Head Lice

What are head lice?

Head lice are tiny parasitic bugs that can infest the skin. They live on people’s heads and feed on their blood. Head lice can cause intense itching.

There are two other types of lice: body lice and pubic lice. This health sheet will focus on head lice.

What causes head lice?

Head lice are very contagious. They spread from person to person by close body contact, and by shared clothes and other personal items. These can include things such as hats, hairbrushes, and combs.

Who is at risk for head lice?

Head lice are seen mostly in child-care settings and among school-aged children. It doesn’t matter how clean your child’s hair or your home may be. It doesn’t matter where children and families live, play, or work.

What are the symptoms of head lice?

The most common symptom of head lice is itching. The itching can be very bad, especially at night. Lice or their eggs (nits) can usually be seen on the hair, behind the ears, or on the neck. They can even be seen in the eyebrows and eyelashes.

How are head lice diagnosed?

The eggs laid by lice can usually be seen. This makes it easy for your child's healthcare provider to diagnose.

How are head lice treated?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Lice are treatable. Treatment will include applying a medicated cream rinse or shampoo to your child’s hair. Many head lice medicines are available over the counter. Your child’s healthcare provider may prescribe a medicine if the OTC medicines did not work for your child.

Talk with your healthcare provider about which rinse or shampoo would be best for your child. Do not use two forms of treatment at the same time. If one treatment does not work, use a different treatment or call your healthcare provider for advice.

In addition to the medicated cream rinse or shampoo, treatment may also include:

  • Removing nits from wet hair with a fine-tooth comb.
  • Soaking combs and brushes in hot water with the shampoo for at least 15 minutes.
  • Checking all other household members closely to see if anyone else needs to be treated. 
  • Washing all bedding and clothing in hot water (130°F or 54°C), or sealing items that cannot be washed in a plastic bag for 2 weeks.  

Children can return to school or daycare the day after their first treatment for head lice.

Can head lice be prevented?

You can help prevent head lice by:

  • Avoiding close physical contact with someone who has lice
  • Encouraging your child not to share hats, combs, brushes, towels, or other personal items.
  • Washing bed sheets, blankets, and other personal items to prevent lice from infesting other people.

When should I call my child’s health care provider?

Some lice treatments are available over the counter. But if you are unsure that your child has lice, or if a home treatment does not work, it is important to talk with your child’s healthcare provider.

Key points about head lice

  • Head lice are tiny parasitic bugs that can infest the skin on a person’s scalp.
  • Lice are highly contagious, spreading from person to person by close body contact, and by shared clothes and other personal items.
  • The eggs laid by lice can usually be seen. This makes it easy for your child’s healthcare provider to diagnose.
  • Lice are treatable. Some medicines are available over the counter, but talk with your child’s healthcare provider if you are unsure of the diagnosis.

Next steps

Tips to help you get the most from a visit to your child’s health care provider:
  • Before your visit, write down questions you want answered.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you for your child.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.