Understanding Head Lice
What Are Head Lice?
Life Cycle of Lice
The head‑lice (Pediculus humanus capitis) progresses through three distinct stages: egg, nymph, and adult. Eggs, commonly called nits, are firmly attached to hair shafts near the scalp and hatch in 7–10 days. Emerging nymphs resemble miniature adults but lack reproductive capacity; they undergo three molts over 9–12 days before reaching maturity. Adult lice live for approximately 30 days, during which each female deposits 5–8 eggs per day, sustaining the infestation if unchecked.
Understanding this timeline is essential for effective eradication. Treatments must target both live insects and newly hatched nymphs, which become vulnerable 24 hours after emergence. Re‑application of a pediculicide or mechanical removal method after 9 days eliminates the cohort that survived the initial round, preventing further egg laying.
Key points for timing interventions:
- Initial action removes most adults and nits.
- Second action 9 days later eliminates nymphs that escaped the first treatment.
- Third action 7 days after the second ensures any late‑hatching eggs are addressed.
Accurate knowledge of the lice life cycle informs the schedule of interventions, reducing the risk of recurrence.
Common Misconceptions
Misunderstandings often delay successful elimination of head‑lice infestations. Believing that a single over‑the‑counter shampoo will permanently eradicate the parasites, assuming that lice cannot survive on clean hair, or trusting that adult insects die without feeding are common errors.
- Lice are resistant to many standard shampoos; only products containing proven pediculicides or properly applied physical methods work.
- Lice eggs (nits) remain attached to hair shafts after the adult dies; failure to remove them results in re‑infestation.
- Adult lice can survive up to 48 hours without a blood meal; lack of immediate feeding does not guarantee death.
- Heat alone, such as a hair dryer, does not reach temperatures required to kill lice; consistent use of a calibrated comb at 130 °F (54 °C) is necessary.
- Natural oils (olive, coconut) are ineffective as sole treatments; they may loosen nits but do not kill live insects.
Correcting these myths speeds recovery and reduces the likelihood of recurrence. Proper chemical or mechanical treatment, combined with thorough nit removal, eliminates the problem reliably.
Identifying an Infestation
Symptoms of Head Lice
Head lice infestations manifest through observable signs on the scalp and hair. The presence of live insects, their eggs, and the body's reaction to their bites create a distinct pattern of discomfort and visual clues.
- Small, white or yellowish nits attached firmly to hair shafts, often within a quarter inch of the scalp.
- Live lice, approximately 2–3 mm in length, moving quickly across the hair or clinging to the scalp.
- Persistent itching caused by an allergic response to louse saliva.
- Red, irritated patches on the scalp, sometimes accompanied by small sores from scratching.
- A feeling of movement or a “crawling” sensation on the scalp, especially when the hair is brushed or combed.
Identifying these symptoms enables prompt intervention, reducing the risk of widespread transmission and facilitating effective eradication measures.
How to Check for Lice and Nits
The first step in eradicating head lice is a thorough examination of the scalp and hair. Detecting live insects and their eggs (nits) determines the need for treatment and guides its intensity.
- Separate hair into sections of about 2–3 cm.
- Use a magnifying lens or bright light to inspect each section closely.
- Run a fine‑tooth lice comb from the scalp outward, wiping the comb on a white tissue after each pass to reveal any captured organisms.
- Examine the combed hair for live lice—small, tan or grayish insects about the size of a sesame seed—and for nits, which appear as oval, yellow‑brown shells attached firmly to the hair shaft within ¼ inch of the scalp.
- Move the comb slowly, covering the entire length of the hair, and repeat the process on the opposite side of the head.
If an infestation is confirmed, repeat the combing procedure every 2–3 days for at least two weeks to catch newly hatched lice before they mature. Record the dates of each inspection to ensure continuity and to verify that the population has been eliminated.
Treatment Methods for Head Lice
Over-the-Counter (OTC) Treatments
Pyrethrin-Based Treatments
Pyrethrin-based products are derived from chrysanthemum flowers and act as neurotoxic agents against head‑lice. When applied to the scalp, the compounds bind to sodium channels in the insect’s nervous system, causing paralysis and death within minutes.
Effective use requires the following steps:
- Apply the lotion or shampoo according to the manufacturer’s dosage, ensuring thorough coverage of hair and scalp.
- Leave the preparation on for the specified contact time, typically 10 minutes, then rinse completely.
- Repeat the treatment after 7–10 days to eliminate newly hatched nymphs that survived the initial application.
- Combine with a fine‑toothed lice comb after each treatment to remove dead insects and eggs.
Safety considerations include:
- Avoid use on children under two months or on individuals with known pyrethrin allergy; a skin‑patch test is advisable.
- Do not apply to broken or irritated skin, as absorption may increase irritation.
- Store in a cool, dry place to preserve potency; expired products lose efficacy.
Resistance to pyrethrins has been documented in some lice populations. In areas with known resistance, alternate insecticides such as dimethicone or ivermectin may be required, or a combination therapy should be employed.
Proper adherence to the dosing schedule, thorough combing, and attention to contraindications maximize the likelihood of eradicating head‑lice infestations with pyrethrin-based treatments.
Permethrin-Based Treatments
Permethrin, a synthetic pyrethroid, is the most widely used active ingredient for treating head‑lice infestations. It acts on the nervous system of lice, causing rapid paralysis and death. Formulations typically contain 1 % permethrin in a lotion, shampoo, or cream rinse, approved for use on individuals of all ages, including infants older than two months.
Application begins with dry hair. The product is applied evenly, saturating the scalp and hair to a depth of at least 1 mm. After a prescribed contact time—generally ten minutes—the excess is rinsed off with warm water. A second treatment, identical to the first, is recommended seven days later to eradicate newly hatched nymphs that survived the initial exposure.
Key safety considerations include:
- Avoid contact with eyes; immediate irrigation is required if exposure occurs.
- Do not use on damaged or inflamed scalp without medical advice.
- For pregnant or nursing persons, confirm suitability with a healthcare professional.
Resistance to permethrin has been documented in some regions. Indicators of reduced efficacy are persistent live lice after two treatment cycles. In such cases, alternative agents—such as dimethicone or ivermectin—should be considered, and mechanical removal (fine‑tooth combing) may augment chemical treatment.
Post‑treatment steps that improve outcomes:
- Wash bedding, clothing, and personal items in hot water (≥ 130 °F) or seal them in plastic bags for two weeks.
- Vacuum carpets and upholstered furniture to remove shed eggs.
- Perform daily combing with a nit comb for one week to detect any remaining lice.
When used according to label instructions, permethrin-based products provide a rapid, effective solution for eliminating head lice, provided that resistance patterns are monitored and complementary hygiene measures are observed.
How to Apply OTC Treatments
Over‑the‑counter (OTC) lice products contain either a pediculicide (e.g., permethrin 1 % or pyrethrin with piperonyl‑butoxide) or a silicone‑based agent that suffocates insects. Correct application maximizes effectiveness and reduces the risk of re‑infestation.
- Read the label – verify the active ingredient, age restrictions, and any contraindications.
- Prepare the scalp – wash hair with regular shampoo, rinse thoroughly, and towel‑dry until damp but not soaking.
- Apply the lotion or cream – dispense the entire contents onto the scalp, starting at the nape and moving forward. Use a comb or your fingers to spread the product evenly over all hair strands, ensuring coverage from roots to tips.
- Cover the hair – place a plastic shower cap or wrap the head with a clean towel for the time specified (usually 10 minutes). Do not exceed the recommended duration.
- Rinse – remove the cap, wash hair with warm water, and follow with a mild conditioner if desired.
- Comb out nits – while hair is still damp, use a fine‑toothed nit comb. Start at the scalp, pull the comb through each section, and wipe the teeth with a tissue after each pass. Repeat every 2–3 days for one week.
- Repeat treatment – apply a second dose after 7–10 days, as instructed, to kill any newly hatched lice that survived the first application.
Additional precautions: avoid contact with eyes, do not use on broken skin, and keep treated individuals away from close head‑to‑head contact for at least 24 hours. Store the product in a cool, dry place and discard any unused portion after the expiration date.
Prescription Medications
Spinosad (Natroba)
Spinosad, marketed as Natroba, is a prescription topical agent specifically formulated for the treatment of head‑lice infestations. It belongs to the spinosyn class of insecticides and is applied directly to the hair and scalp.
The active ingredient disrupts the nervous system of lice by binding to nicotinic acetylcholine receptors, causing rapid paralysis and death. The compound does not rely on the same target sites as older neurotoxic pediculicides, reducing cross‑resistance with permethrin‑ or pyrethrin‑resistant strains.
Application protocol:
- Apply a measured dose (approximately 0.5 mL per 10 cm² of hair) to dry hair, ensuring full coverage from scalp to hair tips.
- Leave the product on the scalp for 10 minutes.
- Rinse thoroughly with water; no shampoo or conditioner is required before or after treatment.
- A second application is not needed for most patients, but a repeat dose after 7 days may be advised for heavy infestations.
Safety profile:
- Common adverse effects include mild scalp irritation, itching, or redness; these typically resolve without intervention.
- Systemic absorption is negligible; contraindications are limited to known hypersensitivity to spinosad or any formulation component.
- Use is approved for individuals aged 6 months and older; pediatric dosing follows the same concentration guidelines.
Efficacy data:
- Clinical trials report cure rates of 95 %–98 % after a single treatment, outperforming many traditional lice‑kill products.
- No significant resistance has been documented in the United States since market introduction, supporting its role as a reliable option when resistance to older agents is suspected.
Spinosad offers a rapid, single‑application solution for eliminating head lice, with a clear mechanism, minimal side effects, and high success rates across age groups.
Ivermectin Lotion (Sklice)
Ivermectin Lotion (Sklice) is a prescription‑only topical formulation specifically designed to eliminate head‑lice infestations. The active ingredient, ivermectin, binds to glutamate‑gated chloride channels in the parasite’s nervous system, causing paralysis and death of both lice and their eggs.
Application protocol:
- Apply a thin layer of lotion to dry hair, covering the scalp from the hairline to the nape.
- Massage gently for 30 seconds to ensure even distribution.
- Leave the product on for 10 minutes, then rinse thoroughly with warm water.
- Do not use a conditioner, hair spray, or other styling products before or after treatment.
- A single treatment is sufficient for most cases; a second application after 7 days addresses any newly hatched nymphs.
Clinical data indicate cure rates of 80–90 % after one application, outperforming many older pediculicides that require multiple doses. The product’s ovicidal activity eliminates eggs, reducing the need for supplemental nit combing, although manual removal of visible nits can improve cosmetic results.
Safety profile:
- Contraindicated in children under 6 months, in individuals weighing less than 15 kg, and in pregnant or breastfeeding women.
- Common adverse effects include mild scalp irritation, itching, or redness; severe reactions are rare.
- No systemic absorption has been observed at therapeutic concentrations, minimizing risk of systemic toxicity.
Practical tips:
- Verify that the scalp is clean and free of other topical medications before use.
- Store the lotion at room temperature, away from direct sunlight.
- Inform close contacts to avoid re‑infestation; simultaneous treatment of household members is recommended.
- In regions with documented ivermectin resistance, consider alternative agents or combination therapy.
Malathion Lotion (Ovide)
Malathion Lotion (Ovide) is a prescription‑strength pediculicide formulated for the treatment of head‑lice infestations. The active ingredient, malathion, is an organophosphate insecticide that disrupts the nervous system of lice, leading to rapid mortality.
The product is supplied as a 0.5 % lotion. Application guidelines are as follows:
- Dispense the lotion onto a dry, clean comb or directly onto the scalp, ensuring complete coverage of the hair and skin from the crown to the neck.
- Massage gently for 10 minutes to distribute the solution evenly.
- Leave the lotion on for at least 8 hours; overnight exposure is common practice.
- Rinse thoroughly with warm water and shampoo as usual.
- Repeat the treatment after 7–10 days to eradicate newly hatched nymphs that survived the initial dose.
Safety considerations include:
- Contraindicated in individuals with known hypersensitivity to malathion or any component of the formulation.
- Not recommended for children under 6 months, pregnant women, or nursing mothers without medical supervision.
- Avoid contact with eyes, mucous membranes, and broken skin; rinse immediately if exposure occurs.
- Use protective gloves during application to prevent dermal absorption.
Efficacy data indicate a cure rate exceeding 90 % when the regimen is followed precisely. Resistance to malathion remains low compared to pyrethroid agents, making it a reliable option when other treatments have failed. Proper combing after the first application enhances removal of dead insects and reduces the likelihood of reinfestation.
Patients should inspect the scalp daily for residual live lice or viable eggs and maintain a clean environment by washing bedding, hats, and hair accessories at 60 °C or sealing them in plastic bags for two weeks. Persistent infestation after two treatment cycles warrants medical re‑evaluation.
Non-Chemical Treatments
Wet Combing Method
Wet combing eliminates head‑lice infestations by mechanically removing live insects and eggs from damp hair. The technique requires no chemicals, making it suitable for individuals sensitive to pesticides or for use in environments where topical treatments are restricted.
The procedure follows a precise sequence:
- Prepare a fine‑toothed nit comb and a spray bottle filled with lukewarm water mixed with a small amount of conditioner (approximately one tablespoon per quart of water).
- Saturate the hair thoroughly; the conditioner reduces friction and helps the comb glide smoothly.
- Starting at the scalp, pull the comb through a small section of hair, moving slowly toward the ends. After each pass, wipe the comb on a white tissue to reveal any captured lice or nits.
- Repeat the combing motion on the same section three times before moving to the next area, ensuring complete coverage of the entire scalp and hair length.
- After processing all sections, rinse the hair with plain water and towel‑dry gently.
Effective wet combing demands consistency. Perform the routine daily for at least seven days, extending to ten days if new nits appear. Separate personal items—comb, towels, pillowcases—after each session and wash them in hot water (≥130 °F) to prevent reinfestation. Regular inspection of the scalp, preferably under bright light, confirms the method’s success and identifies any residual insects promptly.
Essential Oils and Home Remedies («Effectiveness and Safety»)
Essential oils and home-based treatments are frequently employed to eradicate head‑lice infestations. Their appeal lies in accessibility, low cost, and the perception of a natural alternative to chemical pediculicides.
Effectiveness varies among oils. Studies report the following results:
- Tea tree (Melaleuca alternifolia) oil: demonstrated 70‑90 % mortality of lice and nits in laboratory assays; limited clinical trials confirm reduction of live insects after a single 30‑minute application.
- Lavender (Lavandula angustifolia) oil: exhibited moderate toxicity to lice; synergistic effect observed when combined with tea tree oil.
- Peppermint (Mentha piperita) oil: caused rapid immobilization of lice; efficacy enhanced by a carrier oil to improve scalp penetration.
- Neem (Azadirachta indica) oil: reduced egg hatchability by up to 60 % in controlled experiments; requires prolonged exposure (minimum 60 minutes).
- Eucalyptus (Eucalyptus globulus) oil: produced significant lice mortality after 45 minutes; limited data on nit viability.
- Rosemary (Rosmarinus officinalis) oil: weak insecticidal activity; useful primarily for soothing scalp irritation.
Safety considerations are essential to prevent adverse reactions:
- Skin sensitivity: pure essential oils may cause erythema or contact dermatitis; dilution to 1‑2 % in a carrier oil (e.g., coconut or olive oil) is recommended.
- Age restrictions: infants under six months should not receive topical essential oils; children older than two years may tolerate diluted preparations.
- Allergic history: individuals with known sensitivities to a specific plant should avoid the corresponding oil.
- Application duration: prolonged exposure (>2 hours) increases risk of irritation without proportionate gains in efficacy.
- Patch test: apply a small amount of diluted oil to the inner forearm for 15 minutes; discontinue if redness or itching develops.
A practical protocol combines effectiveness and safety:
- Mix 10 drops of tea tree oil and 5 drops of lavender oil with 2 tablespoons of a carrier oil.
- Apply the blend to dry hair, ensuring thorough coverage of the scalp and hair shafts.
- Leave the mixture on for 30 minutes, then comb with a fine‑toothed nit comb to remove dead lice and eggs.
- Rinse hair with warm water; repeat the process every 48 hours for three applications.
- Wash bedding, clothing, and personal items in hot water (≥60 °C) or seal them in airtight bags for two weeks to eliminate residual nits.
When used as directed, essential oils provide a viable adjunct to conventional lice treatments, offering measurable insecticidal activity while maintaining a low risk profile for most users.
Heat Treatment Devices
Heat treatment devices eliminate head‑lice infestations by raising the temperature of the scalp and hair to levels lethal for nits and adult insects while preserving human tissue. The principle relies on sustained exposure to heat above 45 °C for a defined period, typically 10–15 minutes, which disrupts the metabolic processes of lice.
Common devices include:
- Portable hot air blowers – handheld units that direct a calibrated stream of warm air across the scalp. Adjustable temperature controls prevent overheating.
- Infrared lamps – emit radiant energy that penetrates hair shafts, raising internal temperatures without direct contact.
- Steam applicators – generate moist heat that combines conductive and convective mechanisms, increasing lethality against eggs.
Effective use follows a strict protocol:
- Verify device calibration with a digital thermometer before each session.
- Dry the hair completely; moisture reduces heat transfer efficiency.
- Section hair into manageable sections (2–3 cm) to ensure uniform exposure.
- Apply heat to each section, maintaining the target temperature for the required duration.
- Allow the scalp to cool naturally; avoid immediate cold water exposure to prevent thermal shock.
- Inspect the treated area for remaining live insects; repeat treatment if necessary.
Safety considerations:
- Use protective eyewear to shield eyes from infrared radiation.
- Do not exceed recommended temperature thresholds; prolonged exposure above 50 °C can cause scalp burns.
- Conduct a patch test on a small scalp area for individuals with sensitive skin or dermatological conditions.
- Keep the device away from children’s hands and eyes during operation.
Efficacy data indicate that properly administered heat treatment eliminates up to 95 % of live lice and up to 80 % of viable nits after a single session. Combining heat therapy with a thorough combing routine maximizes removal of residual eggs.
In summary, heat treatment devices provide a chemical‑free method for eradicating head lice when applied with calibrated temperature control, systematic coverage, and adherence to safety guidelines.
Post-Treatment Care and Prevention
Cleaning Your Home and Belongings
Washing Bedding and Clothing
Effective eradication of head lice requires thorough decontamination of all textiles that may harbor eggs or nymphs. Bedding, clothing, and personal items must be laundered using temperatures and procedures that guarantee mortality of all life stages.
- Separate all sheets, pillowcases, blankets, and towels that have contacted the infested individual.
- Wash items in hot water at a minimum of 130 °F (54 °C). If fabric care labels prohibit such temperatures, soak in warm water (≥ 95 °F) for at least 30 minutes before laundering.
- Use a high‑efficiency detergent; add a lice‑killing additive such as a tea‑tree oil solution or a commercially approved lice‑control product, following manufacturer instructions.
- Dry on high heat for a minimum of 20 minutes. Heat exposure at ≥ 130 °F for this duration eliminates viable eggs and nymphs.
- For items that cannot be machine‑washed, seal in a plastic bag for two weeks, the period required for lice to die without a host.
Clothing worn by the affected person should receive identical treatment. Undergarments, socks, and outerwear must be laundered in hot water and dried on high heat, or placed in a sealed container for the same two‑week interval if washing is impractical.
After laundering, inspect the washing machine drum and dryer lint trap for stray insects. Clean both with a disinfectant wipe or a solution of diluted bleach (1 % sodium hypochlorite) before subsequent use. This systematic approach prevents reinfestation from residual eggs hidden in fabrics.
Cleaning Combs and Brushes
Effective lice control requires thorough decontamination of combs and brushes after each treatment session. Residual nits cling to the teeth and bristles, allowing reinfestation if not removed.
- Disassemble detachable parts, if possible. Separate comb teeth from the handle to expose all surfaces.
- Submerge the components in hot water (minimum 130 °F / 54 °C) for at least 10 minutes. The temperature kills lice and eggs that may be hidden in crevices.
- Add a tablespoon of liquid laundry detergent or a few drops of antiseptic soap to the water. The surfactant loosens organic matter and enhances microbial elimination.
- Scrub each tooth and bristle with a nail brush or an old toothbrush. Apply firm pressure to dislodge nits attached to the metal or plastic.
- Rinse under running water until no suds remain. Verify that no debris is visible on the comb teeth.
- Dry completely on a clean towel or paper towel. Place the items in a sealed container for 24 hours to ensure any surviving organisms are exposed to air desiccation.
- Store the cleaned tools in a zip‑lock bag or dedicated plastic case, away from other personal items.
If the comb or brush cannot be disassembled, repeat the soaking step with a higher water volume, ensuring all surfaces are fully immersed. For plastic tools, a brief dip in a 1 % bleach solution (one part bleach to 99 parts water) for 5 minutes provides additional assurance; rinse thoroughly afterward to prevent corrosion.
Regular cleaning after each use eliminates the primary reservoir of lice eggs, significantly reducing the risk of recurrence. Maintaining this routine, combined with other treatment measures, yields a reliable, long‑term solution.
Vacuuming and Bagging Items
Vacuuming and bagging are critical components of a comprehensive lice‑removal program because they eliminate eggs and insects that survive on personal items and household surfaces.
Use a high‑efficiency vacuum equipped with a sealed hose and a disposable bag. Run the vacuum slowly over carpets, rugs, upholstered furniture, and mattress seams, paying special attention to areas where the head has rested. After each session, remove the vacuum bag, seal it in a plastic zip‑lock bag, and discard it in an outdoor trash container to prevent re‑infestation.
Collect all washable textiles—clothing, pillowcases, sheets, scarves, hats, and socks—and place each item in a separate, airtight plastic bag. Seal the bags and store them for a minimum of 48 hours; the lack of oxygen kills both lice and nits. For non‑washable items, consider sealing them in the same manner or exposing them to a temperature of at least 130 °F (54 °C) for 30 minutes.
Procedure checklist
- Vacuum all floor coverings, upholstery, and bedding surfaces.
- Dispose of the vacuum bag in a sealed container immediately after use.
- Separate washable fabrics and seal each in an airtight bag.
- Store sealed bags for at least two days before laundering or discarding.
- Apply heat treatment to non‑washable objects when feasible.
Following these steps removes residual lice and eggs from the environment, supporting the overall eradication effort.
Preventing Reinfestation
Educating Children and Adults
Educating both children and adults about lice elimination requires clear, factual information and practical guidance. Young learners need age‑appropriate explanations that describe what lice are, how they spread, and why prompt treatment matters. Adults require detailed instructions on identifying infestations, selecting effective products, and preventing re‑infestation.
For children, use simple language, visual aids, and interactive demonstrations. Show a magnified image of a louse, explain the life cycle in a few sentences, and practice combing a doll’s hair with a fine‑toothed nit comb. Reinforce the message with short reminders posted in bathrooms and classrooms.
Adults benefit from comprehensive briefings that cover:
- Inspection techniques: divide hair into sections, use a bright light, and examine the scalp close to the ears and neckline.
- Treatment options: over‑the‑counter shampoos containing 1 % permethrin, prescription lotions with 0.5 % malathion, or wet‑combing with a nit comb after applying a conditioner.
- Application protocol: apply product according to label, leave for the recommended time, rinse, and repeat after seven days to kill newly hatched nymphs.
- Environmental control: wash bedding, clothing, and hats in hot water (≥130 °F) and dry on high heat; seal non‑washable items in plastic bags for two weeks.
Effective education combines factual content with hands‑on practice, regular reminders, and clear, step‑by‑step instructions. Consistent messaging across schools, healthcare providers, and community centers ensures that both children and adults can identify infestations early and apply proven removal methods safely.
Regular Head Checks
Regular head inspections are essential for early detection of lice infestations and for preventing their spread. Inspecting the scalp promptly after exposure to potential sources reduces the likelihood of a full-blown outbreak and minimizes the need for extensive treatment.
Effective inspection follows a consistent routine:
- Choose a well‑lit, preferably natural light source.
- Part the hair in sections of 1–2 cm, using a fine‑toothed comb or a lice detection comb.
- Examine the comb teeth after each pass for live insects, viable eggs (nits), or translucent shells attached to hair shafts within 1 cm of the scalp.
- Record any findings and repeat the process on the opposite side of the head.
- Conduct the inspection at least twice a week during high‑risk periods (e.g., school terms, summer camps) and after any confirmed case in close contacts.
Documentation of results, including dates and locations of any detected lice or nits, supports timely intervention and informs subsequent treatment decisions. Consistent monitoring enables rapid response, limiting the infestation’s duration and severity.
Avoiding Sharing Personal Items
Sharing personal items creates a direct pathway for head‑lice eggs and nymphs to move from one host to another. Contact with contaminated combs, brushes, hats, scarves, headphones, pillowcases, or hair accessories transfers live lice and viable eggs, undermining treatment efforts and increasing reinfestation risk.
To minimize this risk, keep the following items for personal use only:
- Combs and brushes
- Hair ties, clips, and bands
- Hats, caps, scarves, and headbands
- Earphones, headphones, and earbuds
- Pillowcases, blankets, and towels used during sleep
- Cushions, helmets, and sports equipment that contact hair
When items must be shared—such as in group activities—clean them with hot water (minimum 130 °F / 54 °C) or apply a lice‑specific disinfectant before and after use. Store personal accessories in sealed containers to prevent accidental contact.
Adopt a routine that includes regular inspection of hair, especially after close contact with others, and immediate laundering of any shared textiles at high temperature. These measures reduce the probability of lice transmission and support effective eradication of an existing infestation.