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Head lice in children

Head lice are tiny parasitic bugs that can infest the skin. They live on people’s heads and feed on their blood. Head lice can cause intense itching.

Head lice are very contagious. They spread from person to person by close body contact, and by shared clothes and other personal items. These can include things such as hats, hairbrushes and combs.

Which children are at risk for head lice?

Head lice are seen mostly in child-care settings and among school-aged children. It doesn’t matter how clean your child’s hair or your home may be. It doesn’t matter where children and families live, play or work.

What are the symptoms of head lice in a child?

The most common symptom of head lice is itching. The itching can be very bad, especially at night. Lice or their eggs (nits) can usually be seen on the hair, behind the ears or on the neck. They can even be seen in the eyebrows and eyelashes.

The eggs laid by lice can usually be seen. This makes it easy for you or your child’s health care provider to diagnose.

How are head lice treated in a child?

Treatment will depend on your child’s symptoms, age and general health. It also will depend on how severe the condition is.

Lice are treatable. Treatment will include applying a medicated cream rinse or shampoo to your child’s hair. Many head lice medicines are available over the counter. Your child’s health care provider may prescribe a medicine if the OTC medicines did not work for your child.

Talk with your health care provider about which rinse or shampoo would be best for your child. Do not use two forms of treatment at the same time. If one treatment does not work, use a different treatment or call your health care provider for advice.

In addition to the medicated cream rinse or shampoo, treatment may also include:

  • Removing nits from wet hair with a fine-tooth comb.
  • Soaking combs and brushes in hot water with the shampoo for at least 15 minutes.
  • Checking all other household members closely to see if anyone else needs to be treated. 
  • Washing all bedding and clothing in hot water (130°F or 54°C), or sealing items that cannot be washed in a plastic bag for 2 weeks.  

Children can return to school or daycare the day after their first treatment for head lice.

What can I do to prevent head lice in my child? 

You can help prevent head lice by:

  • Avoiding close physical contact with someone who has lice
  • Encouraging your child not to share hats, combs, brushes, towels or other personal items.
  • Washing bed sheets, blankets and other personal items to prevent lice from infesting other people.

When should I call my child’s doctor?

Some lice treatments are available over the counter. But if you are unsure that your child has lice, or if a home treatment does not work, it is important to talk with your child’s health care provider.

Key points about head lice in children

  • Head lice are tiny parasitic bugs that can infest the skin on a person’s scalp.
  • Lice are highly contagious, spreading from person to person by close body contact, and by shared clothes and other personal items.
  • The eggs laid by lice can usually be seen. This makes it easy for your child’s health care provider to diagnose.
  • Lice are treatable. Some medicines are available over the counter, but talk with your child’s health care provider if you are unsure of the diagnosis.

Next steps

Tips to help you get the most from a visit to your child’s health care provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.