Infestations & Bites
Head Lice (Pediculosis)
Pediculosis capitis
Very common, especially in school children
Yes — by head-to-head contact and shared items
Yes — with proper treatment and combing
What Is It?
Head lice are tiny insects that live on the scalp and feed on blood, causing itching. They lay eggs (nits) that stick to hair shafts near the scalp. Lice are very common in children and spread easily through close head-to-head contact. They're a nuisance but do not cause serious disease.
Signs & Symptoms
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Itchy scalp, especially behind the ears and neck
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Tiny nits (eggs) glued to hair near the scalp
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Live lice, though they're small and move fast
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A tickling feeling of movement in the hair
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Sometimes no itch at all, especially early
Why Does It Happen?
Lice spread mainly through direct head-to-head contact and, less often, by sharing hats, brushes, or pillows. They cannot fly or jump — they crawl. Having lice is NOT a sign of poor hygiene or a dirty home; anyone can get them. The itch is an allergic reaction to lice bites and may take weeks to start.
Treatment Options
Treatment uses a lice medication plus thorough combing, with a repeat treatment to catch newly hatched lice. Treating close contacts and household items limits reinfestation.
LICE TREATMENT
Over-the-counter or prescription products; repeat as directed (often day 9).
WET COMBING
Fine-tooth nit comb through wet, conditioned hair to remove lice/nits.
TREAT CONTACTS
Check and treat household members who also have lice.
HOME MEASURES
Wash/hot-dry recently used bedding, hats, and hair items.
Tips for Managing It at Home
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FOMITES: wash bedding, hats & hair items in hot water (≥60°C) and hot-dry
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Items that can't be washed: seal in a bag for 2 weeks
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Comb wet hair every few days to remove lice and nits
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Avoid head-to-head contact and don't share brushes or hats
When to Call Your Provider
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Lice persist after correct treatment and combing
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Scalp becomes infected from scratching (pus, crusting, swelling)
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Widespread or very stubborn infestation
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Uncertainty about whether it's lice or something else
Sources & further reading
The information in this handout is based on general dermatology guidance from the reputable organizations below. These links are provided for patients who wish to read more from trusted sources.
American Academy of Dermatology (AAD). Head Lice: Overview. https://www.aad.org/public/diseases/a-z/head-lice-overview
Centers for Disease Control and Prevention (CDC). About Head Lice. https://www.cdc.gov/lice/about/head-lice.html
DermNet. Head Lice. https://dermnetnz.org/topics/head-lice
This handout is for general education and does not replace advice from your own provider. Always follow your provider’s specific instructions.
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