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Head lice

Updated: 9/7/2023
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13y ago

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Definition

Head lice are tiny insects that live on the scalp. They can be spread by close contact with other people.

These lice only live in hair and occasionally eyebrows and eyelashes.

See also:

Alternative Names

Lice - head; Nits; Pediculosis capitis - head lice

Causes, incidence, and risk factors

Head lice infect hair on the head. They are easiest to see on the neck and over the ears. Tiny eggs on the hair look like flakes of dandruff. However, instead of flaking off the scalp, they stay put.

Head lice can survive up to 30 days on a human. Their eggs can live for more than 2 weeks.

Head lice spread easily. You can get head lice when you come in close contact with a person who has lice, or by touching their clothing or bedding. Head lice are more common in close, overcrowded living conditions. Lice spread easily among school children.

Having head lice does NOT mean the person has poor hygiene or low social status.

Having head lice causes intense itching, but does not lead to serious medical problems. Unlike body lice, head lice never carry or spread diseases.

Symptoms
  • Intense itching of the scalp
  • Small, red bumps on the scalp, neck, and shoulders (bumps may become crusty and ooze)
  • Tiny white specks (eggs, or nits) on the bottom of each hair that are hard to get off

Lice on scalp and clothing may be difficult to see, unless the infestation is heavy. If you see something moving, it's called a louse.

Signs and tests

To see head lice, you need to look closely. Use disposable gloves and look at the person's head under a bright light. Full sun or the brightest lights in your home during daylight hours work well. A magnifying glass can also help.

Part the hair all the way down to the scalp in very small sections, looking both for moving lice and eggs (nits). Look at the entire head this way. Look closely around the top of the neck and ears, the most common locations for eggs.

Treatment is recommended if even one egg is found.

Treatment

Lotions and shampoos containing 1% permethrin (Nix) often work well. They can be bought at the store without a prescription. If these do not work, a doctor can give you a prescription for stronger medicine. Such medicine should be used exactly as directed.

To use the medicine shampoo, first rinse and dry the hair. Then apply the medicine to the hair and scalp. After 10 minutes, rinse it off. Check for lice and nits again in 1 week and repeat the treatment if necessary.

An important part of treatment is removing the eggs (nits). Certain products make the nits easier to remove. Some dishwashing detergents can help dissolve the "glue" that makes the nits stick to the hair shaft.

  • You can remove the eggs with a nit comb. Before doing this, rub olive oil in the hair or run the metal comb through beeswax. This helps make the nits easier to remove.
  • Metal combs with very fine teeth are stronger and more effective than plastic nit combs. These metal combs are easier to find in pet stores or on the internet than in pharmacies.
  • Removing eggs may prevent the lice from returning if the medication fails to kill every one of them.
  • Treat children and adults with lice promptly and thoroughly.
  • Wash all clothes and bed linens in hot water with detergent. This also helps prevent head lice from spreading to others during the short period when head lice can survive off the human body.
  • Repeat combing for nits in 7-10 days.

Malathion 0.5% in isopropanol is FDA approved for the treatment of head lice. Apply it to dry hair until the hair and scalp are wet. Leave it on for 12 hours. Malathion may be useful for resistant infections.

Treatment can cause significant side effects in children younger than 6 months old, the elderly, and anyone weighing less than 110 lbs (50 kg), especially when the treatment is used repeatedly in a short period of time.

Expectations (prognosis)

Lice are usually killed with proper treatment. However, lice may come back, especially if the source is not corrected. For example, a classroom with many infected children can cause kids to repeatedly get lice.

When one case is detected in a family or a school or child-care center, every child at that location should be examined for head lice. This can help prevent further spreading.

Complications

Some people will develop a secondary skin infection from scratching. Antihistamines can help relieve the itching.

Calling your health care provider

Call your health care provider if symptoms continue after home treatment, or if you develop areas of red, tender skin, which could mean a possible infection.

Prevention

Never share hair brushes, combs, hair pieces, hats, bedding, towels, or clothing with someone who has head lice.

If your child has lice, be sure to check policies at schools, day-care centers, preschools, and nurseries. Many do not allow infected children to be at school until the lice have been completely treated.

Some schools may have policies to make sure the environment is clear of lice. Sometimes, the insects or their eggs get into areas such as carpets. Frequent cleaning of carpets and all other surfaces in child-care centers prevents spread of all types of infections, including head lice.

References

Morelli JG. Arthropod bites and infestations. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF. Nelson Textbook of Pediatrics. Philadelphia, Pa: Saunders Elsevier; 2007:chap 667.

Schlossberg D. Arthropods and leeches. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 380.

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13y ago
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13y ago

Head lice are parasitic insects that live in the hair and scalp of humans. They need human blood to survive. Also they spread easily from person to person by direct contact. Head lice can infest anyone, regardless of personal hygiene.

The scientific name for head louse is Pediculus humanus capitis

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12y ago
Definition

Head lice are tiny insects that live on the skin covering the top of your head, called the scalp. Lice can be spread by close contact with other people.

Head lice may also be found in eyebrows and eyelashes.

See also:

Alternative Names

Pediculosis capitis - head lice

Causes, incidence, and risk factors

Head lice infect hair on the head. Tiny eggs on the hair look like flakes of dandruff. However, instead of flaking off the scalp, they stay put.

Head lice can live up to 30 days on a human. Their eggs can live for more than 2 weeks.

Head lice spread easily, particularly among school children. Head lice are more common in close, overcrowded living conditions.

You can get head lice if you:

  • Come in close contact with a person who has lice
  • Touch the clothing or bedding of someone who has lice
  • Share hats, towels, brushes, or combs of someone who has had lice

Having head lice does NOT mean the person has poor hygiene or low social status.

Having head lice causes intense itching, but does not lead to serious medical problems. Unlike body lice, head lice never carry or spread diseases.

SymptomsSymptoms of head lice include:
  • Intense itching of the scalp
  • Small, red bumps on the scalp, neck, and shoulders (bumps may become crusty and ooze)
  • Tiny white specks (eggs, or nits) on the bottom of each hair that are hard to get off

Lice on scalp and clothing may be difficult to see, unless there are a lot of them.

Signs and tests

Head lice can be hard to see. You need to look closely. Use disposable gloves and look at the person's head under a bright light. Full sun or the brightest lights in your home during daylight hours work well. A magnifying glass can help.

Part the hair all the way down to the scalp in very small sections, looking both for moving lice and eggs (nits). Look at the entire head this way. Look closely around the top of the neck and ears, the most common locations for eggs.

Treatment is recommended if even one egg is found.

Treatment

Lotions and shampoos containing 1% permethrin (Nix) often work well. They can be bought at the store without a prescription. If these do not work, a doctor can give you a prescription for stronger medicine. Such medicine should be used exactly as directed.

  • To use the medicine shampoo, first rinse and dry the hair.
  • Then apply the medicine to the hair and scalp.
  • After 10 minutes, rinse it off.
  • Check for lice and nits again in 8 to 12 hours. If the lice seem active, talk to your health care provider before treating again.

Ask your health care provider if you need to treat people who shared a bed or clothing with the person that has had lice.

An important part of treatment is removing the eggs (nits). Certain products make the nits easier to remove. Some dishwashing detergents can help dissolve the "glue" that makes the nits stick to the hair shaft.

  • You can remove the eggs with a nit comb. Before doing this, rub olive oil in the hair or run the metal comb through beeswax. This helps make the nits easier to remove.
  • Metal combs with very fine teeth are stronger and more effective than plastic nit combs. These metal combs are easier to find in pet stores or on the Internet than in pharmacies.
  • Removing eggs may prevent the lice from returning if the medication fails to kill every one of them.
  • Treat children and adults with lice promptly and thoroughly.
  • Wash all clothes and bed linens in hot water with detergent. This also helps prevent head lice from spreading to others during the short period when head lice can survive off the human body.
  • Repeat combing for nits in 7 - 10 days.

Malathion 0.5% in isopropanol is FDA approved for the treatment of head lice. Apply it to dry hair until the hair and scalp are wet. Leave it on for 12 hours. Malathion may be useful for resistant infections.

Treatment can cause significant side effects in children younger than 6 months old, the elderly, and anyone weighing less than 110 lbs (50 kg), especially when the treatment is used repeatedly in a short period of time.

Expectations (prognosis)

Lice are usually killed with the proper treatment. However, lice may come back, especially if the source is not corrected.

Complications

Some people will develop a secondary skin infection from scratching. Antihistamines can help relieve the itching.

Calling your health care provider

Call your health care provider if symptoms continue after home treatment, or if you develop areas of red, tender skin, which could mean a possible infection.

Prevention

Never share hair brushes, combs, hair pieces, hats, bedding, towels, or clothing with someone who has head lice.

If your child has lice, be sure to check policies at schools, day-care centers, preschools, and nurseries. Many do not allow infected children to be at school until the lice have been completely treated.

Some schools may have policies to make sure the environment is clear of lice. Sometimes, the insects or their eggs get into areas such as carpets. Frequent cleaning of carpets and all other surfaces in child-care centers prevents spread of all types of infections, including head lice.

References

Morelli JG. Arthropod bites and infestations. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF. Nelson Textbook of Pediatrics. Philadelphia, Pa: Saunders Elsevier; 2007:chap 667.

Schlossberg D. Arthropods and leeches. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 380.

Diaz JH. Lice (pediculosis). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 293.

Reviewed By

Review Date: 02/01/2012

Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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12y ago

If a child is scratching their head a lot, there's a chance the child has head lice.

Head lice are tiny insects that sort of look like a grain of rice with six legs. They infect the hair on your head, laying tiny eggs that look like dandruff. Because they can live up to 30 days on a human, head lice spread easily, especially among children at school and daycare centers. You can get them in close contact with others who have head lice or by sharing hats, towels, brushes, or combs of someone with head lice.

Head lice cause intense itching on your child's scalp. Your child may have small, red bumps on their scalp, neck, and even their shoulders. You may notice tiny white specks, they're head lice eggs, on the bottom of hair, close to your child's scalp.

You'll need to look closely at your child's hair to see head lice. Look at their head under a bright light with a magnifying glass, and make sure you wear disposable gloves. Part your child's head down to the scalp in very small sections. You'll be able to see moving lice and eggs. The eggs will be very hard to remove because they're attached to the hair with a substance that's like glue.

Among the most common solutions are lotions and shampoos that contain a chemical called permethrin, or Nix. You can find them at a drug store. You can also use several natural remedies. If these don't work, your child's doctor can give you something stronger. You may need to treat others who've shared a bed or clothing with the child who has lice.

After treating your child's head, you'll want to remove all of the eggs. Some dishwashing liquids can help dissolve that "glue" that makes the eggs stick to hair, or you can rub olive oil in the hair. A fine metal comb is best for removing the eggs, and running the comb's teeth through beeswax first will help. This is called nit combing. You'll want to comb the child's hair for eggs again in about 7 to 10 days. Some people treat lice with careful nit combing alone, perhaps combined with heat.

Lice can survive up to 55 hours without contact with a human host, so it's also important to wash all of the child's clothing and bedding in hot water with detergent, unless you can ensure no contact for more than 55 hours. This helps prevent the lice from spreading to others.

Treating lice usually kills them, but they may come back, especially if the infection is running through your child's classroom or daycare. That's why when one case is detected in a family, school, or daycare center, it makes sense for every child at the location to be examined for head lice.

Reviewed By

Review Date: 10/25/2011

Alan Greene, MD, Author and Practicing Pediatrician; also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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13y ago

just checkout www.webdco.com/thelicenanny.com for all the info and images

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15y ago

this would be a pic of head lice.

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13y ago

It's caused by lice, which are tiny bugs.

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13y ago

The flying head louse.

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11y ago

Head-lice group

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