How To Remove Head Lice In Children

By Sonia Gulati. May 7th 2016

As the school year progresses, children are not only bringing home their report cards and homework, but unfortunately head lice as well. Head lice infestation is becoming an increasingly common problem amongst preschool and elementary school aged children, with approximately 6-to-12 million children between the ages of 3 and 12 being treated for head lice annually in the United States. Girls, due to their longer hair, are more prone to getting lice than boys.


Lice are small, highly contagious, wingless parasites that live and feed on blood from the scalp. Although, head lice are uncomfortable and may even be embarrassing for some children, they do not pose a significant health risk. Contrary to popular belief, lice are not transmitted as a result of poor hygiene, but via close personal contact or by sharing personal belongings. Due to their contagious nature, it is best to treat head lice immediately upon a diagnosis.

Head Lice In Children

Once a child gets head lice, a mature female louse can lay up to 10 eggs or nits per day. These nits, which often look like dandruff, are laid at the base of the hair shaft close to the scalp. However, unlike dandruff, these nits adhere to the hair shaft and can't be removed by simply brushing or shaking them off.

  • Nits hatch in approximately a week-and-a-half, and quickly mature into adult lice in about 9-to-12 days.
  • The adult louse is about the size of a sesame seed and is grayish-white.
  • Most lice feed on blood several times a day, but they can survive up to two days away from the scalp.
  • Unless the infestation is severe, it is more common to see a nit in a child's hair than an adult louse crawling on the scalp.


The primary symptoms associated with head lice are intense itching of the scalp, which intensifies 3-to-4 weeks after the initial infestation, and a rash on your child's neck as a result of bites from the lice. If these bites become infected, they may appear red or crusty and can lead to the development of swollen lymph glands in the neck. Some children may remain asymptomatic for a few weeks, depending on the sensitivity of their skin. Children may also complain of having the sensation that things are moving around or tickling their heads.


Head lice infestation occurs as a result of prolonged and direct head-to-head contact with a person infected with head lice. In children, such contact may occur at summer camps, slumber parties, or sporting events. Children may also get head lice by sharing infected hats, scarves, combs and hair ribbons. In addition, children in nurseries or day care centers can get head lice through prolonged contact with infected beds, pillows or carpeting. Head lice infestation is even possible when trying on hats, ribbons and other items worn on the head at the shopping mall.

(For more information on germs, bugs and parasites found at the mall, see The 5 Grossest Things You Might Find At The Mall.)


If you suspect your child of having lice, you should immediately examine your child's head thoroughly, especially behind the ears and the nape of the neck for adult lice or nits. It may be easier to see lice or nits by parting your child's wet hair into small sections and combing it with a fine-toothed comb. Additionally, a magnifying glass or a bright light may help in assessing a head lice infestation.

However, finding an adult louse is often difficult because there aren't many of them and they tend to crawl very quickly. As such, it may be easier to find a nit at the base of your child's hair shaft. However, nits found more than a quarter of an inch away from the scalp have either hatched, or aren't going to hatch at all. If you are unable to find lice or nits, but still suspect that your child may have lice, contact your child's physician immediately. Furthermore, you may also want to contact your child's school and ask if other children have been recently treated for lice.

How To Remove Head Lice In Children

Removing head lice in children can be a fairly simple process. However, special care and treatment, different from adult treatment, may be needed, especially for children of a younger age:

  • Over-the-counter products. Shampoos containing pyrethrin (Rid) or permethrin (Nix) are considered the first line of defense against lice infestations. It is important to follow the manufacturer's instructions closely for whatever products you may choose to use. Most products will require a second treatment 7-to-10 days after the first head lice treatment. Medicated lice treatments usually kill lice and nits, but it may take 3-to-4 days for the itching to stop.
  • Prescription medications. If in some instances over the counter products do not work, your doctor may prescribe such medications as Ulesfia (Benzyl Alcohol Lotion 5-percent). Ulesfia is a water-soluble gel that suffocates head lice when applied and may be used to treat children over six months of age.

If your child is 2-years-old or younger, it is recommended that you remove nits and lice by hand. To remove lice and nits, use a fine-tooth comb on wet and conditioned hair every 3-to-4 days for two weeks after the last live louse was seen. Wetting the hair beforehand temporarily immobilizes the lice and the conditioner makes it easier to get a comb through the hair.

Prevention Of Reinfestation

Once your child has been treated for lice, it is also recommended to wash your child's clothing, bedding, combs and brushes in hot water in order to prevent another infestation. Additionally, it is also suggested to vacuum furniture, carpets, stuffed animals and car seats. As a general rule, the American Academy of Pediatrics advises that you clean items that have been in contact with the head of the person with infestation in the 24-to-48 hours before treatment . It is also advisable to check all family members for nits and lice as well.


  • Frankowski BL, Weiner LB, Committee on School Health, Committee on Infectious Diseases, American Academy of Pediatrics. Head lice. Pediatrics. 2002;110:638-643
  • American Academy of Pediatrics Clinical Report. Head Lice. PEDIATRICS Vol. 126 No. 2 August 2010, pp. 392-403
  • CDC
  • Kids Health

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