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Lice 101

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Did you get the dreaded note from school? Or see the tell-tale pink rash behind the ears or at the base of the neck? Or notice persistent head-scratching? No matter what it was that prompted you to check, you looked, and you found them: nits (eggs) and/or actual LICE. Now what?

First double check: are they lice? Lots of things look like nits or lice (dandruff, scabs, dirt, bugs that just got caught in the hair), so it can be hard to tell. According to Harvard Medical School, “The eggs or nits of the louse appear as small white, tan or brown dots attached firmly to individual hairs. If nits are seen, then live lice should be sought before considering treatment.” It’s that “attached firmly to the hair” bit that’s important and helps differentiate nits from other stuff in the hair.


And then let’s be honest. Next you panic. When my child got lice, I totally panicked. There are bugs crawling on your child’s head and, especially if this is your first time dealing with lice, panic seems like a completely reasonable reaction. So go ahead and panic inside your head for a couple minutes (you don’t want to alarm your kid) and get it out of your system. Feel a little better? Good. Moving on.

Next, you need to treat the lice.

  • The Centers for Disease Control and Prevention (CDC) suggest starting with an over-the-counter treatment that contains pyrethrin (for example, A–200, Pronto, R&C, Rid, or Triple X) or permethrin lotion, 1% (for example, Nix). Follow the directions carefully. Failure to do so is the most common reason that treatment doesn’t work. If you’ve followed the directions properly and treatment still doesn’t work, then you can see your child’s healthcare provider about prescription treatments.
  • Another option is using a louse or nit comb to comb through the hair to remove eggs and lice. Both Rid and Nix make a special pesticide-free product that helps make the combing process easier, although it does not kill eggs or lice. You must be vigilant, though, and do this thorough combing every day for two weeks. My child had a very mild infection of lice, and this is the treatment option we chose. (By default, as my spouse accidentally came home twice with the wrong package of Rid and by that time it was 10:30 at night, so decided to go with what we had for the night. When we realized how mild my child’s case was, we elected to continue with it. I personally don’t recommend it for long-haired individuals, as my child spent two weeks screaming bloody murder during their comb-outs.)
  • What doesn’t work? Natural remedies: oils, enzymes, smothering the infected person’s head in mayonnaise, or heat treatments. Trust science on this one.
  • Once you’ve done the initial treatment and your child appears to be lice free, some experts recommend a weekly lice check. Lice Happens, a lice treatment business, provides instructions for a quick check in their FAQ section under “How Do I Know For Sure If My Child Has Head Lice?”

Now you take a deep breath. That wasn’t so bad. Except that now you’re incredibly itchy aren’t you? And every time you or someone near you scratches their head, you freak out a little bit. You probably have a few more questions, too.

  • Does everyone in your house need to be treated for lice? Some people recommend preventative treatment if someone is sharing a bed with the infected person are sharing a bed, but it’s really not necessary—although it’s a good idea to check everyone (adults included) for lice. Don’t freak out when I tell you but moms get lice from their kids more often than you’d think. Yes, grown-ups can get lice, too. Oh, your pets can’t, though.
  • Do you need to wash and dry everything you own on hot, bag things you can’t wash, vacuum your whole house, and treat your furniture with a pediculicide (lice-killing chemical)? No, you don’t! Lice can only survive off a human head for something like 6-24 hours, and the eggs that leave a human head simply can’t hatch because the conditions aren’t right. Lice is not really likely to transfer to a human head from anything other than another human head touching it. If it makes you feel better, you can do a thorough cleaning and you can wash bedding and clothing on its normal wash cycle. I would personally throw out any hair brushes and start new though.
  • Should you tell anyone your child has lice? You should report it to the school nurse. You’d like to know if a child in your kid’s class had lice, wouldn’t you? And the parents of your child’s friends would probably like to know, too. Remember close head-to-head contact is how lice is transmitted, and anyone your child has played with is likely to have been exposed. We had to call all my spouse’s siblings because we’d just an entire huge family celebration two days before realized my child was infected. Awkward, but necessary.
  • Do head lice carry disease? Nope. They’re just itchy. They’re also not a sign of bad hygiene or an unclean living space.

That’s about it. Head lice seem scary, but they’re really not. What can you do to prevent head lice? Not much. You can remind kids not to share hats, brushes/combs, hair accessories, or headphones, but this type of indirect transfer of lice is unlikely (that’s why you don’t have to go crazy cleaning your house and shrinking your clothes by washing and drying everything on hot). It’s not a bad idea for kids with long hair to wear their hair pulled back in a braid or ponytail. The best advice you can give kids is not to touch heads with other kids. Which is weird advice when you think about it, yeah?

Anyway, you may have one last question. What about lice repellant shampoos, conditioners, and styling products—do they work? According to the Mayo Clinic, they jury is still out. There’s some research that indicates that some of the common ingredients in lice repelling hair care products might repel lice, but the products aren’t regulated, so no one’s really sure. Can I let you in on a little secret, though? I didn’t get all my panic out way up in step two. I assuaged a little more of it by investing in some lice repelling shampoo and conditioner the day after my child’s initial treatment. While we’ll never know if it’s actually working or if no one else in my house would have gotten lice regardless of what shampoo we used, we all actually really love the shampoo and conditioner! It smells great and everyone’s hair looks amazing. So here’s a vote to check out Fairy Tales Rosemary Repel shampoo and conditioner.

Lice Happens’ motto is “No Shame. No Blame.” I think that’s a good way to look at lice, even if it’s hard since for so many of us, our first instinct is to freak out. It doesn’t matter how our child got lice, it’s there and we need to treat it, report it, be vigilant about the possibility it will come back, and move on with our lives. With delicious tea rosemary- and tea-tree-smelling hair if that’s what it takes.

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