Getting head lice isn't a sign of bad personal hygiene or an unclean living environment. This itchy infestation, also called pediculosis capitis, most commonly spreads through close personal contact and by sharing personal belongings.
Both over-the-counter and prescription medications are available to treat head lice. Following the directions properly and taking necessary steps at home are important to prevent head lice from recurring.
Signs And Symptoms of Head Lice
Common signs and symptoms of head lice may include:
- Intense itching. An allergic reaction to the saliva that lice inject during feeding may result in itchy red bumps on your scalp, neck and shoulders. Some people, particularly if this is their first infestation, don't experience itching.
- Adult lice on scalp. The most common spots to find adult lice are behind your ears and along the back of your neck. Lice are tiny, about the size of a strawberry seed, but they can be up to 1/8 inch (3 millimeters) in size.
- Lice eggs (nits) on hair shafts. Nits resemble tiny pussy willow buds. Nits can be mistaken for dandruff, but unlike dandruff, they can't be easily brushed out of hair.
Head lice can't fly or jump, and they're not transmitted by pets. They spread by head-to-head contact or via contact with contaminated personal belongings or home furnishings.
Head-to-head contact
This is the most common mode of transmission and may occur as children or family members play or interact closely together.
Sharing personal items
Less commonly, head lice may be transmitted via such items as:
- Caps, hats and scarves
- Brushes and combs
- Hair decorations, such as barrettes
- Headphones
Head lice may sometimes be contracted by contact with contaminated:
- Towels
- Clothing
- Blankets
- Pillows
- Upholstered furniture
Treatment and Medication
Over-the-counter medication
Shampoos containing either pyrethrin (Rid, others) or permethrin (Nix) are usually the first option used to combat lice infestations. These work best if you follow the directions very closely.
In some geographical locations, lice have grown resistant to the ingredients in over-the-counter lice treatments. If over-the-counter preparations don't work, your doctor can prescribe shampoos or lotions that contain different ingredients.
Prescription medications
- Malathion (Ovide). Malathion is intended for use in adults and children age 6 or older. You apply malathion to your hair, and then rub it into your hair and scalp. This medication is flammable, so keep it away from heat sources, such as hair dryers, electric curlers and cigarettes. If you're pregnant or breast-feeding, talk to your doctor before using this product, because the medicine could affect your baby.
- Lindane. This prescription medication is available as a cream, lotion or shampoo. Your doctor may not recommend using lindane if you weigh less than 110 pounds (49.9 kilograms); are pregnant or breast-feeding; have seizures; or have HIV infection. Side effects may include skin irritation and seizures.
- Benzyl alcohol lotion. This newer treatment should not be used in children younger than 6 months. Side effects may include irritations of the skin, scalp and eyes. According to the Food and Drug Administration, serious side effects — such as seizures, coma or death — may occur if this product is used on premature infants.
Combing wet hair
If you don't want to employ insecticides, a fine-toothed or nit comb can physically remove the lice from wet hair. Repeat every three to four days for at least two weeks. This method is recommended as the first line treatment for children under age 2.
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