Are you lousy with lice at your house? Alas, these blood-sucking pests are not choosy as they'll show up in anyone's hair — long or short, clean or dirty, rich or poor — and they're especially common in kids who are in day care, preschool or another group setting.[1] And while finding out your child has lice can be upsetting, with some patience and the right tools, you can handle the infestation.

For some help, check out our primer on all things lice-related, including what they look like and how to check for them as well as the best treatments and how to deal with a chronic case. Hang in there and know that lice in kids is often a short-lived phase that you can definitely get through. 

What are head lice?

Head lice are tiny insects without wings that live in human hair and survive on blood from a person's scalp. Officially known as Pediculus humanus capitis, these parasites can also live in the eyelashes and eyebrows.[2] Head lice move around by crawling — they don't fly in the air or hop from head to head or on surfaces. Each louse is about the size of a small seed.

While head lice aren't known to pass along disease, they are found all over the world — particularly in pre- and grade-school children. As far as the numbers go, an estimated 6 to 12 million head lice cases occur annually in kids between the ages of 3 and 11 in the U.S.

What do lice look like?

The life cycle of lice occurs in three different phases, and they can live for a total of about 28 days. Here's how head lice develop through each stage, as well as what they look like:

Egg (or nit)

A female louse will lay eggs (also called nits) at the base of a hair strand near the scalp. Nits are yellow, white or tan dots about the size of a thread knot. But don't mistake these eggs for dandruff. Both nuisances are whitish and flaky, but dandruff can be brushed away while nits cling tightly to hair. The eggs will hatch after 7 to 12 days. 

Nymph

The immature louse that hatches from an egg is about the size of a pinhead. A nymph feeds on human blood for 9 to 12 days before becoming a full-grown louse.

Adult louse

This bug is tan or grayish-white in appearance, has six legs and is about the size of a sesame seed. An adult louse feeds on blood and lives for about a month.

Where do lice come from?

Head lice are contagious and can pass quickly between kids. The most common way is via head-to-head contact, often while toddlers or older kids are playing or sitting close together. 

Older kids typically get lice while away at summer camp or at a slumber party. Lice can also be passed along when kids share or swap clothes, hats, brushes and blankets, though this is less common.

Head lice symptoms

For some help identifying a case of head lice, learn the common signs and symptoms:[3]

  • Tiny brownish, tan dots. You might spy nits attached to the hair shaft close to the scalp.
  • Crawling adult lice. While less common, you may see live ones moving about on the scalp. And once lice eggs hatch, they leave behind a whitish shell that clings to the hair.
  • Itching and scratching. After several weeks of lice infestation, the most common symptom — itching — will begin. Scratching tends to occur around the ears and neck. Kids may also mention that they feel things are moving on their head or tickling them.
  • Red bumps or sores. All of that itching can cause redness, a rash or even a bacterial infection. Look for swollen lymph nodes on the neck or red skin that's oozing or crusty.

How to check for lice

It's a good idea to get into the habit of regularly checking for lice rather than waiting for a school alert or camp announcement. Here's how to do it at home:

  • Seek light. Have your tot sit on a chair in a well-lit room and stand behind her.
  • Divide locks. Part the hair, and look for nits or crawling bugs on the scalp and hairline.
  • Use a comb. Move section by section across your child's head with a fine-tooth comb or one made specially for nits, and check for the eggs or live adult lice in the hair.

How to get rid of head lice

Getting rid of lice is often a multipronged process. Here are the various steps you'll likely take:

  • Ask the doc. The best way to fight lice is with a medicated shampoo or lotion, but speak with the pediatrician as you should only use these if living lice are present on the head.
  • Follow the directions. Read the labels carefully, and don't have your child apply it herself. Rinse the treatment over the sink (rather than the shower) so it doesn't get on her skin. Supervise the whole process, and always lock the medication out of reach when you're not using it.
  • Consider combing. After each treatment application, you can comb your child's hair every couple of days for two to three weeks to help remove more nits and eggs. Use a fine-tooth comb on clean wet hair that's been conditioned. Work in small sections, wiping the tool with a wet towel after each pass, checking it for signs of nits or lice.
  • Wash bedding. If sheets and bath towels were used within two days of a case of head lice, wash them in hot water and dry them on high. Items that can't be washed (like soft toys and stuffed animals) may be dry-cleaned or sealed in a plastic bag for two weeks.
  • Skip pesticides. Don't attempt to rid the house of nits or lice with a chemical spray. This isn't considered safe, and it's unnecessary if you treat your kid's scalp correctly.
  • Check the whole family. Alas, you, your partner and other family members may also be at risk and should be checked over (and treated, if necessary) for head lice.

Best head lice treatments

You can buy head lice treatments over-the-counter or get prescription options from the pediatrician, depending on the severity of the case. The most common treatments are lotions or shampoos with the active ingredient permethrin (1 percent), pyrethrin or ivermectin. Always check with the doctor before using one of these, and review the label and instructions carefully.

These head lice treatments go by the brand names Nix and RID, among others, and you can apply them to dry hair or shampooed, damp hair. The solution sits on the hair for about 10 minutes. You may need to reapply it after nine or 10 days. 

If a prescription is needed, whether oral or topical, the process is similar: Put it on the hair, rinse, repeat if directed.

Home remedies for head lice

As for alternative treatments you may have read about, experts urge parents to skip these home remedies for lice.[4] Pantry and household staples such as olive oil, mayonnaise, vinegar or petroleum jelly may seem harmless enough, but they aren't proven to work, and they can be hard to wash out of hair. Others, like gasoline or kerosene, are actually dangerous. 

The bottom line: Avoid these DIY treatments for head lice.

How long do lice live off the head?

Lice can live up to two days on sheets and pillows, so wash these items in hot water or seal them in plastic, as mentioned. You can soak hair brushes and accessories in rubbing alcohol for an hour. It's also a good idea to vacuum carpets and furniture. 

As for your pets, dogs and cats aren't responsible for having lice or sharing it with people, so you can let sleeping dogs lie.

How long does it take to get rid of lice?

Once lice have been diagnosed, the time it takes to rid the head of these critters depends on the medication that's being used. Some shampoos and lotions are applied and then reapplied about 10 days later. And combing out the hair post-treatment should be done every couple of days for two to three weeks to remove nits and eggs from the hair.

My child keeps getting lice: What can I do?

A child with persistent lice may have a case that's resistant to the active ingredient in the particular product you're using. Ask the doctor about switching to a different one.

Stronger medications are available by prescription — like spinosad (a shampoo) or topical ivermectin (a lotion), depending on your child's age and weight — as a last resort if others don't work.

While the idea of bugs in your kid's hair can seem gross and even embarrassing, know that head lice is common in every kind of school and all across the nation. Try to relax, and follow the treatment directions. Soon the itching should stop and your child will be nit-free.