Millions of school-aged kids in the U.S. get head lice each year. It is a very common condition and lice can easily infect any child who is exposed.

“Head lice don’t discriminate,” says Dr. Pilar Bradshaw of Eugene Pediatric Associates. “Head lice will infect any kid. It’s very common in young kids all the way through teens. The real common denominator isn’t how clean you are, how you dress, who your friends are, anything about your kid. It’s simply contact. Lice can travel from one child to another quite easily.”

Head lice are generally about the size of a sesame seed and are often mistaken for dandruff. The most common symptom that your child has head lice is they will start to itch, typically behind the ears and the back of the neck. While head lice do not cause serious illness or carry disease, they do take diligent effort to treat and prevent from spreading.

Treating head lice
Check closely not only for lice, but for their eggs, Dr. Bradshaw says. “Look just a couple of millimeters along the hair shaft for what we call nits, which are the little eggs. They’re attached to the side of the hair and they’re very adherent white little globs that are very difficult to remove—unlike dandruff that just flakes off. Nits stick onto the hair.”

The most effective treatment is an over-the-counter head lice medicine, followed by diligent and persistent combing. Avoid home remedies as studies haven’t shown them to be effective and some may even be dangerous.

“We don’t recommend home remedies like mayonnaise and Crisco or things like that,” Dr. Bradshaw says. “We actually recommend using these over-the-counter preparations and then doing meticulous removal of the lice and the nits.”

Go through your child’s hair, one small section at a time, with a very fine comb and pick off the nits and lice. It is a slow process and will take some time to do right.

“Especially if your kid has long or thick hair, it takes hours to get rid of the lice and the nits but until you put that time in, no remedy that you use will fix it,” Dr. Bradshaw says.

Some tips to keep in mind:

  • When using head lice treatments, always follow the directions on the package.
  • Never let children apply the medicine or leave them alone with medicine in their hair.
  • Always rinse off the medicine over the sink, not during a shower or bath.
  • Always store head lice treatments out of reach of children.
  • The American Academy of Pediatrics has a helpful guide on the use and effectiveness of lice medicines.
  • The Lice Clinics of America also offers useful information about lice treatment and prevention.

Head lice prevention
If a child has head lice, everyone in the home should be checked, and any clothes, bedding and towels recently used should be washed in hot water and dried on high heat.

The main way that head lice spread is from close, prolonged head-to-head contact. Head lice are crawling insects and cannot jump, hop, or fly. There is a very small chance that head lice will spread by sharing items such as combs, brushes, hats and sports helmets.

While it will take time and work to eradicate a lice infestation, remember that lice require a human host to survive. They can’t live more than a day on other surfaces like furniture or carpets and they can’t live on pets. There’s no need to fumigate a home or use pesticides.

As for school, the American Academy of Pediatrics does NOT recommend that kids be excluded from school because of head lice.