What are head lice?
What are nits?
Nits (lice eggs) are quite small and uniform in shape. They may vary in color after hatching but nits are generally whitish and oval-shaped. Female lice lay their nits at an angle on the hair shafts close to the scalp where the temperature is perfect for keeping them warm until they hatch baby lice (nymphs).
Mother Nature (what a woman!) protects the nits for hatching by having the louse “glue” them at an angle to the hair shaft. They can’t be removed easily by brushing or shaking them off like dandruff. DEC plugs can also be found stuck on the hair but these are irregularly shaped bright white fat cells and not to be confused with nits. (Clearly illustrated on NPA’s Critter Card.)
Unless the infestation is heavy, it’s more common to see nits in a child’s hair than it is to see crawling lice. Even when no crawling lice are seen in the hair, it is important to remember that nits can only be present on the hair shaft when lice have been there to deposit them. The female louse lays approximately 3 to 10 eggs per day, and the eggs then hatch in 7 to 10 days. This is a big gap in time and yet another reason to remove nits as early as possible.
There are three types of lice:
- Head lice. These lice are found on your scalp. They’re easiest to see at the nape of your neck and over your ears.
- Body lice. These lice live in clothing and on bedding and move onto your skin to feed. Body lice most often affect people who aren’t able to bathe or launder clothing regularly, such as homeless or transient individuals.
- Pubic lice. Commonly called crabs, these lice occur on the skin and hair of your pubic area and, less frequently, on coarse body hair, such as chest hair, eyebrows or eyelashes.
- Intense itching.
- Tickling feeling from movement of hair.
- Lice on your scalp, body, clothing, or pubic or other body hair. Adult lice may be about the size of a sesame seed or slightly larger.
- Lice eggs (nits) on hair shafts. Nits resemble tiny pussy willow buds. Nits can be mistaken for dandruff, but unlike dandruff, they can’t be easily brushed out of hair.
- Small red bumps on the scalp, neck and shoulders.
What causes head lice?
Head lice are contagious. You can become infected with head lice when the insects crawl onto your head. Ways you might get head lice include:
- touching your head to the head of someone with head lice
- sharing the personal items (e.g., comb) of someone with head lice
- using a fabric item after a person with head lice
While transmission of lice via inanimate objects may be possible, it’s been found to be highly unlikely. Some of these inanimate objects may include brushes, combs, barrettes, headbands, headphones, and hats.
It may also be possible for lice to live for a time on upholstered furniture, bedding, towels, or clothing.
Again, it should be stressed that the biggest concern for transmission is close head-to-head contact occurring mainly in children during play. Transmission via objects is a rare exception, according to several sources.
There are some differing opinions on the transmission of head lice via inanimate objects, but the science doesn’t seem to support transmission in this manner.
Who is at risk for head lice?
Preschool and elementary school students have the highest risk of getting head lice. They tend to play closely together.
There’s also an increased risk of head lice for family members of school-aged children. People who work in a day care center, preschool, or elementary school share this risk.
What are the symptoms of head lice?
Symptoms of head lice include:
- extreme scalp itchiness
- feeling like something is crawling on your scalp
- sores and scabs on your scalp from scratching
Lice eggs (nits). These look like tiny yellow, tan, or brown dots before they hatch. Lice lay nits on hair shafts close to the scalp, where the temperature is perfect for keeping warm until they hatch. Nits look a bit like dandruff, but aren’t removed by brushing or shaking them off.
Unless a child has many head lice, it’s more common to see nits in the hair than live lice crawling on the scalp. Lice eggs hatch 1–2 weeks after they’re laid. After hatching, the remaining shell looks white or clear and stays attached to the hair shaft. This is when it’s easiest to spot them, as the hair is growing longer and the egg shell is moving away from the scalp.
- Adult lice and nymphs (baby lice). Adult lice are no bigger than a sesame seed and are grayish-white or tan. Nymphs are smaller and become adult lice about 1–2 weeks after they hatch. This life cycle repeats itself about every 3 weeks. Most lice feed on blood several times a day, and they can survive up to 2 days off the scalp.
- Scratching. With lice bites come itching and scratching. This is due to a reaction to the saliva (spit) of lice. But the itching doesn’t always start right away. It depends on how sensitive a child’s skin is to the lice. It might take weeks for kids with lice to start scratching. They may complain, though, of things tickling or moving around on their heads.
- Small red bumps or sores from scratching. Some kids have mild irritation from scratching, while others may get a bothersome rash. Scratching a lot can lead to a bacterial infection. Watch for swollen lymph nodes (glands) on the back or front of the neck, and red, tender skin that might have crusting and oozing. Doctors can treat a skin infection with an antibiotic.
What are the Causes of Head Lice?
You can get lice by coming into contact with either lice or their eggs. Eggs hatch in about one week. Lice can’t fly or walk on the ground. They spread through:
- Head-to-head or body-to-body contact. This may occur as children or family members play or interact closely.
- Proximity of stored belongings. Storing infested clothing in closets, in lockers or on side-by-side hooks at school, or storing personal items such as pillows, blankets, combs and stuffed toys in proximity at home can permit lice to spread.
- Items shared among friends or family members. These may include clothing, headphones, brushes, combs, hair decorations, towels, blankets, pillows and stuffed toys.
- Contact with contaminated furniture. Lying on a bed or sitting in overstuffed, cloth-covered furniture recently used by someone with lice can spread them. Lice can live for one to two days off the body.
- Sexual contact. Pubic lice usually spread through sexual contact and most commonly affect adults. Pubic lice found on children may be a sign of sexual exposure or abuse.
How Can I Check My Child for Head Lice?
Look for lice and nits on the scalp, behind the ears, and around the nape of the neck. It’s rare for lice to be in eyelashes or eyebrows.
It can be tough to find a nymph or adult louse. Usually, there aren’t many of them and they move fast. Look for nits attached to the hair near the scalp. They can look like dandruff or dirt. To tell them apart, pull on the little speck with your fingers — dandruff and dirt can be removed, but nits stay stuck. A magnifying glass and a bright light can help with your inspection.
The best way to check is by using a fine-tooth comb on wet hair. After applying lots of conditioner, comb the hair out in very small sections, and look for lice or nits on the comb. You can wipe the comb onto a tissue or paper towel where it will be easier to see them.
If your child is itchy and scratching their head but you’re not sure if it’s lice, ask your child’s doctor or the nurse at school or childcare center to take a look.
How head lice are spread
Spread is by direct head-to-head contact with a person who has head lice, or more rarely by contact with items which have been recently used by someone with head lice, such as:
Are Head Lice Contagious?
Head lice spread quickly from person to person, especially in group settings like schools, childcare centers, slumber parties, sports activities, and camps.
They can’t fly or jump, but they have claws that let them crawl and cling to hair. They spread through head-to-head contact, and sharing clothing, bed linens, combs, brushes, and hats.
Pets can’t catch head lice and pass them on to people or the other way around.
Where do lice come from?
Like a lice infestation, the exact estimate of how many people get head lice per year is hard to pin down.
The Centers for Disease Control and Prevention (CDC)Trusted Source estimates that there are about 6 to 12 million cases each year in the United States among children ages 3 to 11.
Since lice can only crawl and survive outside your head for 24 hours, most infestations come from direct head-to-head contact. If someone you know has lice, it’s likely they got it from a friend, family member, or stranger with whom they had close contact. Shared items like hats or brushes can also facilitate an infestation.
Common situations that can lead to the transfer of lice include:
- being in school, for children
- sitting in close proximity to others
- sleeping in the same bed, like during slumber party
- sharing combs, brushes, or towels
A national survey asked moms about removing lice and found that most didn’t have accurate facts. Almost 90 percent of moms believe they need to remove eggs (nits,) and half of moms thought they should apply multiple treatments for head lice.
The CDCTrusted Source says that complete removal of nits is unnecessary, though using a lice comb can help. And when it comes to treatment, you should use only one product at a time.
Before you start treatment
As a first line of defense, try a few lifestyle changes and home remedies to combat lice.
You won’t need to call pest control. The CDCTrusted Source says there is no need to fumigate your house or treat your pets for lice. Having lice has nothing to do with cleanliness or environment, as they don’t come from the outdoors or your pets.
How are head lice diagnosed?
You or your healthcare provider can diagnose head lice by:
- checking your hair, close to the scalp, for lice
- checking your hair, close to the scalp, for nits
- running a fine-toothed lice comb through your hair, starting from the scalp, to catch lice and nits
The nits are dark-colored, and hatched lice will be light-colored.
Adult lice move quickly. You’ll most likely find nits if you find any evidence of head lice on your scalp.
You can easily differentiate between nits and dandruff flakes or other debris in your hair. Most debris should be removed easily. Nits will seem like they’re cemented to your hair.
Head lice are contagious. If one person in your household has them, others may too. It’s a good idea to check everyone in the household for signs of lice every few days.
How are head lice treated?
There are several head lice treatments available. Most treatments will need to be used twice. The second treatment, after a week to 9 days, will kill any newly hatched nits.
Some of the major treatments for head lice are described below.
There are both over-the-counter (OTC) and prescription head lice treatments.
Two types of chemicals are commonly used in OTC head lice treatment.
Pyrethrin is a pesticide that’s derived from chrysanthemum flowers. It’s approved for use in people 2 years old and older. Don’t use pyrethrin if you’re allergic to chrysanthemums or ragweed.
Permethrin (Nix) is a synthetic pesticide that’s similar to pyrethrin. It’s approved for use in people 2 months old and older.
Prescription lice treatments may also include other chemicals.
Benzyl alcohol lotion (Ulesfia) is an aromatic alcohol. It’s used to treat head lice in people 6 months old and older.
Malathion (Ovide) is an organophosphate pesticide. It’s used to treat lice in people who are 6 years old or older. It isn’t recommended for women who are pregnant or breastfeeding. Malathion is flammable. Stay away from open flames and heat sources such as hair dryers when using this product.
Lindane is an organochloride pesticide. It’s available in lotion or shampoo forms. Lindane is usually only used as a last resort. It can cause serious side effects, including seizures and death. Lindane shouldn’t be used by premature babies or by people who have a history of seizures.
In order to reduce the risk of side effects:
- Don’t use more than one medication.
- Don’t use any medication more often than directed.
If you want to avoid using pesticides, use a fine-toothed lice comb or a flea comb (sold in pet stores) to remove lice. Apply olive oil to your hair before combing. This will help the lice and nits stick to the comb.
Start combing at the scalp and work through the end of the hair.
You’ll need to do this every 2 to 3 days until you have no more signs of lice or nits.
Treating your home
There’s no need to use pesticides around your home. Lice can’t survive more than a couple of days off your head. The following methods can be used to kill lice on different items:
- Wash clothes and bedding in hot water — 130°F (54°C) or above — and dry on high heat.
- Dry-clean clothes and bedding.
- Soak hairbrushes, combs, barrettes, and other hair accessories in hot water — 130°F (54°C) — for 5 to 10 minutes.
- Vacuum floors and upholstered furniture.
You can get rid of head lice with the proper treatment. However, you may become reinfected. Reduce that risk by cleaning your house properly and primarily avoiding head-to-head contact with people who have head lice until they’ve been treated.
It may be prudent to not share personal hygiene items with others to reduce your chances of getting head lice, although current evidence doesn’t necessarily support this thought.
Frequently Asked Questions About Head lice and nits
What product should I use to treat my child?
There are no over-the-counter or prescription treatments to kill lice that are totally safe and scientifically proven to be 100% effective against head lice and nits. These treatments are potentially harmful pesticides and reliance on them promotes repeated use and contributes to ongoing infestations, outbreaks and resistant strains of head lice. Various “natural” remedies are vigorously marketed on the Internet but we have found no scientific basis for their claims of efficacy and human safety. Manual removal of the live lice and nits is the safe alternative and a necessary component of any head lice treatment regimen. The NPA recommends the LiceMeister® Comb to enable families to screen often, detect head lice early and thoroughly remove lice and nits.
Are lice shampoos potentially hazardous?
Although the FDA requires testing for safety before they give their approval to any product, individuals have unique vulnerabilities that must be considered before any treatment. The NPA warns against the use of any chemicals designed to kill or destroy head lice in any individuals who have a pre-existing illness. This would include, but not be limited to, those with asthma, epilepsy, brain tumors, cancer or AIDS. Those on medication, or who have been previously treated for head lice, as well as pregnant and nursing mothers may be more vulnerable to side effects and should avoid chemical lice treatments for use on themselves or applying them to others.
What chemicals are used in head lice treatments?
Head lice pesticide products contain both “active” and “inert” ingredients. An active ingredient is one that prevents, destroys or repels a pest. An inert ingredient is any ingredient in the product that is not intended to affect a target pest. For example, isopropyl alcohol may be an active ingredient in some products; however, in other products, it is used as a solvent and considered an inert ingredient. Solvents are materials in which pesticides are dissolved or absorbed (sometimes called carriers or vehicles). They are selected by manufacturers to achieve stability of the active ingredients, promote convenience, ease of handling and application and provide maximum killing power. Exposure to such inerts or solvents can result in significant toxic effects that, in many cases, exceed the toxicity of the active pesticide ingredients. While the potential risks of active ingredients are accepted, the inert ingredients cannot be overlooked. Many consumers are misled by the term “inert”, believing it to mean harmless. It should never be assumed that inert ingredients are non-toxic. The concern over inert ingredients and solvents apply to all treatment products.
What about alternative and natural products?
Non-toxic remedies are obviously a preferred choice over pesticides whenever possible. However, this does not mean that everything touted as “natural” is across-the-board safe. Many who try “alternatives” have already had failure with readily available pediculicides from the local drugstores. If there is success with such alternatives, we suspect that it may have to do with motivation and the”parent power” behind the effort – rather than any particular pediculicidal or ovicidal property.
No matter which remedy you’re attempting -wrapping the hair in plastic or a shower cap and putting the children to bed is a bad idea. It is also a source of potential harm to use a wrap with any of the pesticidal treatments (whether in bed or not) as it may alter its chemistry and absorption rates. Effective screening and combing is the ultimate complement to whatever course of action an individual selects. It is impossible to obtain independent scientific data as to the effectiveness and safety on many of the different ideas being circulated about “natural” remedies. Ultimately, it will always be the “parent power” behind the effort that makes the difference.
How do you treat a home or school for lice?
Homes or schools don’t get head lice – people do. Head lice are human parasites and require human blood to survive. Vacuuming is the safest and best way to remove lice or fallen hairs with attached nits from upholstered furniture, rugs, stuffed animals or car seats – wherever someone with head lice may have rested their head. Pesticidal sprays are unwarranted and may pose personal and environmental hazards. Vacuum and save your time and energy for what benefits you the most – thorough nit removal.
Do I have to treat everyone in the house?
Use a nit-removal comb to check everyone. Even if lice are found on an individual, careful consideration should be given before deciding to use a lice killing treatment because each person has unique health vulnerabilities. Lice treatment products are potentially hazardous to health and should not be used “just in case” a child or family member has lice or in an effort to prevent them.
Do I need to spray my furniture and bedding?
Head lice are human parasites and require human blood to survive. They are not environmental pests so pesticidal sprays for furniture and bedding are unnecessary and a serious risk to health. Vacuuming is the safest and best way to remove lice or fallen hairs with attached nits from upholstered furniture, rugs, stuffed animals and cars.
Do I have to bag stuffed animals and other items?
Experts used to suggest bagging items such as stuffed animals for a number of weeks to help bring infestations under control. Since lice cannot survive without human blood, this is unnecessary; vacuuming is a sufficient safeguard for any questionable areas or items that may be in contact with those who are infested. You can also put bed linens, stuffed animals and other items in a dryer for 30 minutes. Save your physical and emotional energies for screening and thorough lice and nit removal.
How are head lice spread?
Head lice can be spread whenever there is direct contact of the head or hair with an infested individual. Lice can also be spread through the sharing of personal articles like hats, towels, brushes, helmets, hair ties, etc. There is also a possibility of spreading head lice via a pillow, headrest or similar items. Head lice do not jump or fly and generally cannot survive longer than 24 hours off the host.
Do head lice jump?
Head lice to not have hind legs to hop or jump. They also do not have wings and cannot fly.
Can you catch head lice from cars, pillows or furniture?
If a louse comes off the head and is left behind (i.e., on a pillow or head rest), it may be possible for the louse to infest another individual who places their head in that area. Vacuuming is recommended for any areas or items that may be in contact with those who are infested.
Can you catch head lice in a pool, pond or lake?
Swimming with someone who has lice carries no greater risk of transmission than any other activity. When lice are in water, they go into a state of suspended animation but remain firmly locked onto the hair – literally hanging on for dear life. This is how they survive shampooing, rain, seawater and swimming pools. Risk of transmission will occur with the sharing of towels, piling clothing or towels, storing personal items in close proximity or direct head to head contact.
Can you catch head lice from headphones or helmets?
The extent to which head lice are transmitted to others via headphones or helmets is unknown. Ideally, risk of transmission can be eliminated by making sure children have and use their own equipment. If this is not possible, you can clean the items between children by wiping them with a damp paper towel. An additional measure would be to encourage each child to wear a baseball cap to help shield the hair from contact with the item. Helmets and headphone should never be sprayed.Most importantly – and best for the entire community – all parents should screen their children regularly.
How can I tell if the nits are dead or alive?
Children, like adults, do not want nits in their hair – dead or alive. The time it would take to make the distinction is time far better spent removing ALL the nits. Finding 10 dead nits guarantees nothing for the 11th.
Where do head lice come from?
Head lice do not come out of the air or from the ground. They are human parasites and have probably been here since the beginning of time. Desiccated (dried up) head lice and their eggs (nits) have been found on the hair and scalps of Egyptian mummies.
Do head lice carry or transmit disease?
While many have thought head lice to be only a nuisance, recent scientific study refutes this notion. DNA technology shows head lice to be the same species as the notorious body louse which has long been associated with diseases such as typhus and relapsing fever. The potential for disease transmission via the head louse should not be underestimated.
How can you verify successful treatment?
First, one must define treatment. Someone can be treated and still be infested. The ultimate determination that someone is no longer infested can only be accomplished with a thorough manual screening to confirm the complete absence of lice and nits.
What is the life cycle of the head louse?
Head lice can survive on a human host for approximately 30 days. They generally cannot survive longer than 24 hours off the host. A female louse lays 3-5 eggs a day. The eggs hatch in 7-10 days and it takes another 7-10 day for the louse to mature and lay their own eggs.
Do pets get head lice?
Head lice cannot be “caught” from pets and cannot survive on pets. They are human parasites and require human blood for survival.
Should fluorescent light be used for lice screening?
Some health professionals recommend the use of fluorescent lighting in screening, but others have reported that it confuses the diagnosis because the light illuminates lint, hair debris and dry skin as well as the nits.Nits are visible to the naked eye in natural light. If you are unsure whether you are seeing a nit, use a magnifying glass to take a closer look. For even better results, use the LiceMeister comb to screen through the hair – it will collect even what you cannot see.Too often, nits are confused with hair debris and children are treated unnecessarily. Be sure you know the difference. NPA’s Critter Card™ has actual images on a handy reference card with instructions to help you distinguish lice and nits from hair debris.
What is the proper procedure for doing head checks?
While rubber gloves may protect the nurse, they will not prevent the communication of infectious dermatological conditions such as impetigo between the students being examined unless the gloves are changed for each exam. Such expenditure in money and time would be impractical for the majority of nurses, who screen hundreds of students at a time and there are more realistic measures available.
NPA promotes the use of disposable wooden screening sticks for each child when doing group screenings. The sticks, which separate hair strands easily, provide a hygienic approach for nurse and child alike. When there is any question or doubt as to whether a child is infested, we recommend a visit to the nurse’s station for a more thorough examination aided by a nit comb. We also recommend this combing for a child who is returning to the classroom after having had his or her infestation properly managed with manual removal of lice and nits. While visual examinations can detect an infestation, it is what one is unable to see that too often results in chronic infestations where families assume they are “reinfested” but in reality have “stayed infested” because the nits remained to continue the cycle.
Are African Americans susceptible to lice infestations?
African Americans are reported to have a much lower incidence of head lice than Caucasians, Hispanics or Asian Americans. Pediatric Dermatology cites various studies that suggest the incidence among African American schoolchildren is less than half of one percent, while the incidence among their non-black schoolmates is usually more than 10 percent.Even though African Americans may be less susceptible to infestations, this should not be grounds for complacency; African Americans can, and do, get head lice.
What makes the LiceMeister comb better than others?
- Unlike other combs, the LiceMeister comb maintains 100% integrity after boiling
- It is the only comb with a permanently sealed handle
- Highly polished, precision spaced, stainless steel teeth are permanently locked into the sturdy plastic handle
- Smooth handle design with no jagged edges or points to snag while combing dry, wet or damp hair
- The back-to-basics approach. No gimmicks like fluorescent lights and electric shocks
- The first and only comb to meet the NPA’s quality standards and receive the NPA’s endorsement
- Reimbursable as an FDA approved medical device
- Fully Guaranteed
- Provides a safe and effective non-chemical treatment alternative for “kids at risk” and others choosing to avoid pesticides
- Prevents unnecessary and direct exposures to ineffective and potentially harmful pesticides
- An earth-friendly alternative to address increasing concerns over lice treatments polluting our environment and water supplies
- Provides the rational solution to resistant lice
- The only brand name that does not promote pesticides, other chemicals, sprays, lotions, repellents or unproven concoctions
- Enables regular screening and early detection in addition to thorough removal of lice and nits
- The cost-effective, reusable tool for the entire family fully guaranteed to last through the school-aged years. Parents can remove lice and nits from their kids and themselves
- The comb is backed by the NPA’s nationally recognized telephone, e-mail and website support
- The NPA is a non-profit organization independent of lice treatment manufacturers. Proceeds from the LiceMeister comb, kit and educational resources support its programs of outreach, prevention and research
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