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Head Lice: Causes and Treatment

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What is Head Lice?

Personal hygiene or cleanliness in the home or school has nothing to do with an infestation of head lice. Head lice can be a problem for children of all ages and whatever socio-economic level. It does not matter how often children bath or wash their hair, they can still be affected by head lice. They are highly contagious and can spread quickly and easily from person to person especially when children are together in groups.

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Causes & Symptoms


Causes and Symptoms of  Head Lice

Head Lice are literally tiny insects that feed on blood from the human scalp. Infestations of head lice mostly affect children. This occurs as a result of a direct transfer of lice from the hairs of one person to another. Many people believe that head lice are as a result of poor hygiene practices, but this is not the case. Head lice don’t carry bacterial or viral infectious diseases. They are usually grey or tan in color and roughly the size of a strawberry seed. The life-cycle of adult head lice is usually 2-4 weeks. At first, it starts off as an egg, then a nymph and finally, after 9-12 days, a mature adult. 

There are some common signs and symptoms of a head lice infestation you should be aware of: 


  • Persistent itching: especially on the scalp, neck and ears. This can also lead to an allergic reaction to louse bites. 
  • Visible lice on the scalp: head lice are small but they can be spotted when looking closely at the scalp. 
  • Lice nits on hair shafts: lice eggs or nits often stick to hair shafts. These nits are easy to spot around the ears, hairline of the neck.
  • Sores on the scalp: scratching your itchy scalp can lead to the development of sores and scarring on the scalp. 

Treatment of Head Lice 

There are some quick and easy remedies for the removal and treatment of head lice infestations. 

  • Watch for tell-tale signs such as frequent head scratching.
  • Check family members on a weekly basis but only treat if there is an infestation. Work under a good light from a lamp, sit by a window or go outdoors when checking.
  • Be careful not to confuse head lice with dandruff.
  • Be careful about rushing to buy an over-the-counter product because all these lice-killing products are pesticides and can be very harmful particularly to anyone who is pregnant, nursing or who has an allergy, asthma, epilepsy or pre-existing medical condition. Never use products that contain lindane and never use a pesticide on or near the eyes for example if someone has nits in the eyebrows or eyelashes.
  • In children who are very young, you can manually remove the head lice by using a grooming comb or hairbrush to remove tangles, then divide the hair in sections and fasten off the hair that is not being worked on. Use a special comb to check from the scalp to the end of the hair. You can dip the comb into a cup of water to remove any lice, nits or debris from the comb between passings. Wash any lice down the sink. An infested child should be checked on a daily basis until you are confident the infestation is over. Look for attached nits (lice eggs) and live lice. Nits are always oval-shaped. While usually grayish-white, they can vary in color and are generally laid close to the scalp but can be found anywhere on the hair shaft.
  • Put clean clothing on a child after treatment.
  • Wash any bedding, recently worn clothing or any other items, you feel may have been contaminated, in hot water and dry in a hot dryer.
  • Combs, brushes and other personal items can be soaked in hot water and soap (130 degrees F) or in rubbing alcohol or Lysol for 10 minutes.
  • Dry clean anything that is not washable or stored in a plastic bag and seal for 2 weeks.
  • Vacuum carpets, upholstered furniture, rugs and car seats to remove any fallen lice or hairs with nits still attached. It is not necessary to have a pest control company spray your home as vacuuming is enough to treat the household.
  • Don't be tempted to use household sprays to kill adult lice.
  • Remember also that each day is a new day for the risk of a new infestation. A daily screening is important for anything that may have been missed and for identifying a new infestation as early as possible.
  • It is only right and civil minded to notify your child's school, camp, child care provider and neighborhood parents of any head lice infestation so that they can check their own children. Check for lice on a regular basis as this is the best way to protect your family and community.


James WD, et al. Pediculosis capitis. In: Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Elsevier; 2020. https://www.clinicalkey.com. (Accessed Feb. 13, 2021).
Dinulos JGH. Infestations and bites. In: Habif's Clinical Dermatology. 7th ed. Elsevier; 2021. https://www.clinicalkey.com. (Accessed Feb. 13, 2021).
Head lice: Treatment frequently asked questions. Centers for Disease Control and Protection. https://www.cdc.gov/parasites/lice/head/gen_info/faqs_treat.html. (Accessed Feb. 13, 2021).

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