Head Lice: 5 Essential Questions, Answered

head lice_640

Spring Break is over and school is back in full swing, which means it’s that time again: time for parents to be hyper-vigilant about watching for that annoying nuisance called head lice. Here, our expert answers your most critical questions.


By Elaine Cudnik, A.P.R.N., Renown Medical Group Pediatrics

For parents of school-aged children, head lice are an all too often annoying intruder. They can be frustratingly hard to treat, and are highly contagious — making it even more important to catch them early in order to try to prevent the spread.

Below, we’ve answered five of the most pressing questions parents have about head lice — from diagnosis to treatment to prevention and beyond.

5 Common Questions About Head Lice

  1. What are head lice?

They are tiny, wingless, parasitic insects that live on human hairs and feed off the blood drawn from the scalp. They are visible to the human eye and can be very itchy and uncomfortable. As a parent, you might see nits (eggs), lice or nymphs (baby lice). The nits typically look like small tan, yellow or brown dandruff that is attached to the hair shaft. However, unlike dandruff, you can’t wipe nits away easily — they cling to the hair shaft. It takes about one-to-two weeks for the eggs to hatch, and once they do, they leave behind dry, white shells on the hair shaft. A mature louse (lice are more than one louse) is about the size of a sesame seed and is tan or light brown in color. The nymphs are similar in appearance, but smaller. Lice feed on the blood supply from the scalp and usually live for one-to-two weeks. They can only survive for about two days off of the scalp/hair shaft. If they are not treated, they typically repeat growth cycles about every three weeks.

  1. How are they spread? Are they contagious?

Lice are highly contagious. However, they are generally spread through head-to-head contact. They cannot fly or jump, but they have strong little claws that allow them to cling to the hair shaft and crawl easily. Sharing hats, hair brushes and close head-to-head contact are all ways to pass lice — which is why this is more common in school-aged children.

  1. Can my child attend school?

The current recommendation of the Washoe County School District is to restrict school attendance until the first treatment is complete. Therefore, if your child comes home with a note that says they have lice, you should treat it immediately; they can then go back to school the next day. If your child is in a class with a child with head lice, you will likely receive notification that there has been a case so you can observe and monitor for signs and symptoms, including itching.

  1. How do you treat lice?

There are several over-the-counter shampoos you can use for a child with head lice, followed by manual removal with a fine-toothed comb, or “nit comb.” Generally, we recommend trying this method first. The over-the-counter shampoo can kill the lice immediately, but it can take a few days for the itching to go away. There are some lice that are resistant to these medications though. Therefore, if you feel like your child still has lice or itching more than than five days from the initial treatment, we recommend making an appointment with your provider to see if a prescription treatment is indicated. Sometimes treatments need to be repeated on a weekly basis to get rid of lice, and in rare cases an oral medication will be prescribed for very tough-to-treat lice.

  1. What can you do to prevent re-infestation?

We recommend washing sheets, clothing, etc. that your child has come in contact with on a hot-wash setting, and drying on a high-heat setting. For anything that cannot be washed or dried, we recommend bagging the items, such as stuffed animals, in an air-tight plastic bag for three days to make sure the lice are killed. Soak hair ties, hair brushes and the like in rubbing alcohol or medicated shampoo for one hour. Make sure to vacuum carpet and furniture carefully, too.

The questions above represent the most pressing concerns parents typically have about lice; but feel free to share with us any other questions you may have.

And just think, parents: A welcome break from the rigors of school-year hyper-vigilance is just around the corner, when summer vacation begins!