Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2004;69(2):349-350

Head lice are small, wingless insects (bugs) that can get on the hair and scalp of humans. Anyone can get head lice—usually from head-to-head contact, but perhaps also from sharing hats, combs, and brushes. Head lice do not jump or fly.

People do not get head lice because they are dirty or poor. Outbreaks of head lice are most common in school-aged children.

Signs of Head Lice

Watch for signs of head lice in your children, such as frequent head scratching.

Because lice can move very fast, they are not always easy to see. You might first notice nits (lice eggs). Female lice “glue” their nits to hair shafts. The nits are tiny, oval shaped, and “stuck” at an angle on hair shafts. Look for nits anywhere in the hair.

If you think someone in your family might have head lice, check everyone in the family. Your family doctor or school nurse can help you diagnose head lice.

Getting Rid of Head Lice

You may choose to use over-the-counter or prescription products to kill head lice. These shampoos and lotions have pesticides or other chemicals in them. If you do not want to use these products, you have to pick the lice and nits out of the hair by hand or use a special comb to remove them.

Killing Head Lice. If you use a shampoo or lotion that kills lice, follow the package directions carefully.

Talk to your doctor before you use these products on yourself or before you put them on anyone else. This is especially important if you are pregnant or nursing a baby.

Products with pesticides in them should not be used on or near the eyes. If you find head lice or nits in eyelashes or eyebrows, call your doctor.

If the product you use does not get rid of the lice, taking them off by hand is often the next best choice.

Nit Removal. No matter what product you use, it will not kill all of the nits. Removing the remaining nits by hand or with a lice and nit removal comb (sample brand name: LiceMeister comb) may reduce the risk of lice coming back. You can buy one of these combs at your drug store.

Carefully comb through all of the hair one section at a time. Remember it's a good thing to comb out lice and nits, not a failure. Comb through the hair every three days (or more often—for at least two weeks) until you stop finding lice or nits.

Cleaning Your Home. Head lice need human blood to survive. They do not live very long if they are not on a human head.

Lice do not infest your home. Therefore, hot-water washing of bed linens, towels, and recently worn clothing is all you have to do. Use a vacuum cleaner on anything that cannot be washed, such as the couch, your child's car seat, and stuffed animals. You do not need to use a lice spray on these items.

After Treatment

No treatment for head lice is 100 percent effective. Therefore, keep looking for head lice and nits, and keep using the lice and nit removal comb.

Continued itching does not necessarily mean that head lice are present. It takes a while for the itching to stop. If the scalp looks irritated from treatments or scratching, you might want to call your family doctor.

For More Information

Your local health department is a good source of information about head lice. You can find the number listed in your telephone book. Here are two other sources of information:

National Pediculosis Association

Telephone: 1–800–446–4672

Centers for Disease Control and Prevention

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