The Facts of Lice

Every year, more than 6 million children are infected with these harmless yet pesky parasites. We've pulled together expert answers to your top questions on everything from prevention to treatment.
Head Lice
Head Lice

What are lice?
Head lice are tiny insects that develop in three stages: from nit to nymph to full-blown louse.

"Nits are eggs that attach themselves to the hair shaft; they're hard to see because they're so small, and also because they can be confused with dandruff or shampoo residue," says Cheri Hayes, R.N., a certified school nurse and author of the children's book There's a Louse in My House. Yellow to white in color, a nit takes about a week to hatch into a baby louse called a nymph, which grows to adult size in another week or so. The louse is about as big as a sesame seed and has a tan to grayish color. It needs human blood to live and can survive up to 30 days in a person's hair.

Why do children get lice so often?
"Although anyone is susceptible, little kids get lice because they are in close contact with each other during playdates, slumber parties, and sports activities," says pediatrician Richard Bonforte, M.D., medical director of the Children's Hospital of Hudson County, in Jersey City, New Jersey. Children also swap hats, scarves, brushes, and earphones, all of which can carry lice. Not surprisingly, girls get lice more often than boys because they generally have longer hair (which is a bug's best hiding ground). Lice almost always turn up on the scalp, usually behind the ears and at the nape of the neck.

What are the signs that my child has lice?
Sometimes your child will feel just a slight sense of something moving on the scalp, but more often it's a deep itch that will cause him to scratch a lot. Inspect your child's hair and scalp closely, looking for nits attached to the hair shaft. Often you'll see the nits rather than lice, which are even more difficult to spot. "Adult lice can move quickly away from your fingers," Dr. Bonforte says. If you're not sure your child is infested, have him checked by a doctor or school nurse.

How do I treat them?
"The most expedient treatment is to use an over-the-counter delousing agent and then comb the eggs out," says Dennis Juranek, D.V.M., a veterinarian at the Centers for Disease Control and Prevention (CDC), in Atlanta. Nix, Rid, and Pronto Plus, which you shampoo into your child's hair, are some of the most popular products. You can also get a prescription for stronger shampoos, like Kwell or Ovide.

A single treatment will likely be effective, but a stubborn case of lice might require a second attempt. Don't worry, though: While it's true that many lice-killing products contain pesticides and that too-frequent treatments can cause rashes or even seizures, a second application is fine. "The products themselves are safe," Dr. Juranek says. "They're only dangerous when you use them improperly or overuse them, causing pesticidal toxins to build up in the body." So it's important to follow your physician's advice and the directions on the label. One last caveat: These products are only safe to use on children over 2, and although it's uncommon for babies to catch lice, if you suspect your little one is infested, check with your pediatrician about the best treatment.

Also helpful is a lice-removal comb, like the LiceMeister (available through the National Pediculosis Association; call 888-542-3634, or visit

How should I delouse my house?
Using hot water, wash all bedding and clothing your child has worn or slept on. Vacuuming is the best way to remove lice and fallen hairs from furniture, rugs, and car seats. If you can't clean certain items, bag them for two weeks to kill lice.

Do natural remedies work?
There are several effective pesticide-free shampoos, experts say, including SafeTek and LiceOut. Some parents swear by home remedies -- everything from coating a child's hair with mayonnaise or petroleum jelly to rinsing it with tea-tree or olive oils to suffocate the lice. But there are no studies showing that these treatments work, according to the CDC and the American Academy of Pediatrics (AAP). They might even do more harm than good: Grease that's left in the hair from these products can reduce the effectiveness of standard medications.

When is it okay to send my child back to school?
If you treat an outbreak promptly and thoroughly, your child can return to school the next day, according to the AAP and the American Journal of Nursing. But find out your school's policy on lice, since some schools have a "no nit" policy that doesn't allow kids to come back to class until they're totally free of lice.

How can I keep my child lice-free?
Each day brings an opportunity for a new lice infestation, so check your child and household every two to three days. Routine screening is vital, because you might spot lice you missed the first time around.

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Copyright© 2004 by Richard Torregrossa. reprinted with permission of Parents magazine March 2004 issue.

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