What to do if your child gets lice

Your own head itches just thinking about lice, right? But the fact is that cases of lice are common among young kids. In the summer, your child can pick up lice at day camp, a sleepover, a sports activity — or anywhere else kids hang out.

And because these critters are highly contagious, they need to be dealt with ASAP. With a little patience, though, you can usually clear up your child’s lice at home.

“While head lice don’t transmit disease, they can certainly cause a good amount of anxiety, sleeplessness and frustration,” says Erum Ilyas, MD. She’s a dermatologist with Schweiger Dermatology Group in Pennsylvania.

Here’s everything you need to know about symptoms and treatments.

What exactly are lice?

Head lice are tiny parasitic insects about the size of a sesame seed. They live on human scalps, feed on blood and make the skin itchy. They lay eggs, called nits, on the hair shaft that are about as big as a knot in a piece of thread. Both nits and lice can be white, yellow or brown. They often blend in with your child’s hair, making them hard to spot.

How do kids get lice?

An estimated 6 million to 12 million cases of head lice among children ages 3 to 11 occur each year in the U.S., according to the Centers for Disease Control and Prevention (CDC). Lice spread easily, and kids tend to pick them up from head-to-head contact with another child. They can also be passed on when kids share items such as:

• Hairbrushes and combs
• Headbands, hair ribbons and barrettes
• Hats and scarves
• Towels
• Pillowcases

So how can you tell if your child has lice? The first clue is often an itchy scalp. If your child is scratching, look closely to see if you can spot a live insect or nit. While lice and nits are visible to the naked eye, they are tiny, and the insects move quickly.

Lice treatment 101

To get rid of lice, you need to kill both the live insects and stop any nits from hatching.

Lice shampoos (such as Nix^® and Rid^®) that you can buy at the pharmacy are an effective first-line treatment, and these treatments are safe, according to the CDC. Here’s how they work:

• You apply the product to your child’s hair, leave it in for several minutes, then rinse it out. (Read the package directions carefully first.)

• You comb through your child’s wet hair with a special nit comb that comes in the package. This comb has teeth that are very close together.

• You place the comb right at the roots and pull it through to the ends. Combing helps physically remove nits and lice from the hair. You should use the nit comb every day for several weeks.

• Have your child wait a few days before shampooing. This lets the medication continue to work.

• After 7 to 9 days, you’ll need to treat your child’s head again with the shampoo, according to the American Academy of Dermatology. This can kill any surviving lice that hatched after the first treatment.

Another over-the-counter (OTC) option for treating lice is ivermectin lotion (brand name: Sklice^®).

One note: You’ll find all sorts of homespun remedies online. These include smothering the lice with mayonnaise, olive oil, petroleum jelly or butter. But there are no studies that prove any of these methods work, says the American Academy of Pediatrics.

The Optum Store carries a variety of OTC lice treatments, including shampoos and cream rinses.

Prescription methods for treating lice

Head lice may resist certain chemical medications. If OTC treatments don’t clear up your child’s lice, see your pediatrician or dermatologist.

Your doctor may prescribe a stronger medication, says Dr. Ilyas. Prescription medications that are available:

• Spinosad (Natroba™): You apply this product to dry hair, leave it in for 10 minutes, then rinse it out. If you see lice 7 days after the first treatment, it needs to be reapplied. You can also use a nit comb to remove any lice or nits that the solution hasn’t killed. Natroba is safe for children older than 6 months.

• Malathion (Ovide^®): This medication is applied to dry hair, then washed out after 8 to 12 hours. It’s approved for use in children 6 years or older. (Caution: Malathion is flammable. Do not smoke cigarettes while applying the medication or use a hair dryer on wet hair.)

Other steps to take

You’re on your way to getting rid of the lice on your child’s head. But you also need to tackle any lice that might be living on their bedding, clothes, hats and other fabrics.

One bit of good news is that lice can survive for only a day or less off the head, and their eggs won’t hatch if they’re not at the same temperature as that found close to the human scalp. Just focus on cleaning the things your child has had the most contact with recently. You don’t need to sanitize the entire house. Try these tips:

• Launder any items that have come in contact with your child’s head. These include shirts, sweatshirts, pajama tops, sheets and towels. Wash them in hot water and toss them in the dryer on a high heat setting.

• Dry clean anything — such as a coat or wool sweater — that can’t go in the wash.

• Vacuum furniture and carpets and toss the vacuum bag afterward.

• It’s also important to soak items used on hair (brushes, combs and clips) in hot water for 10 minutes.

The Optum Store can help you save on your medication — and deliver it right to your door

Learn more

Additional sources
Statistics and treatments: Centers for Disease Control and Prevention (2020). “Head Lice — Frequently Asked Questions”
Lice shampoo: American Academy of Dermatology (n.d.). “Head Lice: Diagnosis and Treatment”
Homespun remedies: American Academy of Pediatrics (2020). “Head Lice: What Parents Need to Know”