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Head Lice: Creepy, Crawly, Itchy, Yuck!

Creepy. Crawly. Itchy. Yuck. These are words I use to describe lice!

Head lice are small bugs that live on human hair, scalps, eyebrows, eyelashes, and necks. These tiny buggers feed on the blood from the scalp.

They may make you itch, but they are not dangerous.

How do I know if I have lice?

Lice are spread by direct contact. This is why lice cases are seen frequently in elementary and middle school children (Think: sleepovers, sports games/practices, and school, etc.). They can only crawl and are unable to fly, hop, or jump.

Although there is a risk of contracting lice through contact with combs, brushes, hats, sports equipment, and other hair accessories, it is less common.

Typically, the first sign that your son or daughter has lice is SIGNIFICANT itching and scratching.

The best way to look for lice is having your child sit in a well-lit room while you divide the hair into sections. Carefully comb through the hair and use a magnifying glass if needed. Nits are typically found close to the scalp. They are TINY and may look yellow/white. Nits are sometimes mistaken for dandruff. A nymph is what hatches from the nit and then eventually turns into an adult louse. Adult lice are about the size of a sesame seed and may appear tan or even gray/white.

It is vital to pay special attention to the scalp, behind the ears, and the nape of the neck.

How do I treat lice?

Treatments are available over the counter and by prescription. If you are unsure if your child has lice or is under the age of 2, call your health care provider before using these products.

Lice cannot live without a food source (blood from your scalp) for more than 48 hours.

I also recommend washing all clothing, bedding, and household items using hot water, followed by drying using high heat. Combs and brushes should also be soaked using hot water for at least 20 minutes. Items that cannot be washed can be put in a plastic bag for at least two weeks. Lastly, I always tell my patients to vacuum carpets, sofas, car seats, etc.

There are many unconventional therapies on the market that do not work. I typically tell my patients and families not to waste their money. There are also dangerous therapies, including gasoline, which is most definitely NOT recommended!

How do I prevent lice?

First and foremost, having lice does not mean you are “dirty.” Anyone can get lice. Even YOU!

Avoiding direct contact (head to head) is the best way to prevent lice.

I also recommend teaching your children not to share combs, brushes, hair accessories, sports helmets, hats, etc.

What is a “no-nit” policy?

Many schools still have a “no-nit” policy. This means a child cannot return to school until he or she is “nit-free.” The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) believe that there should no longer be a “no nit” policy. This policy was first initiated as a way to prevent the spread of lice. Nits, however, are unlikely to spread from person-to-person. This “no-nit” policy can lead to anxiety, teasing, unnecessary missed school days for children, and lost work hours for parents.

Bottom line… Don’t panic.

If you are uncertain about the diagnosis or there are additional concerns, follow up with your provider.

Has your household ever experienced head lice?

Until next time,



Centers for Disease Control and Prevention. (2019). Lice. Retrieved from

Devore, C., & Schutze, E. (2015). Lice. Pediatrics, 135(5). Retrieved from

Mazurek, C. & Lee, N. (2000). How to manage lice. Western journal of medicine, 172(5). Retrieved from

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