Ask a Nurse: A Louse-y Subject or (How to deal with head lice)

Pamela is an RN, MSN/Ed.

Pamela is a mother of 6 amazing children ages 11 to 24. She is a nurse educator and loves to travel overseas to work in medical clinics and teach health-related topics to schools and communities. She has been married to her best friend, Steve, for 29 years. She has many different interests including reading, writing (NOT arithmetic!), baking, teaching, and spending time with her family. She lives in central Pennsylvania with her husband and two youngest daughters.

A Louse-y subject


(How to deal with head lice)

Sooner or later you may be getting a call from your school nurse to come pick up your child because they have head lice. This call is one of the most dreaded and embarrassing ones among parents. As a certified school nurse, I had to be the bearer of bad news too many times to count! I figured that as a former school nurse and parent myself, I can help de-mystify some of the rumors, truth, emotions, and drama associated with this (forgive my pun!) “louse-y” subject!

Let’s begin with some facts.

There are 3 types of “lice” that humans contract: body or clothes louse (Pediculus humanus corporis), pubic (Pthirus pubis) and head louse (Pediculus humanus capitis). Today I am going to discuss the head louse. Head lice are not known to spread disease. The only lice that have been proven to spread disease are the body lice, according to the centers for disease control (cdc).

The main symptom you will notice is intense itching of the head. If your child is scratching his head a lot, check for head lice! Head lice are found in greatest concentration at the nape of the neck and around the ears. The eggs of the lice (nits) need to be ¼” from the scalp to hatch. If you see nits (the eggs that are glued to the hair shaft at an angle) that are farther down than ¼” from the scalp, they are probably not viable. The most effective treatment seems to be removing all the live lice and nits from the hair. The chemicals in treatment shampoos are very harsh and could be harmful, especially to young children or those with sensitivities. Removing lice takes time. A lot of time!

If you find out that your child has contracted head lice, you will need to call everyone that has been in close contact with your child for the past week or so. Check every family member in your household under a bright light, and use a magnifying glass. Part the hair and look carefully. If you are seeing white spots that you are not sure about, gently rub the hair between your thumb and first finger. Dandruff and lint will slip off easily. Nits are glued to the hair and must be scraped off with your fingernail or a good nit comb. Wipe the nits onto a tissue and dispose of in a sealed ziploc bag.

If your Doctor requests that you use a special shampoo to kill the lice, follow the directions carefully! Do not re-treat in a few days; go by the package instructions or by your Doctor’s recommendation. A good way to go through the child’s hair thoroughly is to sit them down in front of a movie and sit behind them with a bright, movable light, a good nit comb, tissues, and a ziploc bag. Concentrate on the nape of the neck and behind the ears, but check everywhere. Clip off areas of the hair with a hair clip, going through a small section at a time. When you think you cannot find any more nits, ask someone else to look, or take a break before re-checking. Check daily for at least a week or two. Nits hatch in 7 to 11 days. Most Doctors recommend another lice killing shampoo to be done during this time period.

You do not need to go overboard with sterilizing your house. The lice do not live very long when they are off of the head. The nits are only found in the hair. Vacuum the carpet and upholstery in the house. Change bedding and wash in hot water and dry in the dryer. Stuffed animals that are from the bed should be washed in the same way. Hats and coats should also be washed or dry cleaned. If you can’t do that, you can put items in the freezer overnight or in a sealed plastic bag for a few weeks.

There is so much information available on this subject!

A few random tidbits about lice:

*Lice do not jump or fly, the can only crawl. Head to head contact is the usual mode of

*Lice prefer clean hair; it is easier to get to the scalp for their blood meal!

*In the United States, African American hair is not usually affected by head lice. The lice
in the US have claws that can grab round hair shafts easily. The head lice in Africa have
different shaped claws that are better for grasping the oval-shaped hair shafts of African
American hair.

*Animals do not get head lice nor pass it to humans.

If you would like to read more about head lice, here are some good sites:

Remember to write me at to have your question or concern addressed in the column!

Be Well,


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