What to know about head lice in children

What is head lice?

Head lice are small insects that inhabit the scalp and hair follicles, feeding on tiny amounts of blood from the scalp. They are highly contagious and spread through close contact with others. Children in particular are more likely to get lice due to close interactions to others at daycare, kindergarten, or school.

Lice can survive on a human for up to 30 days, while their eggs (nits) can remain viable for up to two weeks. You can get lice by being in close contact with an infected person or by sharing personal items with them such as clothing, bedding, towels, hats, or hairbrushes.

Signs and symptoms of lice

• Extreme itching on the scalp
• Small, red bumps on the scalp, neck, and shoulders
• Small white eggs (nits) at the base of  hair follicles that are difficult to remove

How to check for head lice

Head lice can be difficult to spot and are often confused with dandruff. One key difference is that lice are hard to remove, while dandruff can easily be flicked off. To check for lice in your child, follow these steps:

1. Examine your child’s head under bright light.
2. Part the hair into small sections, all the way down to the scalp.
3. Carefully inspect the scalp and hair for moving lice and nits, especially around the ears and the back of the neck.
4. Nits appear as small white or yellow-brown specks, firmly attached to the follicle base. This is how you identify nits.

Treating head lice

• Use a shampoo containing 1% permethrin to wash the scalp and hair to eliminate live lice.
• To remove nits (lice eggs), use a nit comb. Metal combs with fine teeth are more effective than plastic ones. Make sure your child's hair is wet to make combing easier.
• Carefully comb the hair in small sections until you've covered  the entire head. After combing through, wipe the comb on a wet paper towel and carefully examine the scalp, comb, and towel for any remaining lice or eggs.
• When treating head lice, wash all clothes, bedding, and personal items in hot water.
• All household members and close contacts should be checked and treated for lice to prevent a lice infestation in the home.  
• All household members and close contacts with extreme itching should be checked for head lice and eggs.

Lice lifecycle and treatment

​​The life cycle consists of three stages: egg (nit), nymph, and adult.

• Nits are laid by the adult female at the base of the hair shaft, close to the scalp. They hatch in 7 to 13 days.
• Checking for lice involves inspecting the scalp and hair for live lice and nits.
• At least two rounds of treatment is necessary to kill live lice, newly hatched nymphs, and eggs. The recommended interval for the second treatment is 7 to 10 days after the first application.

If you have questions about head lice or lice infestation, reach out to your local or Summer Health pediatrician for support. Summer Health is a pediatric telehealth platform offering 24/7 care, providing answers for everything from urgent concerns to everyday questions about your child’s health.