Head Lice in Kids: Signs, Treatment and Prevention

Getting a note from school that says "head lice" can make any parent's head itch. The good news is that lice are very common in young kids, they do not spread disease, and you can get rid of them at home. The American Academy of Pediatrics says lice are not a health hazard and not a sign that a child or home is dirty.

Here is what head lice are, how to check for them, how to treat them, and how to keep them from coming back.

What are head lice?

Head lice are tiny bugs that live on the scalp and feed on small amounts of blood. Adult lice are about the size of a sesame seed and are tan or light brown. They lay eggs, called nits, that stick to the hair close to the scalp.

Here are some facts from the CDC:

• Lice crawl. They cannot jump or fly.
• An adult louse can live on the head for about 30 days. A female can lay about 6 eggs a day.
• Nits take about 1 week to hatch. The young lice grow into adults in about 7 more days.
• If a louse falls off the head, it dies within 2 days.
• Pets do not get or spread head lice.

How do kids get head lice?

The most common way is head to head contact. This happens a lot when kids play, hug, take selfies or share a bed. Lice can also spread, less often, by sharing hats, scarves, hair ties, combs, brushes, towels or pillows. The CDC says getting lice has nothing to do with how clean you or your home is.

Signs your child has head lice

• An itchy head, most often behind the ears and at the back of the neck
• A tickly feeling, like something is moving in the hair
• Trouble sleeping or feeling cranky
• Small sores on the scalp from scratching

Some kids have no itching at all. The CDC says the first time a child gets lice, it can take 4 to 6 weeks for the itching to start.

How to check for lice

The American Academy of Dermatology suggests these steps:

1. Sit your child in a bright spot.
2. Wet the hair. This slows the lice down and makes them easier to see.
3. Split the hair into small sections.
4. Use a fine tooth lice comb. Start at the scalp and comb out to the ends.
5. Look closely behind the ears and at the back of the neck.

Nits or dandruff? Dandruff, sand and lint come off easily. Nits feel glued to the hair and are hard to pull off. The best sign of lice is finding a live, moving louse.

How to treat head lice

Most lice can be treated at home with a lice shampoo or lotion from the store. The AAP says products with pyrethrins or permethrin are usually the first choice. Talk to your child's doctor before treating a young child, and ask about prescription options if store products don't work.

The CDC and the AAD give these tips:

• Do not use conditioner or a shampoo with conditioner before the lice medicine.
• Follow the label exactly. Don't use more than it says.
• Rinse it out over a sink, not in the bath or shower, so it touches less skin.
• Put clean clothes on your child after treatment.
• Don't wash the hair again for 1 to 2 days.
• Comb out nits and dead lice with a lice comb every day for 2 to 3 weeks. A flea comb for pets also works.
• Check the hair 8 to 12 hours after treatment. If lice are still moving fast, don't treat again right away. Call your doctor, because you may need a different medicine.
• Most store products need a second treatment about 7 to 9 days later to kill lice that hatched after the first one.

Check everyone in the house, but only treat the people who have lice. People who share a bed with your child should be treated at the same time.

Lice combing takes time, and little kids don't like to sit still. Play a fun song to help. The Bath Song walks your child through shampooing their hair, rinsing it off and drying with a towel. You can also put on one of our cartoons while you comb.

What about home remedies?

You may hear about mayonnaise, olive oil or butter. The CDC says there is no scientific proof that these work. Never use kerosene, gasoline, bug spray or pet flea products on your child. They can be very dangerous.

Cleaning your home

You do not need to deep clean your whole house. The CDC says the chance of getting lice from a carpet or couch is very small. Just do these simple steps:

• Wash sheets, pillowcases, clothes and towels your child used in the 2 days before treatment in hot water (130°F) and dry on high heat.
• If something can't be washed, like a stuffed animal, seal it in a plastic bag for 2 weeks.
• Soak combs and brushes in hot water (at least 130°F) for 5 to 10 minutes.
• Vacuum the floor and furniture where your child sat or lay.
• Do not use bug sprays or fogs. The CDC says they can be toxic.

Can my child still go to school?

Yes. The AAP says head lice are no reason for a child to miss school. Your school may have its own rules, so check with them. Going back to school can feel hard if your child is embarrassed. Remind them that lice happen to lots of kids. Our song First Day Of School reminds kids that "just be yourself and you are going to do great."

How to prevent head lice

• Teach your child not to share hats, hair ties, combs, brushes or helmets.
• Remind them to avoid head to head contact during play.
• Tie long hair back in a braid or ponytail for school and camp.
• Check your child's hair once a week if lice are going around at school.

Want to learn more about common health problems? Read our posts on common health problems in toddlers and health and safety tips for kids.

Questions Parents Ask About Head Lice

How did my child get head lice?

Most kids get lice from head to head contact with another child who has them. It can also happen by sharing hats, brushes or pillows. It has nothing to do with being dirty.

Can lice jump from one head to another?

No. Lice can't jump or fly. They can only crawl, so they need close contact to move to a new head.

How long can lice live off the head?

Adult lice die within 2 days if they fall off the head. Nits that fall off usually die within a week because they need the warmth of the scalp.

Do I need to treat my whole family?

Check everyone in the house, but only treat people who have live lice. Anyone who shares a bed with your child should be treated at the same time.

Why do I need to treat lice twice?

Most store products kill live lice but not all the eggs. A second treatment about 7 to 9 days later kills the new lice that hatched before they can lay more eggs. Always follow the product label.

Can my dog or cat give my child lice?

No. The CDC says animals do not get or spread head lice.

Do I have to remove every nit?

Combing out nits helps make sure the lice are gone. The CDC says nits more than 1/4 inch from the scalp are almost always hatched or dead. Some newer prescription products don't need nit combing at all. Ask your doctor.

This post is for general information only. It is not medical advice. If you have questions about your child's health, please talk to your child's doctor.