Head Lice

What do lice and nits (eggs) look like?
Lice are grayish-brown wingless insects. Nits are grayish-white, always oval shaped, and glued at an angle to the side of the hair shaft. Lice can crawl quickly through the hair, but do not fly or jump. Nits will not flake off the hair easily like dandruff or hair debris.

How did my child get head lice?
Anyone can get head lice . . . mainly by head-to-head contact, but also from sharing personal items such as hats, combs, pillows, headbands, and brushes from an infested person. Healthy, clean children are ideal hosts for head lice. Except for the common cold, head lice infestation affects more school-age children than all other childhood communicable diseases combined. Three to ten year old children are the most common victims. Human lice only live on humans. You do not need to treat your pets.

How do I get rid of head lice?
Most of your time and energy should be spent on the heads of infested family members. Head lice are human parasites and will not survive without human blood. Unless advised differently by your health care provided, treat each infested person with a lice killing product. Follow package directions carefully. Do not apply for longer, or more frequently than indicated in the instructions. All lice-killing products are pesticides and must be used with caution. None of the lice-killing products are 100% effective at killing all the eggs. Remove all nits from the head to ensure total lice treatment. Nits will not come off the hair with the shampoo treatment; you will need to manually remove them. Nit removal is very time consuming. Separate the hair in sections and work on one section at a time, removing all attached nits with a nit-removal comb, baby safety scissors, or your fingernails. Dispose of nits in the garbage.

How do I treat the home environment?
Wash bedding and recently worn clothing in hot water and dry in a hot dryer (at least 20 minute cycles). Dry clean non-washable garments, or seal in a plastic bag for fourteen days. Combs and brushes may be soaked in hot (not boiling) water for 10 minutes, and cleaned with old toothbrush and soapy water, or soaked in a lice-killing solution for one hour. Avoid lice sprays. Vacuuming is the safest and best way to remove lice or fallen hairs with attached nits from upholstered furniture, rugs, stuffed animals and car seats.

When can my child return to school?
We would like your child to return as quickly as possible. As soon as your child has been treated with a lice-killing product and all nits have been removed, they are ready to return to school. In special situations you may be advised by your health care practitioner to do manual removal of lice and/or nits, instead of using a pesticide. Please talk with your school nurse about this situation.

Is there anyone else I should notify about head lice?
Since lice are most often spread by direct head-to-head contact, it is important that any children your child has had direct contact with are also checked for presence of head lice. Notify your child's school, camp, child care provider and parents of children who have had close contact with your child. Continue to check your child for lice on a regular basis. This is the best way to protect your family and community. Please feel free to contact your school nurse for questions or concerns.

Use of lice treatment products:
There are a variety of medicated shampoos and cream rinses available. Most are available without a prescription. Consult your physician before using any product on children under 2 years, or if you are pregnant, nursing, have allergies, asthma, or lice or nits in the eyebrows or eyelashes. Never use a pesticide on or near the eyes. These products are not recommended if sores or open areas are present to the scalp. Consult your health care provider if it is financially difficult for you to purchase a treatment. Some insurances (like Healthy Options) will cover the cost of certain over the counter products (but you need to obtain a prescription from your health care provider). Do not buy lice sprays, or products used to kill fleas or other insects. These sprays are unnecessary and can be harmful since family members would be inhaling insecticides in a gaseous form. Apply all lice medications according to manufacturer's directions. They should be applied to a child over a sink, not a bathtub or shower, in order to prevent the product from contacting other parts of the child's body. Do not use cream rinse, conditioner or vinegar, since these products may reduce the effectiveness of the lice killing product.

For more information, link to the Public Health - Seattle & King County lice web page. Click here to access the information.

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