Head Lice / Nits

Lice are small insects that lay their eggs and attach them to hair shafts in egg cases called nits. The nits look like bits of dandruff in the hair; however, they are firmly attached to hair shafts.

Lice can be passed from one person to another by direct contact or by clothing. The lice cause itching. If the skin is scratched open, sores can develop. The lice and sores must be treated by your child's doctor or nurse.

To destroy the lice and nits, you must follow these directions carefully.

  • Medicated shampoo or rinse -- this can be a prescription or an over-the-counter product
  • Fine-toothed comb
  • Soap
  • Towels 

There are several products available such as shampoos, rinses and combs. (Examples may include Rid®, Nix®, Ulesfia®, Ovide® or Elimite®.)

When using a medicated shampoo or rinse, carefully read all of the instructions before beginning. Different products will have different directions. These medications are strong and should be used carefully. They may not be effective if used incorrectly.

  1. After the shampoo or rinse, comb hair with fine-toothed comb to remove nits. Have your child sit in a chair with a towel over his / her shoulders. Comb each section of hair removing all the nits. Three hours after the shampoo or rinse, you can also use 1/2 strength vinegar on hair to loosen nits. Leave the solution on hair in a towel wrap for 30 minutes. After rinsing out the solution, comb each section of hair again.
  2. Look at the hair and scalp in 24 hours to be sure all lice and nits are gone. After one week, you can repeat the shampoo or rinse treatment if necessary, as directed. Do not give more than two shampoo or rinse treatments.
  3. Call your child's doctor for advice if more than two treatments are needed. 
  • Wash all hats and caps, all washable clothes, towels, washcloths, and bed linens. Dry clean all non-washable clothes that the child has used. Vacuum your child’s room.
  • Wash combs and brushes, barrettes and hair bands in soapy water after each shampoo. Use a little of the medicated shampoo or rinse in the water. This is very important.
  • Consider treating the whole family.  
  • Your child may return to school after treatment the next day.

Please report this condition to the nurse at the child's school, the day care director, or the baby sitter. A nurse can check other children for nits and make sure that they are treated, too.

If you have any questions, please call your child's doctor or your local Health Department.


Last Updated 06/2013