Head Lice in Children

What are head lice in children?

Head lice are tiny parasitic insects 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 in a child?

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 coats, hats, hairbrushes, and combs.

Which children are at risk for head lice?

Head lice are seen mostly in childcare 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. Any child can get head lice.

What are the symptoms of head lice in a child?

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 in a child?

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 in a child?

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 (OTC). 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.

What can I do to prevent head lice in my child?

You can help prevent head lice by:

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

When should I call my child’s healthcare 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 in children

• Head lice are tiny parasitic insects 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.
• To prevent lice from infesting other people in the home, sheets, blankets, and other personal items need to be washed.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• 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 healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.