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Head Lice

Baltimore County Department of Health
6401 York Road, Third Floor
Baltimore, MD 21212-2130

Phone: 410-887-2718
TTY users call via Maryland Relay

Frequently Asked Questions

What are head lice?

Head lice are parasites—very small bugs. They live on the head and the hair of the head. Sometimes you find them in eyebrows, eyelashes and beard.

Head lice are most commonly found in young, school age children. But anyone can get head lice—it does not matter whether a person is young or old, dirty or clean, rich or poor.

Adult head lice are hard to see. They are gray or brown in color and about 1/8 inch long. But their eggs, called nits, are easier to find. Nits are tan or off-white in color. The nits may at first look like dandruff, but you will find that the nits are very firmly stuck to the strands of hair. Nits will not flake off or wash off like dandruff.

Head lice live for about one month. They multiply very quickly. Adult female lice lay up to six nits a day. These nits will hatch in seven to 10 days. And about eight to 14 days later they will be mature and laying more eggs. Head lice can live away from the human body and on other things for a time—live up to two days and nits up to 10 days.

How do you get head lice?

You can get head lice by:

  • Direct contact with a person who has head lice—head touching head

  • Sharing items with a person who has head lice—such as combs, brushes, hats, headbands, scarves, barrettes and hair ribbons. Children should be warned not to share these things.

  • Using items a person with head lice has used, laid on or played.

Head lice do not jump or fly.

Head lice do not come from or live on animals. Your pets do not need to be treated during a head lice outbreak.

How do you know if you have head lice?

Here are some things to look for:

  • Itching of the head

  • Scratches, bite marks or rash on the head or neck. Sometimes these scratches get infected.

  • Nits on the hair strands. It may help you see the nits if you have good lighting and use a magnifying glass. Nits may be found throughout the hair but are more often at the back of the head and behind the ears.

  • Sometimes swollen glands in the neck and under the arms.

    Please be advised that some very young children, teens and adults may have head lice and have no itching. They may also spread the lice without knowing it.

How do you get rid of head lice?

As soon as you find head lice, you should treat them because they spread so quickly. If one person in a family, school or group has head lice, there is a good chance that others will have it, too. So everyone should be checked, and all those who have head lice should be treated at the same time. Treatment means:

  • Using a lice treatment on the hair recommended by your pharmacist or doctor.

  • Removing all nits, and

  • Cleaning things the person with head lice has used or worn.

Head Lice Treatment

There are a number of approved lice treatments that may be used to get rid of head lice. Some of these treatments you can get over the counter (just tell the pharmacist what you need), and some must be ordered by a doctor. You must use one of these special head lice treatments. Washing with regular shampoo will not get rid of head lice.

Before using any of these head lice treatments, read all the directions and follow them exactly.

This will take time but you must do it if you want to get rid of the head lice. Just using a lice treatment is not enough, as it will not kill or remove all the nits. You can do nit removal with a special nit comb—the metal combs are best—or with your fingers. Nit combing is easier if the hair is dry or slightly damp. Work in a well-lit area and work through a small section of hair at a time so you don't miss any nits.

After the treatment and nit removal, check the person's head every day for at least 10 days. Some lice treatments will need to be used again in 10 days. If after the second treatment there are still more signs of head lice or nits, call your doctor. Do not treat again without your doctor's advice.

Clean everything that has been in contact with the head and neck of the person who has head lice. These items may have lice or nits on them. If you don't clean them well, you will just get head lice again. Items to clean include:

  • Combs, brushes and barrettes. Soak them in hot water with a strong disinfectant for one hour.

  • Washable things like clothes, jackets, sweaters, scarves, hats, headbands, sheets, pillows, pillowcases, towels and washcloths. Wash in hot water and dry in a hot dryer.

  • Clothes and other materials that cannot be washed. Bag them up and take them to the dry cleaners.

  • Upholstered furniture, car and bus seats, pillows, mattresses, box springs, rugs, floors, and stuffed animals should be vacuumed well. With furniture, vacuum cushions then take them off the chair and vacuum in all the corners and folds. Lockers, gym mats, bed and cot surfaces must be vacuumed. After use, the vacuum cleaner bag must be thrown away in a sealed plastic bag.

  • Smaller, non-washable things—like stuffed toys and pillows. Store in a tightly sealed plastic bag for 14 days.

There is no need to have your home or school fumigated for head lice. In fact, spraying or fumigating has been found in some cases to be harmful to small children and pets. Head lice do not infest an area like fleas do. Careful cleaning and vacuuming of the area is all that is needed.

Head Lice in School or Childcare

If you find head lice or nits on your child, tell the school or childcare director right away. Remember, head lice can happen to anyone. The important thing is to tell the right people so steps can be taken to stop the spread of head lice. Everyone who has head lice will have to be treated, or the children will just keep re-infesting each other.

Also, tell the parents of the children your child plays with. These playmates should also be checked for head lice.

The child with head lice and nits is kept out of school until properly treated for head lice. This is done because head lice can spread so quickly. When your child has been treated and you are ready to bring the child back to school, call your school nurse. The school nurse will check your child's head before putting the child back into the classroom.

Revised January 26, 2018         


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