• Signs and symptoms
• Home care
• When to call your doctor

Signs and symptoms

Lice are tiny gray and brown parasites that cause itching. Head lice infection is NOT a sign of uncleanliness. Anyone can get head lice despite taking baths and washing hair frequently.

• Itchy scalp


• White eggs (called nits)


• Nits look like tiny white grains of sand. You can tell the difference between nits and dandruff by trying to pull the white dot off with your fingers. If it pulls off easily, then it is probably dandruff (flakes of scalp skin). If the white dot is firmly attached to the hair and you cannot easily pull it off, then it is probably a nit. Usually there are numerous nits visible.


• Lice: Lice are about 1/16 of an inch (2-4 mm) long and move quickly.

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Home care

Treatment: You can buy an over the counter (no prescription needed) shampoo to stop the lice infection. The shampoo is 5 percent permethrin (brand names are Elimite or Acticin) or 1 percent permethrin (brand name Nix). Other shampoo brand names include Rid or Pronto or Clear. You may need to repeat the treatment in 7 to 10 days. Do not use the shampoo more frequently unless directed by your doctor. Using the shampoo too often may cause a rash. Although one treatment kills the lice, it may take a few days after treatment for the itching to stop. You do NOT need to cut or shave hair to cure lice.

Removing nits: After treatment, use a fine-tooth comb to remove nits. You may try using a solution of half vinegar and half rubbing alcohol to loosen the nits. You can also buy products available without a prescription (such as Clear Lice Egg Remover, Pronto Creme Rinse, or Rid Lice Egg Loosener) to help loosen the nits.

Prevention: Do not allow your child to share combs, brushes, hats, scarves or hair ornaments with other children. Please examine and treat other members of your household who have had close contact with your child. If they have any scalp rashes or itching, they should be treated even if nits or lice are not seen. Do not allow your child to return to school until after treatment.

Cleaning the house: Vacuum your child's room thoroughly. Combs and brushes should be soaked for at least one hour in medicated shampoo or very hot water. Wash clothing and bed linens in very hot water. Items that cannot be washed (hats, stuffed animals, coats) should be placed in tightly closed plastic bags for 2 weeks. You do NOT need to fumigate the house.

Contagiousness: Lice are very contagious. They cannot jump from person to person, but they can be spread through clothing, bed linens, combs, brushes or hats. Your child may return to school after one treatment with the shampoo.
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When to call your doctor

Head lice infection is NOT an emergency. Please call during regular office hours only (Monday through Friday, 8 a.m. to 5 p.m.)

Call if:

• New eggs appear in the hair after treatment


• The sores start to spread or look infected (red, increased swelling)

Please remember that this advice is for educational purposes only and should only be used as a guide.

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