Head Lice: Care Instructions

Overview

Head lice are tiny bugs that can live in your hair and on your head. Live lice are tan to grayish white. They're about the size of a sesame seed. It may be easiest to find them on the back of the neck at the hairline or behind the ears. When you have lice, all people living in your home need to be carefully checked and then treated if they have it.

Lice eggs (nits) may be easier to see than live lice. They look like tiny yellow or white dots attached to the hair, close to the scalp. Nits can look like dandruff. But you can't pick them off with your fingernail or brush them away.

Lice aren't dangerous. They don't spread disease or have anything to do with how clean someone is. The lice may make your head itch. This is because of your body's reaction to the lice bites.

You can treat lice and their eggs with prescription or over-the-counter medicines. After treatment, your skin may still itch for a week or more.

How can you care for yourself at home?

• Use an over-the-counter medicine to kill lice. Your doctor or pharmacist can help you choose a medicine that is safe.
• Follow the directions that come with the medicine carefully. Some medicines should only be used once. Others require a second treatment 7 to 9 days after the first treatment. Don't use more medicine than you should or two medicines at the same time.
• Do not shampoo or condition your hair before you use the medicine. It's best to wait 1 to 2 days after you use the medicine before washing your hair.
• To rinse out the medicine, use warm (not hot) water. Make sure to wash out the medicine over the sink instead of the shower. This helps to avoid some of the medicine coming into contact with your skin.
• Check your scalp for live, active lice 12 hours after treatment. If you find some, talk to your doctor. You may need a different type of treatment.
• Try wet-combing, which may help remove lice and nits. Use a comb with teeth that are close together. A flea comb that's made for dogs and cats will also work. Wet the hair. Comb all of the hair very carefully. Combing needs to be done over and over.
• Try not to scratch. Scratching can cause sores on the scalp, which can lead to an infection. It may help to use an over-the-counter anti-itch cream to calm the itching. If the itching is really bad, ask the doctor about an over-the-counter antihistamine. Read and follow all instructions on the label.

How can you help prevent them?

• Check everyone in your home for lice. If your child shares a bed with someone, the other person should be treated too. (Don't worry about pets. They can't get lice.)
• Teach your children not to share anything that comes into contact with hair. For example, don't share hair bands, towels, helmets, hats, combs, or brushes.
• You don't need to spend a lot of time or money deep cleaning your home. But it's a good idea to:
  • Soak hairbrushes, combs, barrettes, and other items for 10 minutes in hot water (at least 130 °F [54.4 °C]).
  • Machine-wash clothes, bedding, towels, and hats that touched the head in the last 2 days in hot water (at least 130 °F [54.4 °C]). Dry them in a hot dryer. If you don't have access to a washing machine or if items can't be washed or dried, store these items in a sealed plastic bag for 14 days.
  • Vacuum carpets, mattresses, couches, and other upholstered furniture.