How do I know if my child has lice?
The most common symptom of head lice is itching, especially behind
the ears or at the back of the neck. However, an itchy scalp may
also be a symptom of other conditions such as eczema, dandruff, or
allergic reactions to hair products.
Head lice are
often difficult to find. A positive diagnosis of an active case of
head lice can only be made if you find live lice. Nits can remain on
the hair for months but do not indicate an active infestation.
check for head lice
To check your
child for head lice, follow these steps
child in a brightly lit room, in an area where you can easily
examine the head from different angles.
Part the hair
and look at your child's scalp. Nits will look like small white
or yellow-brown specks. They will be firmly attached to the
hair. Nits may be easier to see at the hairline at the back of
the neck or behind the ears. Live lice will move quickly away
from the light.
your child's hair in small sections using a fine-tooth comb.
After each comb-through, wipe the comb on a wet paper towel.
Examine the scalp, comb, and paper towel carefully.
You may need to
use a magnifying glass. It is often difficult to tell the difference
between dandruff or other hair debris and nits. However, dandruff is
much easier to comb out of the hair while nits are much harder to
Treatment for head lice
In the past,
the only way to get rid of head lice was to comb them out or, in
some cases, shave the child's head. Today, chemical treatments for
head lice are available and can be found at your local drug or
discount store. Most of these products contain 1% permethrin as a
cream rinse, which has proven to be a very effective treatment for
head lice. Although head lice treatments also are available by
prescription, they are not usually the first choice for treating
there are 3 steps in treating head lice. Because it is possible for
head lice to show resistance to these treatments, see your
pediatrician if you have followed these steps but your child still
has live lice.
Kill the lice.
treatments come in a variety of forms such as shampoo, cream rinse,
gel, and mousse. Most need to be applied to dry hair because wet
hair can dilute the chemicals in the treatment. Keep the treatment
on the hair for the full amount of time recommended by the
manufacturer. While lice treatments are effective at killing live
lice, they may not always kill all of the eggs. For this reason, a
second treatment is usually necessary 7 to 10 days after the first
Comb out the nits.
This step is
not necessary to prevent lice from spreading; however, it may make
you and your child feel better knowing the nits are removed. It may
also prevent your child from being misdiagnosed with an active case
of head lice. And it will help prevent your child from becoming
reinfested from any eggs that were not killed at first.
Nits can be
combed out after the treatment has been applied to the hair. Many
products include a special comb. Carefully read the directions that
come with the treatment for proper combing instructions.
the nits often takes a great deal of time and patience. During this
step you may want to give your child something to do, such as a book
check your child's hair daily for 2 weeks after treatment. If you
still see nits in your child's hair, use a fine-tooth comb (or try
using your fingernail) to remove them.
Prevent lice from spreading.
You do not
need to throw away any items belonging to your child, but you may
want to follow these prevention tips
child's clothes, towels, hats, and bed linens in hot water and
dry on high heat.
and brushes in boiling hot water for 5 to 10 minutes.
furniture, carpeting, car seats, and other fabrics that your
child was in contact with 24 to 48 hours before treatment.
your child has been in very close contact with that cannot be
washed, such as stuffed animals or toys, can be placed in a
plastic bag for 2 weeks (by which time any live lice would die).
Do not spray
pesticides in your home because they can expose your family to
members of your household for lice and, if present, treat these
persons and manage their personal items as outlined previously.
live lice cannot live more than 24 to 48 hours off the head, so
extraordinary cleaning measures are usually not necessary. It is
better to spend the time properly treating the child with head lice.
You may have
heard of home remedies that involve "washing" your child's hair with
thick or oily substances such as petroleum jelly, mayonnaise, tub
margarine, herbal oils, or olive oil and leaving it on the hair
overnight (the child sleeps wearing a shower cap). The theory is
that coating the hair with these substances will smother the lice.
These remedies have not been scientifically proven to work. However,
they certainly won't hurt your child. Home treatments that should be
avoided include coating your child's hair with any toxic or highly
flammable substances such as gasoline or kerosene, or using products
that are intended for use on animals.
While having head lice
may be embarrassing to you or your child, it does not put your child
at risk for any serious health problems. If your child has head
lice, work quickly to treat the condition and prevent the lice from
spreading. You may need to repeat the treatment to ensure all the
lice are gone.
If you are unsure about
how to detect head lice, suspect your child has lice, have tried to
treat a case of head lice only to have them return, or have
additional questions about treating head lice, call your
Source: Head Lice: Every Parent's Concern (Copyright © 2003
American Academy of Pediatrics)
order this publication in multi-copy packs.
Parents can find more information on this topic in Caring for Your
Baby and Young Child: Birth to Age 5. To order a copy of this book
contained in this publication should not be used as a substitute for the
medical care and advice of your pediatrician. There may be variations in
treatment that your pediatrician may recommend based on individual facts