Head Lice

Welcome to the informational page about head lice provided by the Kittitas County Public Health Department. Here, you will find essential information regarding head lice, including what they are, who is at risk, common locations for infestation, signs, and symptoms, as well as facts and tips for prevention and treatment.

Kittitas County Public Health Communicable Disease staff offers limited technical consultation on head lice to school and child care professionals only.

What Are Head Lice?

Head lice are small insects without wings that survive by feeding on human blood. They are typically found in the hair of people’s heads and necks, close to the scalp, where they lay eggs called nits. While head lice infestations are common, particularly among school-aged children, they can affect individuals of any age. It's important to note that head lice don't transmit diseases and are generally not considered a serious health threat. However, excessive scratching due to infestation can lead to secondary skin infections.

Who Is at Risk for Getting Head Lice?

Kids at school, those in daycare, and family members of people with head lice are more likely to get them. Living in crowded places also makes it easier to get head lice. Sharing things like hats or combs can spread lice, but it's not as common. Still, anyone can get them if they're close to someone who has them or share their items. To lower the risk, avoid close contact and don't share personal things.

How are head lice spread?

Head lice are spread through close contact with someone who already has them. Lice do not jump or fly. Most commonly, head lice are spread by direct head-to-head, or hair-to-hair contact. This usually happens when heads touch during activities like playing or hugging. Lice can also spread by sharing things like hats, brushes, or pillows with someone who has an infestation.

Where Are Lice Most Commonly Found?

Head lice and their eggs, called nits, are usually found on the scalp, especially behind the ears and near the neckline at the back of the head. Sometimes, though rarely, they can be found on eyelashes and eyebrows. Nits stick firmly to the hair and can be tough to remove, even after the baby lice, called nymphs, hatch from the eggs.

Signs and Symptoms of Head Lice Infestation

  • Itching: The main sign of head lice is itching, caused by an allergic reaction to their bites. Sometimes, people can have lice without feeling itchy, especially at first or if there are only a few lice. According to the Centers for Disease Control and Prevention, it may take 4-6 weeks for itching to appear the first time a person has head lice.
  • Tickling sensation: Some individuals may feel a tickling sensation as lice move in their hair.
  • Irritability: Having head lice can make you feel irritated and have trouble sleeping, especially because lice are most active at night.
  • Sores: Scratching your head a lot can lead to sores or infections from bacteria on your skin. But remember, head lice themselves don't spread diseases.
Picture of the life cycle of head lice

Treatment Steps and Prevention

To prevent head lice, it's important to take steps to lower the chance of getting them. If someone gets lice, it's crucial to treat them quickly to avoid spreading them. There are treatments you can buy or have prescribed by a doctor to kill lice and their eggs. Also, cleaning personal items and the area around where you live well can help get rid of lice. Follow the steps below to treat and prevent head lice:

1. Examine

Examine everyone in the home for lice and nits.
First, look at a person’s hair, close to the scalp around the ears, and across the back of the neck. Then carefully check the rest of the head and scalp.
Separate the hair strands carefully while looking. Nits are small, white to yellowish brown, oval-shaped eggs that are glued to the hair near the scalp. Nits are more easily seen than live lice. Dandruff will come off easily while nits will be stuck to the hair.
Lice are dark in color and the size of a poppy seed. Look for lice crawling on the scalp.

2. Treat

Treat only those household members who have head lice.

If you find someone with head lice in your home, use a lice treatment product on their hair. You can buy these products at drugstores or grocery stores. Some need a doctor's prescription. These treatments won't kill all the lice and eggs, but they're a good start. Follow the instructions on the package or from your doctor carefully. Using too much, using it too often, or leaving it on longer won't make it work better and could be harmful.

3. Comb

Comb. Comb. Comb.

After treatment, comb the infested person’s hair with a lice-removal comb (called a nit comb) to remove lice and nits. Nit combs with long, round, metal teeth tend to be sturdier and more effective. Try to remove every nit and any lice you find. It’s OK if you can’t get them all on your first try. Just spend time every day until you do get them all.

Combing the hair in the opposite direction of normal brushing will help you find more eggs. Nit-picking can also be done by hand, using your fingernails or tweezers. Get rid of nits in the sink, toilet, or garbage. Vacuum around the area where you were combing out nits. Both people should change their clothes afterward.

Comb, using the nit comb daily for seven days, or until you no longer find any lice or eggs. This step takes the most time, energy, and patience. Combing is the most important step!

4. Clean

Keep your home clean by doing regular tasks like washing clothes, towels, and bedding, vacuuming floors and furniture, and cleaning combs and brushes with warm, soapy water. Avoid using fumigant sprays because they can be harmful if breathed in or absorbed through the skin. Head lice can only survive for 1 to 2 days without feeding if they fall off a person.

5. Repeat

Most treatments recommend a second treatment 7-10 days after the first. Follow the directions just as you did for the first treatment. Afterward, remove any eggs or lice that you might find. Continue to check heads daily on everyone in your household until one week after the second treatment or one week after the last egg or louse is removed.

6. Notify

Notify everyone that may be affected, for example:

  • School
  • Church
  • Childcare
  • Friends
  • Family

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Head Lice Facts & Tips

  • Anyone with clean or dirty hair can get head lice.
  • It can be hard work to get rid of them.
  • Head-to-head contact is the way head lice are almost always spread.
  • Lice don’t jump or fly, but they are fast crawlers.
  • Pets do not carry or spread human lice.
  • Head lice do not spread disease.
  • Head lice need human blood to live. They’ll die within 48 hours if they can’t get it.
  • It takes head lice eggs (nits) about a week to hatch.
  • An itchy scalp is the most common symptom of having head lice and may continue for a while after you have successfully ended an infestation.
  • Lice treatment products help kill most of the lice. Even so, you’ll still need to physically remove the lice and nits, by combing or picking them out, to be sure they’ll no longer be a problem.
  • Don’t panic or retreat if you see live lice after treatment. Look for them and remove any lice you find until they are all gone. Continue to look until you haven’t seen any for seven days.
  • Do not use a combination shampoo/conditioner, or conditioner before using lice medicine. Do not rewash the hair for one to two days after the lice medicine is removed.
  • The use of mayonnaise, kerosene, Vaseline©, vinegar, and other home remedies are not proven to be effective and can be dangerous. Shaving the head is not necessary. If you do not want to use an over-the-counter treatment product, just comb out the nits with a good lice comb.
  • Always follow the directions when using treatment products.
  • Notify anyone who may be affected.

Head Lice Resources: