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Head Lice in Children


What do I need to know about head lice?

Head lice are tiny bugs that attach to your child's hair. They live on tiny amounts of blood from your child's scalp. They are about the size of a sesame seed. They lay eggs (nits) and attach the eggs to your child's hair. Anyone can get head lice but it is most common in children ages 3 to 11. Head lice are spread through direct contact. For example, sharing combs, hats, hair ribbons, or hairbrushes can spread lice. Your child may also get lice if he shares pillows, towels, clothes, or blankets.

What are the signs and symptoms of head lice?

Your child will not feel the bites. Your child may have any of the following:

  • Severe itching on the scalp, neck, or ears
  • Nits (tiny ovals that are grey, yellow, or white)
  • Tan or reddish-brown bugs in your child's hair
  • Small red bumps or a rash on your child's scalp
  • Swollen lymph glads in your child's neck

How are head lice diagnosed?

Your child's healthcare provider will examine your child's scalp and hair. He may use a fine-tooth comb to collect the lice and examine them with a microscope.

How are head lice treated?

Lice medicine is used to kill head lice and is available without a doctor's order. Lice medicine usually come as a shampoo. Use it as directed. If your child has hair past her shoulders, you may need a second bottle of lice medicine. If you are pregnant or breastfeeding, ask your healthcare provider before you apply lice medicine to your child. You may need to reapply in 7 to 10 days if you see more lice. Ask your child's healthcare provider about using lice medicines if your child is 2 years old or younger. Throw away all lice medicine that you do not use. Keep it away from your eyes. Other medicines may also be given to decrease itching and inflammation.

How can I manage my child's head lice?

  • Comb your child's wet hair with a fine-tooth comb. Do this every 3 or 4 days for 2 weeks to remove all lice as they hatch. Wet combing may be the only treatment recommended for children younger than 2 years. To help remove eggs, soak your child's hair in equal parts water and white vinegar. Then wrap a towel around your child's head for 15 minutes. Remove the towel and comb his hair with a fine-tooth comb.

  • Remind your child to not scratch his scalp. This can make his symptoms worse. Trim his fingernails or have him wear soft gloves or mittens if scratching is a problem.
  • Do not shave your child's hair. Do not use pet products, acetone, bleach, kerosene or other flammable products to kill lice.

How can I prevent the spread of head lice?

  • Check family members for lice. Treat those who have lice at the same time. Do not share personal items or bedding.
  • Wash all clothes, stuffed animals, towels, and bedding in hot, soapy water. Dry them on the hot cycle for at least 20 minutes. Items that cannot be washed or dry cleaned should be sealed in an airtight plastic bag for 2 weeks. Vacuum furniture, rugs, carpets, car seats, or other fabrics.
  • Disinfect personal items. Soak combs and brushes in rubbing alcohol for 1 hour. Wash lice combs and clothing your child wore during each lice treatment and after each combing.
  • Tell your child's school or daycare center. Children that may have been exposed to lice need to be screened and treated. Your child can return to school after he has used lice medicine.

When should I seek immediate care?

  • Your child becomes more irritable or fussy than normal.
  • Your child is dizzy, has nausea or vomiting, or a seizure after using lice medicine.

When should I contact my child's healthcare provider?

  • Your child has a fever.
  • You still see lice after 2 days of treatment.
  • Your child's bites become filled with pus or are crusty.
  • Your child's scalp burns, stings, or is numb after using the lice medicine.
  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.