, and cleanliness. The bugs can survive underwater for up to 6 hours, so kids who bathe regularly are just as vulnerable. The good news is lice don't carry diseases.

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Head Lice at School

According to the American Academy of Pediatrics, a healthy child should not be kept home from school because of lice. It recommends that a child remain in class but avoid head contact with others. After treatment, dead eggs may remain in a child's hair until they are removed. Some schools have a "no nits" policy, meaning the eggs must be removed before the child returns to class. The American Academy of Pediatrics discourages this policy.

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Guarding Against Head Lice

If you have young children, there's unfortunately very little you can do to ward off head lice. Kids will be kids, and when they put their heads together or share hair bows, lice get a ticket to ride. Your best defense is to examine your child's hair and scalp regularly so you can catch an infestation early. Quick treatment will help prevent the bugs from spreading to the rest of the family.

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Sources | Medically Reviewed on 06/29/2017 Reviewed by Dan Brennan, MD on June 29, 2017

IMAGES PROVIDED BY:
(1)   Oxford Scientific
(2)   CDC/ Dr. Dennis D. Juranek
(3)   Glow Images
(4)   Darlyne A. Muraawski / National Geographic
(5)   Interactive Medical Media LLC
(6)   Medicimage
(7)   Dr. P. Marazzi / Photo Researchers, Inc.
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(10)   Peter Cade / Iconica
(11)   Glow Images
(12)   IAN HOOTON/SCIENCE PHOTO LIBRARY
(13)   George Bernard / Photo Researchers, Inc.
(14)   Véronique Burger / Photo Researchers, Inc.
(15)   BSIP / Phototake -- All rights reserved.

SOURCES:

American Academy of Pediatrics Clinical Report.

CDC.

Dale Pearlman, MD, department of dermatology, Stanford University, Palo Alto, CA.

Frankowski, B. American Journal Managed Care. 2004.

Hoekelman, R., ed. Primary Care, Mosby, 2001.

Jahnke, C. Archives of Dermatology, 2009.

Lebwohl, M. Pediatrics, May 2007.

Richard J. Pollack, PhD, department of immunology and infectious diseases, Harvard School of Public Health, Boston.

Roberts, R. New England Journal of Medicine, May 23, 2002.

University of Nebraska-Lincoln.

Reviewed by Dan Brennan, MD on June 29, 2017

This tool does not provide medical advice. See additional information.

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.