Ask a Pediatrician: What to Do If Your Child Comes Home with Lice
WVU Medicine provider offers insight on checking for, treating, and preventing lice cases
Back to School season can bring health concerns as kids head back into classrooms, including cases of lice.
"Head lice are common, and getting lice does not mean that a child or family is unclean. Lice can affect anyone. They are tiny crawling insects that cannot jump, hop, or fly,” WVU Medicine Pediatrician Angel Sunny, MD, said. “The most common way they spread is through close, prolonged head-to-head contact. There is a much smaller chance of spreading them through shared items such as combs, brushes, hats, or sports helmets.”
If your child's school reports a case of lice, Dr. Sunny’s first piece of advice is not to panic.
"Most cases of head lice can be treated using over-the-counter or prescription medications," she said. "It can feel daunting to take on head lice, but the good news is they aren't likely to cause any serious health issues and can be remedied with a few steps and precautions."
Checking for Lice
Take a few minutes to check your child's scalp carefully. Sit your child in a brightly lit area, separate the hair into small sections, and look closely for live lice or nits, paying close attention to areas like:
- Behind the ears.
- Along the hairline.
- On the neck.
“Nits are small, white or yellow-brown eggs that are firmly attached to the hair near the scalp,” Dr. Sunny said. “They are often easiest to find behind the ears and along the hairline at the back of the neck. Unlike dandruff, they don't brush away easily.”
A fine-tooth lice or nit comb can also be very helpful. You can wet the hair and work through it in small sections, checking the comb and scalp carefully after each pass.
“This comb-out method can help identify and remove lice and nits, although it generally should not be relied on as the only treatment when live lice are present,” Dr. Sunny said.
Itching is the most common symptom, particularly around the back of the neck and behind the ears. But remember, itching may not start immediately, and some children may have lice without significant symptoms.
Treating Lice
If you find live lice, that's when it's time to talk with your child's pediatrician and discuss treatment.
“Lice medications should be used when there is a confirmed infestation and should always be used exactly according to the instructions,” Dr. Sunny said.
After treatment, combing the hair every two to three days for two to three weeks can help remove remaining nits and lice.
"Please don't turn to dangerous home remedies. Never use products such as gasoline, kerosene, or medications intended for animals,” Dr. Sunny said. “There is also no good evidence that remedies such as mayonnaise, petroleum jelly, essential oils, or olive oil will eliminate head lice.”
Preventing Future Lice Outbreaks
According to Dr. Sunny, there’s no need to deep clean your entire house or throw away belongings after a case of lice.
If items such as clothing, towels, hats, or bedding were used within the two days before the lice were discovered, they can be washed and dried using high heat,” she said. “Items that cannot be washed can be sealed in a plastic bag for two weeks.”
Educating children about lice can happen without creating shame or fear, according to Dr. Sunny. Parents should encourage children not to have prolonged head-to-head contact and not to share items that touch their hair, while reminding them that having lice is nothing to be embarrassed about.
“As pediatricians, our goal is not only to treat the condition but also to help families understand it, prevent unnecessary anxiety, and know what to do next,” Dr. Sunny said. “Check carefully, treat safely, and remember — head lice can happen to anyone, and they can be treated.”
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