You’ve always known it was possible. You’ve heard of other people getting lice in children, seen it on TV and in movies, and just hoped it wouldn’t ever happen to your family. Then, one day, you open a suspiciously titled email or unexpected note in your kid’s backpack and find a message that sends shivers down your spine and sets your scalp itching.
There’s not much you can do to prevent lice from showing up in a child’s hair, especially once they start attending school or daycare. The most common method of transmission is direct head-to-head contact, which is typical when you get a whole bunch of kids together in an enclosed space, like a lice in classroom situation. As frustrating as head lice can be, they’re pretty easy to attack and don’t fight back.
Head lice can’t fly, they can’t jump, they can’t even walk very well on anything except for stalks of hair, and they die almost immediately (between 12 and 48 hours) when separated from the human body. They aren’t exactly welcome guests, but lice are not known to transmit diseases of any kind. The only significant symptoms are itching and a case of the heebie jeebies. If you’ve got the creepy crawlies at the thought of an insect infestation, that’s understandable, but before you grab the hair clippers, read on.
How do kids get lice? (and why it might keep happening!)
First and foremost, head lice couldn’t care less about personal hygiene or the cleanliness of your home. To a louse, one warm scalp is as good as the next. Lice in children are almost exclusively passed through direct head-to-head contact. While it’s possible to spread head lice by sharing headwear or hair accessories (hats, helmets, hair brushes, etc.), that rarely happens.
Head lice are most common in school-aged children, particularly between the ages of 3 and 11, precisely because they are most likely to be in close quarters with a whole bunch of their peers all at the same time. If any of those kids is carrying a louse, it’s only a matter of time before lice in the classroom is spread to everyone. Then, they go home and spend time with their siblings, caregivers, or neighbors, and the cycle continues. That cycle looks something like this:
- Infestation: an adult louse or several adult lice arrive in a new environment (head of hair)
- Lice eggs: Also called nits, the eggs are glued to the base of the hair stalk
- Hatching: Lice nymphs hatch after 6 to 9 days
- Maturing: Nymphs grow into their adult form over the course of 9 to 12 days
- Adult stage: Adults live for several weeks and can lay 6 to 10 eggs per day
Confirming Head Lice In Children
If you suspect your child has been infested with head lice, there are a few signs to look out for:
- Itching: varies from person to person but tends to concentrate at the nape of the neck and around the ears
- Nits: lice eggs, typically small ovals attached to the hair within a quarter inch of the scalp
- Insomnia: head lice are most active at night, leading to increased itching and trouble sleeping
- Sores: persistent scratching can lead to sores in the skin and even secondary infections
- Live insects: nits and nymphs are small and easily missed; even the adults are fast and sneaky. However, the most surefire sign of infestation is finding live lice in the hair.
Treating Head Lice In Children
Once lice have established themselves in your child’s hair, they’re never going to leave on their own. Fortunately, there are several over-the-counter treatments containing pediculicides, a form of insecticide specialized for attacking head lice.
Popular brands include Rid and Nix, but the active ingredients are more important than the label. You’re looking for something with pyrethrin or permethrin. Pyrethrin is an extract taken from chrysanthemum flowers and is toxic to lice. Permethrin is a synthetic compound that mimics the effects of pyrethrin and works in basically the same way. Notably, both compounds are only truly effective at killing live lice and won’t wipe out all of the unhatched nits. That will be important to remember during treatment. Specific instructions may vary slightly from one product to another, but it generally looks something like this:
- Thoroughly saturate the hair with medicated lotion/shampoo. Use towels as needed to protect the eyes.
- Leave in the hair as long as directed—usually about 10 minutes. It’s important to leave it in long enough to be effective but not longer than directed.
- Rinse out with warm water. Some treatments recommend leaving hair unwashed for several days after, while others recommend washing with shampoo right away.
- Comb through hair with a fine-toothed lice comb. These are often, but not always, included with over-the-counter lice treatments. Combing will remove dead and dying lice as well as some (but probably not all) nits.
- Separate hair into sections and move along the scalp an inch at a time. Start the comb as close to the scalp as possible and pull away. Wipe the comb clean in a tissue between each swipe and discard lice and nits in a plastic bag.
- Repeat treatments. You’ll want to repeat combing every couple of days for a few weeks to catch any stragglers. It’s also a good way to inspect the hair and scalp to ensure everything is healing well. Because over-the-counter treatments don’t always kill unhatched nits, it’s often recommended to do a second treatment 7 to 10 days after the first to stop a second wave before it gets a foothold.
Why do my kids keep getting lice even after treatment?
By the time you figure out that your child is infested, the nearly microscopic invaders may have already spread. Even if no one else has symptoms, inspecting everyone in the household is worthwhile. You may even want to treat everyone, not just the affected individuals, to prevent any potential spread. The focus should be on the hair, as that’s almost always how lice spread. If it makes you more comfortable, you can wash hats, pillowcases, sheets, and stuffed animals. Running them through the washer and dryer on the hot water and hot air cycles will introduce enough heat to kill off any lice who happen to be hitching a ride, but that’s probably not necessary. A lost louse rarely finds its way back home.
Shaving the hair is extreme but can be an effective treatment. Lice can’t exactly live in your hair if there is no hair to live in. If your kiddo usually has a short haircut or wants a short haircut, a buzz cut can’t be beaten in terms of getting the job done. On the other hand, if you’re looking for a way to evict the lice without anyone needing a new passport photo, over-the-counter anti-lice medications are commonly available and widely effective.
In rare cases, head lice may be resistant to over-the-counter treatments. If that’s the case, contact your healthcare provider for help taking a more forceful eradication approach.
