Get The Facts On Head Lice

Head lice…nits…just the thought of them makes you itchy. Head lice, or Pediculus humanus capitis, is a parasitic insect that infests the hair and scalp. Head lice can infect anyone, so it’s important to know the symptoms and treatment options in case you or a family member gets them.

Head lice can be a wintertime headache for families and schools, but simple precautions can stop the spread of these small, sesame seed-size parasites.

We sat down with Allison Massey, a physician assistant at Franciscan ExpressCare, to learn more about this itchy, crawly nuisance.

Symptoms Of Head Lice

"The most common symptom of head lice is an itchy scalp," Massey said.

Another sign is seeing the live lice or nits (their eggs) on the scalp and hair. The best way to see the lice and their white or clear capsule-like eggs is by using a fine-tooth comb to carefully look through wet or dry hair. "You can more easily see the nits on the hair shaft, but they're difficult to remove," Massey said.

While not harmful, head lice can cause significant discomfort and should be mitigated as soon as possible both to ease symptoms and stymie further spread.

Risk Factors For Head Lice

Head lice is most commonly spread in the United States during preschool and elementary school. Each year, 6 million to 12 million children in the United States, ages 3 to 11, experience head lice infestations, according to the U.S. Centers for Disease Control and Prevention.

"Head lice occur most commonly in children, but they can infect all ages and socioeconomic backgrounds," Massey said.

How Head Lice Spread

"Direct contact with the head of an infested person is the primary way to get head lice," Massey said. "Lice do not jump or fly."

The common misconception is that head lice can spread through contact with everyday objects, like hats, brushes or pillows. However, research studies don't actually support that theory. Direct person-to-person contact is how nearly all cases of head lice occur.

Treating Head Lice 

Before starting treatment, you should confirm living lice are present on the scalp. If there are, you can use one of the following treatment options:

• Over-the-counter topical medications. Topical medications, applied directly to the skin, are typically the first way to treat head lice. Topical permethrin (Nix) is readily available at drug stores. After applying the treatment, remove lice eggs (nits) with a fine-toothed comb, seal them in a plastic bag and repeat treatment in seven days if needed. 
• Prescription topical medications. If over-the-counter medications aren't enough to kill and remove the lice, you can ask your healthcare provider for a prescription topical treatment, such as malathion, spinosad or ivermectin.
• Oral medication. If you've had multiple cases of head lice, your primary care provider may suggest oral (taken by mouth) medication taken for around a week.
• Wet combing. If you would rather avoid taking medications or can't use topical or oral medications, try carefully combing the lice and nits out of wet hair to remove them.
• Wash items such as clothing, bedding and other fabric items in hot water and dry on high heat. Non-washable items, like stuffed animals, should be sealed in a plastic bag for two weeks. 

The CDC no longer requires children with lice to be sent home immediately; they can finish the school day, begin treatment after school, and return the next day.