How to avoid lice

kids share everything – time together, towels, hats, even lice. Anyone can get lice. But it’s totally treatable and there are no long-term effects.

We spoke with Dr. Molly Martyn, a pediatrician at Children’s Hospitals and Clinics of Minnesota, about how to prevent, identify and treat it.

1.  What are some of the signs of lice?

Lice are most often seen rather than felt.  Most children do not have symptoms when they have lice.  In some cases, they can develop itching from an allergic reaction to the lice saliva.

The head louse is about 3 mm long (about the size of a sesame seed) and is a grayish-white color.  Lice move by crawling, not by flying. Females lay eggs (commonly called “nits”) at the base of hair shafts.   The eggs hatch after a week and leave the remains of their white case in the hair. The eggs are firmly attached to the hair, so they move away from the scalp as hair grows.

The best way to look for live lice is to comb the hair with a fine-toothed nit comb. Hair should be wet with a conditioner. With a fine- toothed comb, start touching the scalp and comb through to the end of the hair, looking for lice or nits after each stroke.

Nits (eggs or the empty egg cases) can stay in the hair for some time even after active infestation is cleared. 

2.  How do lice spread?

Lice spread through contact, most commonly from contact with the head of a person with lice. Lice can also transfer through shared clothing, hats, combs, hair brushes, headbands and hair ties, headphones, towels, pillows, beds, etc. 

It is important to remember that lice can happen to anyone, and is not a sign of being dirty or having poor personal hygiene. 

3.  What is the difference between dry scalp and lice?

This can be a surprisingly difficult thing to tell by just looking at a scalp.  Nits can be confused with dry scalp, residue from hair gels or sprays, or fungal infections of the scalp.  Nits are usually more firmly cemented to the base of the hair and are difficult to dislodge.  Your child’s pediatrician or family doctor can help you distinguish between dry scalp and lice.

4.  What are things parents can do to prevent their child from getting lice?

it is a good idea to have a conversation about things they shouldn’t share such as hats, hair brushes, hair styling items, headphones, etc. 

You can also ask if children will be participating in activities requiring helmets and send your child’s own helmet if they have one that is appropriate for the activity.  Wearing appropriate head protection should never be avoided, even if it is shared.

5.  If a child acquires lice, what should a parent do?

Dealing with lice can be a very stressful thing for families.  Given that it spreads by contact, many families end up treating not just one child, but multiple family members.

There are a number of different approaches to treating lice and you can always ask your child’s doctor for advice.  It is most often treated with a topical lotion or shampoo that helps to kill the lice when applied to the scalp.  The exact instructions on use will vary depending on the type of treatment used.  Some types of treatment are repeated at seven to 10 days because they kill only the adult lice, not the eggs.  Follow instructions closely, as the topical medications can have serious side effects if misused or overused.

Some families may choose not to use a topical medication and instead remove lice through processes such as repeated “wet combing.”  This is also a good option for children who are too young to use the topical medications.

If one member of your family is diagnosed with lice, it is important to check all family members.  Bedding, towels, and clothing should all be washed in hot water and heat-dried.  You should also vacuum your home to remove any hairs that were shed with nits attached.  Throw away combs and brushes used by the infected person or soak them in hot water greater than 130 degrees for 10 minutes.

We have many visits and calls to our clinic regarding lice, and have a standard way of helping families to treat and get rid of lice. We are happy to help!

6.  Where can I find out more about lice such as how to do the wet combing method?

The Centers for Disease Control and Prevention (CDC) has a terrific website with information on how to recognize, treat, and stop the spread of lice: http://www.cdc.gov/parasites/lice/head/index.html .

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