Head Lice Prevention

Don’t Bug Out about Head Lice

It’s the dreaded phone call that no parent wants to receive from their child’s school nurse – your child has head lice. Immediately panic starts to set in and feelings of denial, horror, embarrassment, anger, and despair quickly follow. Parents begin to wonder: How did my child get head lice? Will it spread to the rest of my family? Is our entire house infested? What will others think? Lice can unexpectedly crash into your life and turn your whole world upside down.

Facing a head lice infestation can be downright traumatizing, especially for parents. While there is a lot of information out there about how to deal with head lice effectively, some of it is good, but much of it is grounded in myths that drown out the best advice. As the executive director of the American School Health Association, even I fell victim to the noise that many parents hear when dealing with lice. As a recent survivor of head lice, I hope the information shared below will encourage other parents to be open about their battle against head lice, and ultimately help ease the journey for other parents down the road.

The Stigma of Head Lice

The social stigma associated with head lice continues to be perceived as a major barrier to reducing its spread. Stigma results in children being teased, isolated during lunch time, and made to feel dirty once news that they have contracted head lice circulates. They may also miss valuable time in school due to controversial no-nit policies. 

Parents, on the other hand, will go to great lengths to keep secret that head lice has hit their household, traveling miles outside of their way to seek treatment. Both parents and children may feel ostracized as a result of the myths and negative social stigma that surround the condition. 

To help dispel the most common myths that contribute to the head lice stigma and help parents deal with these pesky parasites quickly and effectively, I’ve enlisted head lice expert, Dr. Shirley Gordon. Dr. Gordon has devoted much of her research to examining conditions like head lice that contribute to social stigma. According to Dr. Gordon, below are a few of the most common stigma-causing myths that parents should be aware of when navigating the battlefield against head lice.

Equal Opportunity Condition

Head lice is an equal opportunity condition that can affect anyone, regardless of socioeconomic status – yet so many myths continue to surround head lice. According to the Centers for Disease Control and Prevention (CDC), head lice impacts an estimated 6 to 12 million children ages 3-11 each year. The CDC also lists head lice as one of the most common childhood diseases, alongside ear infections, chickenpox, and measles. However, unlike other common childhood diseases, head lice is typically not reported to a health care professional, making it more difficult to track and treat effectively.

Health, Not Hygiene

A widespread misconception is that head lice infestations are associated with poor hygiene or unclean living conditions. Contrary to this popular belief, it does not matter if the hair is clean, dirty, long, or short. Moreover, while an itchy scalp is a common symptom, if someone is infested for the first time, it may take up to 4-6 weeks for this warning sign to surface. Keep in mind, not everyone with a head lice infestation will develop itching.

Head Lice Don’t Jump

Head lice move from one person to another by crawling and cannot jump or fly. The condition is usually spread from direct head-to-head contact, not from sharing brushes, hats, or bedding (although these are possible). Children tend to contract head lice at school, camp, daycare, slumber parties, and sports activities, among others, which can contribute to how quickly the condition may spread within a community. However, it is important to note that anyone who comes into head-to-head contact with someone who has head lice is at risk for an infestation. Therefore, it can be commonly transmitted within families.

Key Takeaways

So what should you do if you find yourself in a battle against head lice? Speaking personally as a parent who has overcome this obstacle and Dr. Gordon speaking as a nurse who has counseled countless parents on how to overcome infestation, we know that you can get through this seemingly impossible challenge of ridding your loved ones and homes of these pests. Our best advice is as follows:

Keep Calm and Contact Your Health Care Provider

At the first signs of head lice, parents should consider contacting a health care professional who is equipped to provide accurate, effective information about the condition and available treatment options. 

After confirming the diagnosis of an active infestation and completing the recommended treatment, take proper precautions to clean personal items such as bedding or clothing and hair accessories worn during infestation to reduce the risk of reinfestation. Head lice do not infest homes, so you don’t need to spend a lot of time or money cleaning your house, but it is a key element of a thorough lice management plan.

Stomp out Stigma

Remember, a head lice infestation is nothing to be ashamed or embarrassed about. You are not alone, and chances are high that someone you know has also encountered head lice. Help to break the stigma associated with the condition by speaking up and sharing your story with other parents in your community. Together, we can debunk the myths, fight the stigma, and effectively combat head lice.

What’s new in the head lice arsenal?

In regard to school management, the new guidance reiterates its assertion that children should not be excluded from school or school events because of lice, and that screening for nits is not a good indicator of infestation. In fact, such screenings have been shown to have little effect on the incidence of head lice and are not cost effective. For example, the AAP highlights a study in which, of 1729 children screened for head lice, only 31% of the 91 children with nits had an active live lice infestation. Another 18% with nits developed an infestation within 2 weeks of observation.

“Because of the lack of evidence of efficacy, routine classroom or schoolwide screening should be discouraged,” the AAP says. “Although children with at least 5 nits within 1 cm of the scalp were significantly more likely to develop an infestation than were those with fewer nits (32% vs 7%), only one- third of the children at higher risk converted to having an active infestation. School exclusion of children with nits alone would have resulted in many of these children missing school unnecessarily.”

Additionally, says the AAP, lice infestations have low contagion in classrooms. Between that and the fact that children who are diagnosed have likely been infested a month or more by the time of diagnosis, students diagnosed with a lice infestation should remain in class but close head contact with others should be discouraged. Alerting an entire classroom of parents also should be questioned, the AAP says, citing sentiments from experts that “because of the relatively high prevalence of head lice in young school-aged children, it may make more sense to alert parents only if a high percentage of children in a classroom are infested.”

“No-nit” policies that exclude children from school activities until all nits are removed also should be abandoned according to many health professionals, the report says. “International guidelines established in 2007 for the effective control of head lice infestations stated that no-nit policies are unjust and should be discontinued because they are based on misinformation rather than objective science,” the report states. “The American Academy of Pediatrics and the National Association of School Nurses discourage no-nit policies that exclude children from school. However, nit removal may decrease diagnostic confusion, decrease the possibility of unnecessary retreatment, and help to decrease the small risk of self-reinfestation and social stigmatization.”

Flea Bites vs. Lice – How Do You Tell Them Apart?

Both fleas and lice are blood sucking ectoparasites that live on animals as well as on humans. I often get queries from readers asking about the main differences between fleas and lice. So today, I am going to cover the all important topic of Flea Bites vs Lice and the characteristics which set them apart. I will also show you some of the best ways to treat these parasites at home.

Fleas vs Lice – What is the difference?

Both fleas and lice are wingless insects. They are equipped with piercing mouthparts that allow them to bite through human or animal skin and suck blood. Flea bites can be painful and may cause itchiness, swelling and flea allergy dermatitis. Lice bites cause similar symptoms and may result in rashes. Furthermore, both parasites could be vectors of diseases which they can transfer from one host to another. Here are their individual characteristics:


Fleas have a flattened body which makes them run rapidly through their host’s hair. They are also equipped with claws that enable them to hold on to the host. They have a third pair of legs which are very strong and enable them to jump from host to host. Fleas need blood meals to complete their various life cycle stages but they can also leave the host for a few days to lay eggs or to mate. Typical hosts of fleas are animals such as dogs, cats, pigs, rats and mice, but in the absence of these hosts, they may feed on humans. Fleas are vectors of bubonic plague and anthrax germs may also be present in their saliva. Chances of developing anthrax grow when the germs get rubbed or scratched into the host’s skin.

Flea bites

Flea bites typically appear as swollen, red welts. The swelling and itchiness can get extremely uncomfortable. In young animals like puppies and kittens, fleas can also cause symptoms of anxiety. Excess itchiness could also lead to flea allergy dermatitis and may even turn into anemia in weaker animals.


The bodies of lice, like fleas, are also compressed dorsally which enables them to move easily through the host’s hair. Like fleas, lice have claws to hold on to the host’s body. But this is where the similarities between fleas and lice end. Lice spend their entire lifetime on the host’s body and they do not leave the host like fleas do for laying eggs. The eggs, which are called nits, hatch into nymphs and are yellowish oval particles that are attached to the host’s hair shaft. Lice travel from one host to another through direct close contact.

Lice bites

Lice bites lead to extreme itchiness and irritation. Typically, lice are found in the scalp and pubic areas in humans. The bites of lice, when scratched, could develop secondary skin infections which are harder to treat. These can even turn into sores filled with pus. Lice are also vectors of diseases like typhus and European relapsing fever. The lice excreta could also get rubbed into the bitten areas of the scalp causing serious infections.

So how do you tell Fleas and Lice apart?

  • Flea bites on humans usually occur in irregular groups of several dozen or more. There is also a central spot surrounded by an erythematous ring. Chronic exposure to flea bites can cause urticaria which is characterized by severe itching. Flea bites are also concentrated on lower limbs, legs and feet and also around the areas where the clothing is tight, such as the waistband etc. A heavy flea infestation can be recognized by marks on clothing and beds. This is the undigested blood ejaculated by the fleas.

  • Pubic lice can cause bluish discoloration of skin in humans while head lice bites are pustular and may cause blisters on head, scalp and neck. The skin of people who continually harbor body lice is usually hardened and darkened.

There are many different species of fleas and lice. While some of them do not cause any disease, their biting can be a serious nuisance. I hope this guide helps you understand the differences of flea bites vs lice and that it helps you make an informed decision for their prevention and control. Good luck!

Do head lice change color?

According to the research of R. Hoeppli, ancient Chinese medicine used lice to cure “high fever and severe headaches as if the skull is cracking.” A paste made from 300 – 500 black lice, spread on the head, was said to do the trick. I must admit, I’d rather have 500 pureed lice on my head than 500 live ones, but the question this raised for me was where one would find black lice. Is there such a thing?

Head lice that I’ve seen have ranged from pale ivory through a golden – sometimes reddish – brown; magnified, they are transparent. Lice that have fed have a black mass inside – presumably blood in the process of being digested – but are not, themselves, black. There is a colour range, to be sure. But black? A literature search turned up some interesting things:

  • Head lice may have a natural way of blending in without actually changing color. Ibarra and Hall wrote: “Eggs and lice are well camouflaged, reflecting the colour of their surroundings.”

  • Newly hatched lice that have not fed are transparent (Meinking) and do not have color until after they’ve fed.

  • Color that matches the background has been shown to have evolved in other species of lice. This, however, refers to colour change over generations, not within the life span of a single organism.

The ‘wisdom’ that human head lice change color depending on the hair color of the host is oft repeated on websites and in non-academic publications. Published scientific information to back it up, however, appears nonexistent. Similarly, parasitology texts and laboratory identification references do not mention it

I remain highly skeptical that our head lice can change color within one generation, or that black head lice actually exist. I conclude that the Chinese remedy called for human head lice that had fed and had blood in their guts..

Lice Facts for Kids

  • Even though they are extremely small, both lice and their eggs can be seen with the naked eye.

  • A single female produces between 80 and 100 eggs in her lifetime.

  • A single host can be infested by thousands of lice at one time!

There is a handful of human lice species found worldwide and throughout the United States. The most common types of lice include head lice, body lice and crab lice. Only the body louse can transmit diseases to people.

Chewing Lice

There are over 2,500 different kinds of chewing lice. They get their name because their mouths are designed specifically for chewing. They have claw like features on at the end of their legs that enable them to stay on a host.


Chewing lice feed on feathers, hair, blood, scales and skin


They live on mammals and birds but are not found on humans.


Chewing lice can cause itching and small welts on the skin. Their bites can result in hair and feather loss, blood loss and even skin infection if not managed.

Depending on how well animals are groomed, some may become weak due to blood loss and become vulnerable to disease while some animals may be infested with lice and show no ill effects.


Keep animals clean and treat with specialty flea and tick shampoo and grooming products.

Sucking Lice

There are over 500 different species of sucking lice. The most commonly found species of sucking lice are "head lice" and "crab lice". They get their name because their mouths are designed specifically to suck blood.


Sucking lice are parasites. They feed on blood and only appear on mammals. In fact, most species of Sucking lice prefer to feed off rodents. "Head lice" and "crab lice" are more commonly found on humans.


The only way "head lice" can get food and water is by sucking blood from the scalp but they can be found on other parts of the body. They can spread from one person to the next through contact with bedding, clothing or by sharing combs. "Head lice" are common problems in crowded places, such as elementary schools, since children tend to share clothing more and frequently come into close contact with each other. 
”Crab lice" are usually found in other areas containing hair, such as beards, eyebrows, armpits and the pubic region. "Crab lice" are not as common in places such as schools, since they can only be spread through direct physical contact.


Hundreds of years ago, due to lack of hygiene and over crowding in dirty conditions, lice were considered deadly because they carried deadly diseases such as typhus. Today, Sucking lice are not really considered a health threat, but their bites may result in itching and redness around the area of the bite. 

If you suspect exposure to lice, wash all clothes, bedding, combs, towels, etc. You can also use special combs, shampoos and conditioners designed specifically to treat lice. Also, try saturating hair with baby oil at night to kill both lice and their eggs. If you do this, wrap a towel around your head to keep from soiling your bedding and be sure to wash your hair thoroughly in the morning.


  • Avoid using other people's combs, hats, towels, etc.

  • Have someone check your scalp at least once a month to make sure you have not been exposed.

My Battle With Head Lice

It was late at night, the tail end of Thanksgiving break. As a teacher, every child’s holiday is my own. I anticipate spring break and summer vacation. I pray for snow days on cold winter evenings. When days of rest come I sink into them gratefully.

I stared into the bathroom mirror, slowly brushing my hair. From the other room I could hear my husband snoring. I looked down at the sink and against the white background saw something dark move. Or did I? Was it a piece of an earlier woodland walk falling from my locks? I got in closer and moved the thing around with my finger, still unsure. I went back to brushing my hair, looking more suspiciously at my head. I brushed toward the sink. Then something else fell onto the white backdrop, a tiny, moving little creature.

Ugh. I looked up at myself in the mirror. The horror! Lice! No mistaking it, a full on louse with small trembling legs. I began to brush my hair more vigorously but couldn’t dislodge anything else. Frantically I dug under the sink, rifling through the old arsenal, the leftover instruments of a previous war. No good, just a bottle of lice spray. I needed a comb. I twisted my hair up into a bun.

I went downstairs and looked through the junk drawers. Nothing. I looked through the kitchen window out onto the back porch. “The cats’ flea comb,” I thought.  I retrieved the blue comb and stood looking at it for a full minute. I tried to remember the last time it had been used on one of our two feline friends. My head began to itch. I decided it didn’t matter. This was no time for pride. I boiled the comb in some water, waited for it to cool, then stood at the kitchen table with some white paper towel and did a search. The search turned up more lice and some nits. 

There is something about trying to pull lice off a head that is reminiscent of moments from my country childhood; a childhood full of stickers, ticks, and fleas. My eyes squint with determination and I get that stubborn feeling. It’s me versus the wild. I want to annihilate the enemy. I don’t care what it takes. I am disgusted by the fact of the parasites’ existence, aware that they are trying to live off me by sucking my blood. Birthing and biting and walking the shafts of my hair like little spiders. The grossness can’t overpower my singular intensity.

That night I did the best I could to rid my head of the beasties but I knew they’d won that battle. They were still there, breeding. In the morning I found my daughter’s head teaming, ground zero. My three boys and husband had gotten off scott free. No fair! 

The last time lice hit our family the boys had brought it in from a sleep over. We all had a round of toxic shampoo to eliminate the bugs. While I was tempted to start down that path as soon as the sun came up, I hesitated. I thought about my daughter’s tender skin, prone to contact dermatitis. I thought about my diligent efforts to buy organic food for my children. I thought about my growing realization that big business is not looking out for my family’s best interest or long term health. 

A quick internet search produced a wealth of disturbing information about lice removal insecticides.  Cases ranged from headaches to death. No thank you. And sometimes these products don’t even work. 

I looked for home remedies.  There were lots of suffering victims offering advice. There was the mayonnaise solution, very popular: mayo and an overnight cap. There were the usual hippie gold standards like tea tree oil and aloe. Of course there were more exotic suggestions like Vaseline and Listerine. Everyone was in universal agreement that you had to have a good comb and you had to comb, comb, comb. And here’s where I came up against another problem. I knew I could comb, comb, comb my daughter’s hair. And I knew that we could experiment with a vast array of kitchen products on hand but who was going to comb, comb, comb my hair?

My husband is the kind who cleans the toilet when it’s dirty and mops the kitchen floor. He doesn’t shy from work. But he can’t paint trim and he won’t clean the brush when he’s done. He has no patience for repetitive nit picking tasks. I didn’t trust him to delouse me. Not by a long shot. My girlfriends were gone for the holidays.

I went back to the internet and was pleased to find several companies that would provide a lice removal service, including one that would come to your home. When I found the perfect company that would come to my home I made an appointment right away. All of their products are natural, non toxic, and free of sulfates and pesticides. They even provide a guarantee with the condition that everyone in the family has a head check with them.

By Monday I had washed everything in my house and had my hair in a straightjacket. The lice technicians arrived and started right away with a head check for each one of us. They were able to decisively tell us not only that we had lice but for how long we’d had them. They checked my son’s hair. He was along for the ride. He came out clean.

Our hair received a phase 1 treatment (all natural) that helped to loosen up the nits. We sat for half an hour and then returned to have our hair combed. The trick is to comb quickly because lice can move fast.  

When they were finished I felt completely happy to shell out the money. I knew they’d defeated the enemy and they didn’t even have to wipe out the city to do it. Now that I’ve seen it done, I’m pretty sure we could handle another round ourselves. Let’s hope we never have to. So far, so good.

The 5 Stages of Head Lice: From Denial to Depression

There are few things in this world that send a shiver down a parent’s spine more than the dreaded words, “Your child has head lice.” You never think it will happen to your children since you keep a clean home and even cleaner kids. Lice only happens to people who don’t bathe regularly, right?

Wrong. No one is immune to these infectious parasites. They live on the human scalp and feed on blood to survive. The female lice lay eight-10 eggs daily, which mature in less than two weeks and have the capability of living up to 30 days on the scalp. I learned the hard way that not only do lice travel at the speed of light through an elementary school classroom, they can also invade the cleanest heads and have the agility of an Olympic pole vaulter.  

My experience with head lice can be summed up in five phases similar to Kubler-Ross’ five stages of grief: Denial and anger, followed by bargaining, depression, and acceptance. 


When I noticed a tiny population of insects zip-lining down my daughter’s hair shafts, I was certain the dog had given her fleas. Although her school posted warnings about an outbreak of head lice, I never dreamed it would happen to my squeaky clean child. On closer inspection, I discovered hundreds of microscopic eggs in her hair and muffled a scream. MY DAUGHTER HAD HEAD LICE! 

I lined up all four of my children and found lice on every one of their heads. Before my husband could sneak out the door that night for a hockey game, I reminded him that he married me for better or worse, and this would definitely fall under the category of “worse.”

First, I made a trip to the drugstore for a lice removal kit. This was more humiliating than purchasing an industrial size box of heavy duty tampons, because even the cashier leaned away from me while ringing up my nit kit.

Once home, my husband and I boiled hairbrushes, vacuumed carpets, sprayed all the upholstery and mattresses in the house with lice repellent, steam-cleaned the car, stripped the beds, and threw a mountain of linens, clothing, and 50 assorted stuffed animals into the dryer. In between this delousing nightmare, we took turns washing and rinsing our children’s hair, then plucking out their nits like monkeys examining each other’s heads in a zoo. Six-and-a-half hours, 531 nits and lice later (yes, I counted), we were parasite free.


We lived in ignorant bliss for approximately 10 days while continuing the preventative measures of washing, rinsing, and spraying, when suddenly my youngest daughter began vigorously scratching her head. I was seriously angry at whichever parent had been negligent in the delousing process and sent their child to school with a head full of nits. Maybe they didn’t stay up until 3 a.m. running a nit comb through their child’s hair, or maybe they forgot to turn their dryer on a temperature equivalent to the surface of Mercury to burn the bionic bugs out of the family bedding.

Armed with a prescription of toxic nit shampoo and an electronic lice zapper, I went to work on four heads while my husband deloused the house for a second time. Both of my daughters had waist-length hair, but I snipped off their beautiful tresses in an attempt to cut my nit picking time in half. I’m not sure who cried more – me or my daughters – but as they watched me fill a vinegar bowl with dozens of squirming insects the size of weevils, they understood my desperation.


I promised the kids that if they allowed me to inspect their heads daily after school and wrap their hair in a mixture of mayonnaise and vinegar each night, I wouldn’t burn down the house to rid our family of the lice once and for all. They agreed, even though it meant spending a week with sticky hair that reeked of rancid salad dressing.


For weeks we remained ostracized from society, hunkered down in our home like lepers to avoid spreading the mutant parasites to other families. After the first seven days of confinement, I’d memorized the lyrics to every Disney song on the DVDs that my children watched for hours on end. It pushed me to a breaking point in my sanity, which explains why my husband found me curled up in the fetal position on the couch with a glazed look in my eyes.


By the time we experienced a fourth round of head lice in a two-month span, I was a seasoned pro with a nit comb in one hand and a bottle of lice repellent in the other. I could spot a nit a mile away and had no problem donning a shower cap and rubber gloves to inspect the heads of every child on our block. Lice were a fact of life, and we had survived the invasion.

Luckily, our children’s lice never bothered to play hide-the-egg on my scalp or my husband’s.

Which is a good thing, because if they had, my house would have been burned down long ago.

How to Avoid and Manage Dreaded Head Lice

Two words parents dread hearing--head lice. Head lice are parasites that can be found on the heads of people, most common among preschool and elementary children. Each year millions of school-aged children in the U.S. get head lice. Though it may be a nuisance, the good news is that lice will not cause medical harm and in most cases can be effectively treated at home.

Lice are highly contagious and can spread quickly from person to person, especially in group settings, such as schools, sporting events and slumber parties. Head lice spread mainly by direct head-to-head contact with a person who already has head lice, but it can also be transferred indirectly when kids share combs, brushes, pillows or hats. Because children play closely together and often in large groups, all children can potentially be affected, and poor personal hygiene is not a significant risk factor for getting head lice. In other words, if your child is exposed to someone with head lice, they have a pretty good chance of bringing it home as well.

Does your child have lice?

The most obvious sign of head lice is an itchy scalp. If you notice your child scratching behind their ears or at the back of his neck, examine the child’s head for signs of lice. Lice are very small, but it is possible to detect them with the naked eye. Combing through the child’s hair with a fine-toothed comb can help reveal any eggs. If you are unsure, visit your pediatrician. An itchy scalp may also be caused by an allergy, eczema or dandruff.

Don’t panic- Head Lice is very treatable

If your child has head lice, take action immediately once you’ve made the diagnosis as lice can spread easily from one person to another, putting other members of your household at risk. The most common treatment is an over-the-counter or prescription cream, lotion or shampoo. You apply it to the skin or scalp to kill the lice and eggs. In many cases, two treatments are necessary. If after two treatments you believe your child may still have head lice, contact your pediatrician. Your child’s doctor can recommend a different form of treatment.

You may be tempted to throw away bedding, clothing or other items in your household, but a simple wash will do the trick. Toss your child’s bed sheets, clothes, hats and other belongings in the washing machine in hot water, and dry on high heat to kill any remaining lice. Other members of your household should also be checked for lice.

To prevent kids from getting lice or becoming re-infested, tell kids not to share combs, brushes, hats or other personal items with anyone else. To prevent head lice, examine your child’s scalp regularly, especially during the school year, to detect lice early.

Remember, lice are very preventable and treatable. Be patient and follow the treatments and prevention tips as directed by your child’s pediatrician for keeping lice at bay and your household bug-free.