Head Lice (How to treat them)

One of the most common misconceptions is that head lice only happen to the poor, the unclean, or the uneducated. For a long time, it was thought that people got head lice only from being in filthy environments or because of poor hygiene. We know that isn’t true. Head lice are found on children who attend any school, who shampoo daily and have short or long hair. In fact head lice prefer a clean head. It can happen to anyone.


Head lice are small insects about the size of a sesame seed. They are tan or grayish and are often difficult to see. They like to be in dark places and will quickly hide under hair when you part it to look for them. It is usually easier to find the nits or eggs. Nits are whitish and teardrop shaped and very tiny. You will find them attached to the hair. They are “glued” on and are difficult to remove. Head lice can’t fly or jump, so don’t be concerned when you are looking for them.

If you are certain your child has head lice, check other family members. Everyone infested should be treated at the same time. Don’t worry about the family pet, head lice only live on people. Please inform the school ASAP so that the spread in your child’s classroom can be limited.

Children cannot ride the school bus until the school nurse has checked the child.

To successfully treat head lice several steps need to be followed:

1. Use of a lice (pediculicide) shampoo. There are several brands available, without prescription, at local pharmacies. Consult with your doctor before using any lice product on pregnant/nursing women, infants, or those with allergies. Read the label carefully and follow directions. Apply the shampoo to dry hair. Wetting the hair first makes it less effective. It is best to do this over a sink as this keeps the shampoo on the scalp only. Make sure behind the ears and the nape of the neck is treated thoroughly. If you notice swollen glands in the neck or under the arm, or scratch marks can be seen, infection may be present. Consult with your doctor before giving any treatment.

2. Comb out the nits while the hair is still wet. Use the comb that came with the shampoo or a separate one can be purchased. Many people find a metal comb more effective and it can be sterilized and re-used. It is time consuming but very important to remove all of the nits. If you are having a lot of difficulty, some people find that a vinegar rinse helps to loosen the nits. After you are done with this, shampoo with a regular shampoo. Check daily and keep removing any nits that might have been missed. A second treatment, 7-10 days after the first treatment, may be necessary to eliminate any new nits or lice. If after these two treatments the problem still exists consult with your doctor. Remember your child has to be “nit free” to return to school.

3. Since lice can survive off the body for several hours and nits for longer, it is important that your immediate environment be cleaned. Vacuum carpets, rugs, upholstered furniture and mattresses. Wash recently worn clothing, towels, sheet and linens in hot, soapy water and dry in a hot dryer for at least 20 minutes. Items that can’t be washed can be vacuumed or placed in a plastic bag and sealed for 2 weeks. Soak all combs and hairbrushes in hot water (130 degrees) or in rubbing alcohol for 10 minutes. Vacuum your car seats and headrests.

Do not use sprays-they are not effective and are potentially harmful to humans and pets. All of these measures take time and patience, but should limit the spread of head lice in your family and in school. If you have any questions about head lice and treatment, I am more than happy to help you with the answers.

If you have a computer handy go to the National Pediculosis Association web site at www.headlice.org. They have a wealth of information.

Nurse Donna