Head lice are usually transmitted through close personal contact with another infested individual or through use of common combs, brushes, and other grooming aids: through sharing hats, caps, wigs, coats; or through commingling of these items at the homes of friends, at school, at church, or other public places. Most parents have the impression that lice become established on persons who are unclean. In the case of head lice, this is NOT true. Frequent bathing will neither prevent head lice nor eliminate an infestation once it. has become established.


    Head lice are elongated insects about this (-) long and are greyish~white with dark margins. Lice do not have wings and, therefore, cannot fly. They do not jump, but move very quickly; -this makes them difficult to find in the hair.

    Since they are difficult to see, the diagnosis of infestation is frequently made on the basis of finding nits. A nit is a louse egg. Nits are teardrop in shape, about this size/), and vary in color, from yellowish~brown to white. Head lice attach each nit to a hair shaft with a waterproof, cement~like substance. Thus, nits cannot be washed out or brushed out of the hair like dandruff or other debris that sometimes lock like nits to the naked eye. Clusters of nits may be found in any section of hair, but in light infestations a careful examination of the entire scalp may be necessary to detect them.


    Treatment is directed at the infested, person and their personal articles, e.g. caps, combs, brushes, towels, bedding, and clothing. The U.S. Public Health Service does not recommend fumigation of or use of insecticides in the home, school, or school buses.

    A. Individual Treatment

    1.        Remove all of the child's clothing and place him/her in a bathtub or shower.

    2.        Apply lice shampoo or creme rinse according to doctor's instructions or label instructions. Several over the counter lice shampoos are available but the prescription creme rinse seems to show the best results and lasts 14 days.

    3.        Have child put on clean clothing after treatment. Children may return to school after proper treatment. Use the fine-toothed comb to remove nits from the hair.

    4.        If using the shampoo instead of the creme rinse, repeat the treatment in 7-10 days. The shampoo does not kill the nits; therefore repeating the treatment will kill the newly hatched lice. The 7-10 day interval corresponds to the incubation period.

    5.        Close friends of infested children should be checked. AS a precaution all family members should be treated, this is the only way to check the spread within the family.

    B. Decontamination of Personal Articles and Environment: Since heat is lethal, to lice and their eggs, many personal articles can be disinfected by machine washing in hot water and/or drying using the heat cycle of the dryer can disinfect articles. Eggs are killed in 5 minutes at 51.5°C (12 F), and crawling forms succumb to slightly lower temperatures, Home hot water heaters keep water at about 60°C when the heat selector is set on medium or high. However, some water heaters are not. able to sustain the 60 water temperature when several loads of laundry are processed one after the other or when other demands for hot water (bathing) are made simultaneously. To maintain the water at 60 C or higher, allow time between loads of laundry or baths for the water heater to regain its maximum water temperature. If total reliance is placed on the clothes dryer for disinfection, dry articles for at least 20 minutes at the heat setting. Some nonwashable articles may be disinfected in the dryer provided that the heat will not harm them.

    1.        Machine wash all washable clothing and bed linens that have been in contact with the infected person within the last three-(3) days.

    2.        Personal articles of clothing or bedding that cannot be washed or put in dryer may be dry cleaned or simply placed in a plastic bag and sealed for a period of 10 days.

    3.        Combs, brushes, and, similar items can be disinfected by soaking them in a pan of water heated on the stove to about 150 F for 5-10 minutes (caution: heat may damage some things). Articles may also be soaked in a solution of lice shampoo.

    4.        Because lice can live only a short time if they fall off the head, the U.S. Public Health Service recommends that environmental cleanup be limited to simple vacuuming of carpets, upholstered furniture, etc. Use of insecticides or fumigants on upholstered furniture, carpets, bedding, etc., is not recommended.


    Parents of your child's closest friend(s) should be notified; their child may also be infested since the children play together. This is particularly important, if the children have slept together, or participated in activities involving frequent body contact such as wrestling, ballet classes, football, etc.

    It is important that parents attend to this nuisance problem as soon as it is discovered and important that, the schools be notified so that the school nurse can give follow-up attention to pupils.