Head Lice, Pediatric
Lice are tiny bugs, or parasites, with claws on the ends of their legs. They live on a person's scalp and hair. Lice eggs are also called nits.
Having head lice is very common in children. Although having lice can be annoying and make your child's head itchy, having lice is not dangerous, and lice do not spread diseases.
Lice spread easily from one child to another, so it is important to treat lice and notify your child's school, camp, or daycare. With a few days of treatment, you can safely get rid of lice.
Lice can spread from one person to another. Lice crawl. They do not fly or jump. To get head lice, your child must:
Have head-to-head contact with an infested person.
Share infested items that touch the skin and hair. These include personal items, such as hats, combs, brushes, towels, clothing, pillowcases, or sheets.
Children who are attending school, camps, or sports activities are at an increased risk of getting head lice. Lice tend to thrive in warm weather, so that type of weather also increases the risk.
SIGNS AND SYMPTOMS
Rash or sores on the scalp, the ears, or the top of the neck.
Feeling of something crawling on the head.
Tiny flakes or sacs near the scalp. These may be white, yellow, or tan.
Tiny bugs crawling on the hair or scalp.
Diagnosis is based on your child's symptoms and a physical exam. Your child's health care provider will look for tiny eggs (nits), empty egg cases, or live lice on the scalp, behind the ears, or on the neck.
Eggs are typically yellow or tan in color. Empty egg cases are whitish. Lice are gray or brown.
Treatment for head lice includes:
Using a hair rinse that contains a mild insecticide to kill lice. Your child's health care provider will recommend a prescription or over-the-counter rinse.
Removing lice, eggs, and empty egg cases from your child's hair by using a comb or tweezers.
Washing and bagging clothing and bedding used by your child.
Treatment options may vary for children under 2 years of age.
HOME CARE INSTRUCTIONS
Apply medicated rinse as directed by your child's health care provider. Follow the label instructions carefully. General instructions for applying rinses may include these steps:
Have your child put on an old shirt or use an old towel in case of staining from the rinse.
Wash and towel-dry your child's hair if directed to do so.
When your child's hair is dry, apply the rinse. Leave the rinse in your child's hair for the amount of time specified in the instructions.
Rinse your child's hair with water.
Comb your child's wet hair close to the scalp and down to the ends, removing any lice, eggs, or egg cases.
Do not wash your child's hair for 2 days while the medicine kills the lice.
Repeat the treatment if necessary in 7–10 days.
Check your child's hair for remaining lice, eggs, or egg cases every 2–3 days for 2 weeks or as directed. After treatment, the remaining lice should be moving more slowly.
Remove any remaining lice, eggs, or egg cases from the hair using a fine-tooth comb.
Use hot water to wash all towels, hats, scarves, jackets, bedding, and clothing recently used by your child.
Place unwashable items that may have been exposed in closed plastic bags for 2 weeks.
Soak all combs and brushes in hot water for 10 minutes.
Vacuum furniture used by your child to remove any loose hair. There is no need to use chemicals, which can be toxic. Lice survive only 1–2 days away from human skin. Eggs may survive only 1 week.
Ask your child's health care provider if other family members or close contacts should be examined or treated as well.
Let your child's school or daycare know that your child is being treated for lice.
Your child may return to school when there is no sign of active lice.
Keep all follow-up visits as directed by your child's health care provider. This is important.
SEEK MEDICAL CARE IF:
Your child has continued signs of active lice (eggs and crawling lice) after treatment.
Your child develops sores that look infected around the scalp, ears, and neck.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.