Keeping Your Wits about Nits: A Primer on Head Lice
There is hardly a problem that is more taxing to your wits than head lice are!
Head lice are very small, tan colored insects about the size of a sesame seed. They live only on human heads, and lay eggs, or nits, close to the scalp. The nits are about the size of the eye of a needle, oval shaped, and gray, white, brown, or tan in color. The nits attach themselves to a shaft of hair within a ½ inch from the scalp, and cannot be washed out of the hair or blown away.
The first signs of lice infestation are usually, irritation and redness of the skin. Head lice tend to nest at the crown of the head, behind the ears, or at the nape of the neck. They survive by a meal of blood, which causes the irritation. A bright light or a magnifying glass will help you spot lice or nits.
Head lice cannot hop, jump, or fly. They do not spread to or from pets. They are spread head-to-head by the use of infested brushes, combs, clothing, or other shared personal items. Lice may crawl and fall off the head, but do not live more than 48 hours. Even the cleanest families can pick up lice from the cap, jacket or comb of an infested person.
Prevention of Head Lice
Children should not share hair care items, towels, clothing, hats, sports headgear, or headphones. Avoid sharing lockers. If jackets and hats must be hung next to each other, control the spread of lice by hanging the clothing inside a plastic bag. Bedding, when not in use for naptime, can be stored in individual plastic bags or storage boxes.
How to Get Rid of Head Lice
1. Look at the hair in natural light with a magnifying glass. You might not find the lice, but you will be able to see the nits.
2. Inspect all family members, but treat only those with live lice or nits. It is preferable to treat all family members with lice or nits on the same day. Use a different towel for each step of treatment and for each person treated. Wash and dry all the towels after use.
3. Select a louse remedy. There a variety of treatment products which are available at the drugstore or the grocery store.
Suffocating Agents |
Chemical Agents |
Mayonnaise (100% real)
Oil (Vegetable, Olive or Mineral)
Petrolatum Gel (Vaseline) |
Over-the-Counter Crème Rinse
Over-the-Counter Shampoo
Prescription Lotion
Prescription Shampoo (see warning below) |
Do not use the following products:
· Antibiotics unless prescribed for another medical reason (may increase antibiotic resistance)
· Elimite or Nix 5% solution (used primarily for scabies, and is toxic). The 1% solution is preferable.
· Kerosene or other flammable liquid (may cause burns)
· Insect killing products such as Raid (costly, and toxic to children)
When using a suffocating agent, pile the hair on the head, and apply the product directly to the head, saturating the hair and scalp. Cover with a loose fitting shower cap, and leave for three hours. Remove the shower cap and wash the hair to remove the product. Baby Oil will be helpful to remove Vaseline. If using oil, it may be left in throughout the nit removal process. Remove the nits using the instructions below. Wash the hair thoroughly to remove any remaining product. Check for nits again, and remove any remaining ones. Because there are no harmful chemicals, this treatment can be repeated as often as needed.
There are important precautions with chemical treatments. Chemical treatments should not be used on children less than two years of age. Consult your physician before using a chemical treatment with someone who is pregnant, breast-feeding, or has a pre-existing medical condition. Do not use chemical treatments if there are open sores on the scalp.
Follow all the directions carefully, if using a prescription or over-the-counter product. Directions regarding the amount of the product to use, the length of time on the hair, and whether to use on dry or damp hair will vary from product to product. After the treatment, it may take up to 24 hours for lice to die. If lice are still present two days after treatment, switch to a suffocating agent. Use of a chemical agent may be repeated once, after seven days.
4. Remove the nits physically, with a special metal comb, your fingernails, tweezers, or scissors. Some lice eggs (nits) survive head lice treatments. The only way to be sure that lice won’t come back is to remove all the nits. Nits left in the hair will hatch and cause a new case of head lice. Expect to find larger numbers of nits at the nape of the neck, and around the ears and crown of the head. Remember that nits are usually close to the scalp. Nits, which are more than ½ inch from the scalp, are dead or empty, and will not hatch.
Have on hand a good supply of hair clips for pinning the hair, off in one-inch sections. Go through the hair section by section, removing all the nits. Be sure to have good lighting or a magnifying glass, and consider choosing a TV program or videotape to keep your child occupied. Continue to check for nits every day for two weeks. After each use, soak all utensils used, in very hot water (130 degrees) for 15 minutes, or use the lice treatment product. Be sure to wash your hands and clean under the nails thoroughly.
Suffocating agents will loosen the nits naturally. Chemical treatments do not loosen nits, so using a nit-loosening agent may speed the nit removal. Commercial nit loosening products are available, and there is one easy homemade product. Mix white vinegar and water in equal proportions, for example, three cups of each. Soak the hair in the mixture, and wrap the hair in a damp towel soaked with the same mixture for 30 – 60 minutes. After this time, do the nit removal, and rinse the hair.
Very long hair is more difficult to manage when doing nit removal. One last alternative to consider is to cut the hair to a shorter, cute style.
5. Clean the environment. Cleaning activities are best done on the same day of treatment. For upholstered furniture, mattresses, and car seats used by persons with lice, vacuum thoroughly. Clothing worn in the past three days, bedding, backpacks, and other washable items such as hair barrettes and hats should be washed in hot (130 degrees) water or dried in a hot dryer for 20 minutes. Items that can not be washed can be placed in a sealed plastic bag for 48 hours, or at freezing temperatures for 24 hours. Do not use household lice killing sprays or insect sprays.
The “Infectious Diseases in Childcare Settings and Schools” manual recommends that children with head lice be excluded from day care and school until the first lice treatment is completed and no live lice are seen. Nits are not considered live lice. The parent fact sheet from this manual can be found at http://www.hennepin.us/files/HennepinUS/HSPHD/Public%20Health%20Protection/Epidemiology/Daycare%20Manual/1355_head%20lice%20parent.pdf
Another helpful resource with detailed information on various treatments can be found at http://www.co.washington.mn.us/info_for_residents/public_health/family_health/lice/
Following these instructions will assist you in keeping your wits. Success in lice treatment depends upon daily checking to be sure that all lice and nits are gone. If no lice or nits are seen for three weeks, most likely the lice are gone for good. For further information, or to keep your wits about you, you may call Scott County Public Health at 952-496-8555 to speak with a public health nurse.