3855 Trueman Court | Hilliard, Ohio | 43026
Hilliard Pediatrics, Inc. - Dr. Tim Teller, MD
Head lice are a scalp and hair infection from tiny gray bugs called lice. A live louse is 1/16th of an inch long, gray in color, difficult to see, and they move quickly. The eggs of the lice are called nits and are found attached to the hair. Please remember that head lice do not spread any disease, therefore they are not a health hazard. However, they certainly often cause itching of the scalp and neck.
Human head lice spread from one person’s hair to another person’s hair. Although it is possible for the lice to spread from combs, hair brushes, hats, pillow, bed clothes, and furniture to someone’s hair, this is less common. Pets very rarely spread head lice to people. A live louse cannot live longer than 2 days away from the scalp.
Lice place their eggs very close to the scalp on the hair shaft. In 7 to 12 days (usually 8 or 9 days), the eggs (nits) hatch. In 9 to 12 days, the lice mature to adulthood and can quickly lay more eggs.
It can be difficult to tell the difference between the nits of head lice and dandruff or hair debris. Nits are firmly attached to the hair. The farther they are from the scalp, the longer time the nits (eggs) have been on the hair shaft. Nits start off just 1/8th of an inch from the scalp. Hair regularly grows about ½ inch per month. Therefore if nits are found more than an inch from the scalp, they have been there for weeks or months. It is also difficult to tell the difference between hatched nits and unhatched nits.
Remind your school-aged children to not share combs, hats, scarves, coats, etc. with other children because sharing these items makes it more likely to become infested with lice.
The goal in cleaning the house is killing any live lice or nits that are not on someone’s head when the medicated shampoo (or other treatment) is used. What we recommend.
Smothering (or suffocating) the live lice with the use of Vaseline petroleum jelly, olive oil, butter, or mayonnaise is untested and therefore hard to recommend. Because these treatments are not as likely as Nix or other available treatments to work well, we cannot actively recommend these treatments. These would certainly be difficult to remove from the hair later (requiring lots of shampoo).
Remove the nits from the hair by combing through with a special nit comb. There are various combs available – sometimes packaged with the treatment shampoos or rinses. The LiceMeister® is one of many metal combs that seem to work well and is available over the counter. The nits can be removed by hand individually also. This is not a quick job. It can take quite some time, especially with children with lots of thick, long hair, to comb through the hair and remove the nits.
Some products like LiceMD® and Rid Lice & Egg Comb-Out Gel® can make it easier to remove the nits. These products are not necessary, but can be helpful if you are frustrated with combing through the hair to remove the nits (eggs).
Once the treatment has been done, your child can return to school. For most children, that means that if your child is treated with a medication in the evening and you have done your best to remove nits from the hair that evening, they can return to school the following day. If your child has live lice, they are still contagious. Many schools still have a “no nits” policy, meaning that they have to be free of nits (the lice eggs) before they can return to school. Since after treatment the nits could be live or dead, it can be difficult to tell whether your child could still have live lice hatch and be contagious. So although we do not feel that it is practical to have a school policy of no nits before return to school, it is best to remove all the nits to the best of your ability.
As of the summer of 2014, we had seen so much resistance by the lice to the over the counter treatments that we decided to change our recommendations about lice treatment. Please recall that having lice is not an emergency and can be dealt with during routine daytime office hours. We ask you to call at that time if you need to call us concerning lice.
If you find live lice:
If you used the Nix® and see live lice in 7-10 days:
If you tried Rid® or LiceMD® or another over-the-counter treatment (but not Nix®) and you see live lice within a few days after using the product:
If you see live lice within the first 4-5 days after using Nix®:
If you used a product that killed the lice and you find live lice more than 2 weeks after the treatment:
Last Updated: 06/2019