What should you do if a child has lice?

Understanding Head Lice

What are Head Lice?

Head lice (Pediculus humanus capitis) are tiny, wing‑less insects that live on the scalp and feed on human blood. Adults measure about 2–4 mm, are tan to gray, and have six legs with clawed ends that cling to hair shafts.

The life cycle consists of three stages: egg (nits), nymph, and adult. Eggs are glued to the base of hair strands and hatch in 7–10 days. Nymphs resemble smaller adults and require an additional 9–12 days of feeding to mature. An adult female can lay 6–10 eggs per day, producing up to 100 eggs over her lifespan of approximately 30 days.

Transmission occurs through direct head‑to‑head contact, which is the most efficient route. Indirect spread via hats, brushes, or bedding is possible but less common because lice cannot survive more than 48 hours away from a host.

Key characteristics for identification:

Small, oval, gray‑brown insects moving quickly on the scalp.
Nits attached firmly to the hair shaft, often within ¼ inch of the scalp and difficult to remove without a fine‑toothed comb.
Itching caused by allergic reactions to saliva injected during feeding.

Head lice do not transmit disease and are not a sign of poor hygiene. Their presence indicates close personal contact, which is typical among school‑age children. Understanding the biology and transmission of head lice provides the foundation for effective control measures.

How to Identify Head Lice

Symptoms of Infestation

A child with a lice infestation typically shows several observable signs. The most reliable indicator is the presence of live insects or eggs (nits) attached to hair shafts, especially near the scalp. Nits appear as tiny, oval, yellow‑white or brown specks that do not easily brush away.

Additional symptoms include:

Intense itching, caused by an allergic reaction to lice saliva.
Red, irritated spots on the scalp or neck from scratching.
Small, raised bumps that may resemble pimples.
A feeling of movement or crawling sensations in the hair.
Wet‑looking, discolored patches of hair where lice congregate.

In severe cases, secondary bacterial infection can develop at sites of excessive scratching, leading to pus‑filled lesions or swelling. Prompt identification of these signs enables immediate treatment and prevents further spread.

Visual Inspection Techniques

A thorough visual examination is the first practical step when a child is suspected of having head‑lice. The goal is to locate live insects or viable eggs before any treatment is applied.

Separate the child’s hair from the scalp, using a fine‑toothed lice comb or a bright, magnifying hand lens.
Begin at the hairline, moving the comb slowly toward the occipital region; each pass should be examined for nits firmly attached to the shaft within ¼ inch of the scalp.
Inspect behind the ears, under the chin, and at the neck folds, where lice often hide.
Look for adult lice: grayish‑brown bodies about the size of a sesame seed, moving quickly when disturbed.
Use a well‑lit area or a portable lamp; natural daylight reduces shadows that can conceal insects.
After each pass, wipe the comb on a white tissue to improve visibility of any captured specimens.
Document findings with a quick note or photograph to track the infestation’s progress and to inform caregivers or health professionals.

Consistent application of these techniques enables accurate detection, limits unnecessary chemical use, and supports prompt, effective management of the infestation.

Initial Steps Upon Discovery

Don’t Panic: A Calm Approach

Finding lice on a child can cause alarm, but a steady response prevents escalation.

First, verify the infestation by examining the scalp for live insects and attached eggs. Notify the child’s school or childcare provider promptly so they can take appropriate precautions. Keep personal items such as hats, brushes, and hair accessories separate from those of other children.

Treatment protocol

Apply a medicated lice shampoo according to the product label; leave it on for the recommended duration.
Rinse thoroughly, then use a fine-toothed nit comb to remove nits from each hair strand.
Repeat the entire process after seven to ten days to eliminate any newly hatched lice.

Environmental control

Wash all bedding, clothing, and towels used within the past 48 hours in hot water (minimum 130 °F) and dry on high heat.
Place items that cannot be laundered in a sealed plastic bag for two weeks.
Vacuum carpets, upholstered furniture, and car seats; discard the vacuum bag or clean the canister afterward.

Follow‑up

Inspect the child’s hair daily for two weeks; continue combing to catch any missed nits.
Communicate progress to the school or daycare to coordinate any necessary re‑examinations.

A calm, systematic approach limits spread, reduces discomfort, and restores normal routine quickly.

Notifying Relevant Parties

School and Daycare Policies

When a child is identified with head lice, schools and day‑care centers rely on written policies to protect all participants and to manage the situation consistently. These policies establish the responsibilities of parents, staff, and administrators, and they define the criteria for temporary exclusion and readmission.

Common elements of lice policies include:

Immediate notification to the facility’s health coordinator or designated staff member.
Requirement that the child receive appropriate treatment before returning, typically a medicated shampoo or lotion applied according to label instructions.
A minimum exclusion period, often 24 hours after the first application of treatment, to reduce the risk of transmission.
Documentation of treatment dates and products used, kept on file for verification.
Guidelines for notifying other families, usually through a confidential notice that alerts them to the presence of lice without revealing personal information.
Recommendations for routine screening, such as visual checks during enrollment or periodic health assessments.

Parents should follow the facility’s protocol by informing staff promptly, obtaining a prescription or over‑the‑counter remedy, completing the full treatment course, and submitting proof of treatment as required. After treatment, they must adhere to any prescribed waiting period before the child re‑enters the program.

Administrators must maintain up‑to‑date policy documents, train staff on identification and response procedures, and ensure consistent enforcement. Records of incidents should be retained for a defined period to monitor trends and evaluate the effectiveness of preventive measures.

Close Contacts

When a child is diagnosed with head‑lice infestation, every person who has had direct head‑to‑head contact with the child must be considered a close contact. Close contacts typically include siblings, classmates, teammates, and anyone who shared hats, helmets, hairbrushes, or sleeping arrangements with the affected child.

Identify all close contacts promptly. Ask the child and caregivers to list recent activities involving head contact. Verify the list with teachers or coaches if necessary.

Treat each identified close contact even if no lice are visible, because nits can be present without adult insects. Recommended actions:

Perform a thorough combing with a fine‑toothed lice comb on dry hair; remove any live lice or nits.
Apply an FDA‑approved pediculicide according to the product label; repeat the treatment after 7‑10 days to eliminate newly hatched lice.
Wash all clothing, bedding, and personal items used within the previous 48 hours in hot water (≥130 °F) and dry on high heat; items that cannot be laundered should be sealed in a plastic bag for two weeks.
Instruct close contacts to avoid head‑to‑head contact and sharing personal items until the treatment course is completed.

Monitor close contacts for at least two weeks. If live lice appear, repeat the treatment protocol. Documentation of treated individuals helps schools and childcare facilities track the outbreak and prevents further spread.

Treatment Options

Over-the-Counter Treatments

Pyrethrin-Based Products

Pyrethrin‑based lotions, shampoos, and sprays are among the first‑line chemical agents used to eliminate head‑lice infestations in children. The active compounds are natural extracts derived from chrysanthemum flowers; they act on the nervous system of lice, causing rapid paralysis and death.

Effectiveness depends on correct application. Follow these steps:

Apply the product to dry hair, saturating the scalp and all strands.
Leave the preparation on for the time specified on the label, typically 10 minutes.
Rinse thoroughly with warm water.
Comb the hair with a fine‑toothed nit comb to remove dead insects and eggs.
Repeat the treatment after 7–10 days to eradicate newly hatched nymphs.

Safety considerations include:

Avoid use on children under two years of age unless a pediatrician approves.
Do not apply to irritated, broken, or inflamed skin.
Discontinue use if the child experiences severe itching, rash, or respiratory symptoms; seek medical advice promptly.

Resistance to pyrethrins has been documented in some regions. If live lice persist after two treatment cycles, switch to a prescription‑only pediculicide or consult a healthcare professional for alternative therapy. Regular inspection of hair and household items, combined with the above protocol, reduces the likelihood of re‑infestation.

Permethrin-Based Products

Permethrin is a synthetic pyrethroid approved for over‑the‑counter treatment of head‑lice infestations. The 1 % lotion or cream rinse is the standard concentration for children. It disrupts the nervous system of lice, causing rapid paralysis and death while remaining safe for human skin when used as directed.

Application steps:

Wash the child’s hair with regular shampoo; rinse thoroughly and towel‑dry.
Apply the permethrin product to damp hair, ensuring coverage from scalp to tips.
Leave the treatment on for the time specified on the label, typically 10 minutes.
Rinse hair with warm water; do not use conditioner or hair spray afterward.
Comb the hair with a fine‑toothed nit comb to remove dead lice and eggs.
Discard the comb after each use to prevent re‑contamination.

A second treatment is required 7–10 days after the first to eliminate newly hatched nymphs that survived the initial application. Repeat the same procedure; no additional products are needed if the second round is successful.

Safety considerations:

Do not apply to children under two months of age; consult a pediatrician for younger infants.
Avoid contact with eyes, mouth, or open wounds; rinse immediately if exposure occurs.
Store the product away from heat and direct sunlight to preserve potency.

If live lice are detected after the second treatment, consider resistance testing or an alternative prescription medication, such as a malathion or ivermectin formulation, under medical supervision. Regularly inspect the child’s hair and household linens for at least three weeks to confirm eradication.

Application Instructions

The following instructions detail the correct application of a lice‑removal product for a child.

Gather necessary items: the recommended medication, a fine‑tooth nit comb, disposable gloves, a towel, and a timer. Ensure the child’s hair is dry and free of styling products.
Verify the product label: confirm the child’s age meets the minimum requirement, note the prescribed dosage, and read any safety warnings.
Apply the medication: wearing gloves, dispense the exact amount indicated onto the scalp, covering the entire head from hairline to nape. Massage gently to distribute evenly.
Observe the required exposure period: set the timer for the duration specified on the label (typically 10 minutes). Do not exceed the time limit.
Rinse thoroughly: after the interval, rinse the hair with lukewarm water, removing all residue. Avoid using hot water, which may irritate the scalp.
Comb out nits: while the hair remains damp, run the nit comb through each section from root to tip. Wipe the comb after each pass to prevent re‑transfer.
Repeat the treatment: schedule a second application 7–10 days after the first, as instructed, to eliminate any newly hatched lice.
Decontaminate the environment: wash the child’s bedding, clothing, and towels in hot water (≥ 130 °F) or place them in a sealed bag for two weeks. Vacuum furniture and carpets; discard hair accessories that cannot be cleaned.

Follow these steps precisely to achieve effective eradication and minimize the risk of reinfestation.

Prescription Medications

When to Consult a Doctor

If over‑the‑counter remedies do not eliminate the parasites after two full treatment cycles, professional medical evaluation is required. Persistent nits on the scalp, especially after careful combing, indicate that the infestation is resistant and may need prescription‑strength medication.

Allergic or adverse reactions to topical agents—such as redness, swelling, blistering, or intense itching—warrant immediate consultation. These symptoms can signal skin irritation or an infection that could worsen without proper care.

Signs of secondary bacterial infection, including crusted lesions, pus, foul odor, or fever, also demand prompt medical attention. An infection can develop when scratching damages the skin, and antibiotics may be necessary.

Infants younger than six months should be examined by a pediatrician before any treatment is applied. Their delicate skin and developing immune system require guidance on safe, effective options.

When a child has a chronic or recurrent lice problem, a clinician can assess underlying factors, such as household crowding, shared items, or resistance to common treatments, and recommend comprehensive control strategies.

Key situations for seeking professional help:

No improvement after two complete treatment rounds
Severe skin reaction to lice products
Evidence of bacterial infection
Child under six months of age
Repeated infestations despite proper hygiene measures

In each case, a healthcare provider can prescribe appropriate medication, advise on safe application, and monitor for complications, ensuring a swift resolution and preventing spread.

Common Prescription Options

When a child is diagnosed with head‑lice infestation, clinicians often prescribe medicated treatments that are more potent than over‑the‑counter options. The following agents are routinely recommended:

Permethrin 1 % cream rinse – applied to dry hair, left for 10 minutes, then rinsed; usually requires a second application one week later.
Pyrethrin‑based shampoo – combined with piperonyl‑butoxide to enhance efficacy; similar dosing schedule to permethrin.
Malathion 0.5 % lotion – oil‑based formulation; left on hair for 8–12 hours before washing; effective against resistant lice strains.
Benzyl alcohol 5 % lotion – applied for 10 minutes, then rinsed; does not contain neurotoxic insecticides, suitable for children over six months.
Ivermectin 0.5 % lotion – single application, no repeat dose needed; oral ivermectin (200 µg/kg) may be used when topical agents fail.
Spinosad 0.9 % lotion – applied for 10 minutes, then washed off; effective after one treatment, approved for children six months and older.

Prescriptions are selected based on the child’s age, allergy history, and local resistance patterns. Follow‑up evaluation after the treatment course confirms eradication and guides any necessary retreatment.

Non-Chemical Methods

Wet Combing Technique

When a child is found with head lice, the wet‑combing method offers a chemical‑free solution that removes live insects and eggs. The approach relies on thorough saturation of the scalp, systematic combing, and careful disposal of debris.

Prepare a fine‑toothed lice comb and a bowl of warm water mixed with a small amount of conditioner. The conditioner loosens the glue that holds nits to hair shafts.
Dampen the hair completely; the strands should be slick but not dripping. This prevents breakage and allows the comb to glide.
Starting at the scalp, pull the comb through each section of hair in a slow, steady motion. After each pass, wipe the comb on a paper towel and rinse it in the water bowl.
Repeat the process for the entire head, working from the crown to the nape. Perform at least three passes per section to ensure that both lice and nits are captured.
After combing, rinse the hair with plain water and dry gently with a towel. Dispose of the collected material in a sealed bag and wash the comb in hot, soapy water.

The procedure should be repeated every two to three days for ten days, covering the entire life cycle of the parasite. Concurrently, wash bedding, hats, and personal items in hot water or place them in a sealed bag for two weeks to eliminate any surviving eggs. Regular monitoring of the scalp for several weeks confirms the effectiveness of the treatment.

Suffocation Methods «e.g., Mayonnaise, Petroleum Jelly»

When a child is infested with head lice, some caregivers consider suffocation agents such as mayonnaise or petroleum jelly. These substances aim to block the insects’ respiratory spiracles, forcing them to die.

Application of a suffocation product requires thorough coverage of the scalp and hair. The process typically includes:

Washing the hair with a gentle shampoo to remove surface debris.
Applying a generous layer of the chosen agent, ensuring every strand and the scalp are coated.
Covering the head with a plastic cap or shower cap to maintain moisture and limit airflow.
Leaving the treatment in place for 8–12 hours, often overnight.
Removing the cap, washing the hair thoroughly with warm water and shampoo, and combing with a fine-toothed lice comb to extract dead lice and nits.

Effectiveness varies. Petroleum jelly creates a thicker barrier than mayonnaise, reducing the likelihood of the product washing out prematurely. Mayonnaise may be easier to apply but can harden, making removal more difficult and increasing the risk of residue buildup on the scalp.

Safety considerations include:

Avoiding use on children with known allergies to the product.
Monitoring for skin irritation; discontinue if redness or itching develops.
Ensuring the child does not ingest the substance, especially with mayonnaise, to prevent gastrointestinal upset.

Suffocation methods are not universally recommended by medical professionals because they do not address nits that are already attached to hair shafts. Combining a suffocation agent with a proven pediculicide and meticulous nit removal provides the most reliable outcome.

Home Remedies «Cautions and Efficacy»

Home‑based treatments can reduce lice numbers but require careful handling to avoid skin irritation, resistance, or reinfestation.

Olive oil or coconut oil: suffocates insects when applied thickly and left for several hours. Effectiveness varies; eggs may survive. Risk of greasy hair and possible allergic reaction; wash thoroughly afterward.
Vinegar (white or apple cider): loosens nits from hair shafts, facilitating removal with a fine‑tooth comb. Does not kill lice directly. May cause scalp dryness; rinse with water and condition hair.
Tea tree oil (diluted 1–2 % in carrier oil): possesses insecticidal properties reported in limited studies. Over‑application can provoke dermatitis; perform patch test before full use.
Mayonnaise: creates an occlusive layer that immobilizes lice for several hours. Limited evidence of success; heavy residue requires extensive shampooing. Potential for bacterial growth if left too long.
Heat (hair dryer on low, warm towels): kills lice and nits exposed to temperatures above 45 °C for several minutes. Risk of scalp burns; maintain safe distance and monitor temperature.
Regular combing with a nit comb: essential adjunct to any remedy. Removes live lice and eggs mechanically. Requires multiple passes and repetition over two weeks.

Cautions common to all approaches: avoid products containing harsh chemicals on broken skin; discontinue use if redness, itching, or swelling intensifies; keep treated child away from shared bedding, hats, and brushes until the infestation is cleared. Efficacy of home methods alone is generally lower than that of approved pediculicides; combine with thorough cleaning of personal items and environment for optimal results.

Preventing Reinfestation

Cleaning and Disinfecting Your Home

Washing Bedding and Clothing

When a child is found to have lice, laundering personal items removes eggs and adult insects that may survive on fabrics. Effective washing eliminates the primary source of re‑infestation and protects other household members.

Use water at least 130 °F (54 °C) for sheets, pillowcases, blankets, towels, and clothing worn during the infestation period.
Add a normal detergent; bleach is unnecessary unless the fabric label permits it.
Run a full wash cycle, then dry on high heat for a minimum of 30 minutes. Heat above 120 °F (49 °C) kills both lice and nits.

Items that cannot be machine‑washed require alternative treatment:

Seal in a plastic bag for two weeks, the typical lifespan of a louse without a host.
Apply a dry‑heat method (e.g., a hot dryer on a non‑fabric setting) if the material tolerates it.
For delicate fabrics, consider professional cleaning with a temperature‑controlled process.

All bedding and clothing used by the child during the previous 48 hours should be processed immediately. Repeat washing after one week to capture any newly hatched nits that survived the first cycle. Store cleaned items in a clean, dry environment to prevent re‑contamination.

Cleaning Combs and Brushes

After a lice incident, any combs, brushes, or hair accessories used by the child must be decontaminated before reuse. Residual eggs (nits) can survive on these items and re‑infest the scalp if not eliminated.

First, separate all grooming tools from other household objects. Remove hair and debris by rinsing each item under running water. This step reduces the load of organic material that can shield eggs from treatment.

Submerge the combs and brushes in a solution of hot water (minimum 130 °F/54 °C) and a mild detergent for at least 10 minutes.
For plastic or metal tools, add a tablespoon of white vinegar or a few drops of essential oil with proven pediculicidal properties; let the mixture sit for an additional 5 minutes.
Scrub each tooth or bristle with a stiff brush or an old toothbrush to dislodge any remaining nits.
Rinse thoroughly in hot water, then place the items in a sealed bag or container and expose them to a dryer on high heat for 20 minutes, or store them in a freezer at –4 °F (–20 °C) for 24 hours if heat is unavailable.

Finally, inspect the cleaned tools visually; any sign of residual debris warrants repeat treatment. Store decontaminated combs and brushes in a clean, sealed container until the child’s scalp is confirmed lice‑free. Regularly sanitizing these items after each use prevents future outbreaks.

Vacuuming Furniture and Floors

Vacuuming furniture and floors removes detached nits and live lice that have fallen from a child’s hair, reducing the chance of re‑infestation. Use a vacuum equipped with a HEPA filter to trap eggs and insects that might otherwise be released back into the air.

Attach a brush head for upholstered surfaces; run it slowly over sofas, armchairs, and cushions.
Employ a narrow nozzle for cracks in baseboards, under beds, and around carpet edges.
Vacuum carpets and rugs thoroughly, overlapping each pass to capture hidden nits.
After each session, empty the canister or bag into a sealed plastic bag and discard it outside the home.

Repeat the process daily for at least one week, because newly hatched lice become mobile after 7–10 days. Maintaining a clean environment complements treatment of the child’s hair and helps break the life cycle of the infestation.

Educating Your Child

Avoiding Head-to-Head Contact

When a child is found to have lice, the most immediate preventive measure is to stop any direct head‑to‑head contact, as this is the primary route for transmission. Reducing such contact limits the opportunity for nits and adult lice to move to another host.

Practical steps to eliminate head‑to‑head contact:

Keep hair tied back or secured with a bandana during play, sports, or group activities.
Supervise classroom or daycare interactions; intervene if children attempt to rest their heads together.
Encourage the use of individual hats, helmets, or scarves that do not touch other children’s hair.
Arrange seating so that children facing each other do not tilt their heads toward one another.

Additional precautions reinforce the primary action:

Wash clothing, bedding, and personal items in hot water (minimum 130 °F) and dry on high heat.
Vacuum upholstered furniture and car seats to remove stray nits.
Treat the affected child with an approved pediculicide, following the product’s instructions precisely.

Consistent enforcement of these measures curtails the spread of lice and supports a rapid resolution of the infestation.

Not Sharing Personal Items

Avoiding the exchange of personal items is a primary measure to stop head‑lice transmission. Lice move only through direct contact with hair or objects that have recently touched the scalp; keeping belongings separate removes a common pathway for infestation.

Hats, caps, and beanies
Hairbrushes, combs, and styling tools
Helmets and sports headgear
Pillowcases and blankets used during sleepovers
Towels, especially those used after washing hair

Maintain a strict policy: each child must use their own items, stored in individual, labeled containers. Parents should inspect and clean personal accessories regularly, washing fabrics in hot water (minimum 130 °F) and drying on high heat. For plastic or metal tools, soak in a disinfectant solution for at least ten minutes, then rinse and dry. Schools and childcare centers should enforce the no‑sharing rule through clear signage and routine checks, ensuring compliance by staff and families.

Regular Checks and Monitoring

Post-Treatment Inspection Schedule

After applying a lice‑removal product, a structured follow‑up is essential to confirm eradication and prevent reinfestation. The inspection routine should be timed to correspond with the lice life cycle and the residual activity of the treatment.

Day 0 (immediately after treatment): use a fine‑toothed lice comb on damp hair, starting at the scalp and moving toward the ends. Remove all visible nits and live insects; disinfect the comb between passes.
Day 7: repeat the combing process on dry hair. At this stage, any surviving nits will have hatched; remove them promptly. Record the number of insects found, if any.
Day 14: perform a final combing session. Absence of live lice and nits confirms successful clearance. If any are detected, initiate a second round of treatment and resume the schedule.

During each inspection, examine the entire scalp, behind the ears, and at the hairline. Dispose of removed debris in sealed bags or wash the comb in hot, soapy water. Maintaining the schedule eliminates hidden eggs and reduces the risk of recurrence.

When to Seek Professional Help

Persistent Infestations

Persistent lice infestations require a systematic approach beyond a single treatment. Begin by confirming the presence of live nits within a quarter‑inch of the scalp; any missed eggs can hatch and restart the cycle. Apply a prescription‑strength pediculicide according to the label, then repeat the application after seven to ten days to eliminate newly emerged insects.

If infestation recurs after two complete treatment cycles, consider the following actions:

Inspect the child’s hair daily for live lice and viable nits; remove any found with a fine‑toothed comb.
Wash all clothing, bedding, and towels used in the previous 48 hours in hot water (≥130 °F) and dry on high heat.
Seal non‑washable items in sealed plastic bags for two weeks to starve remaining lice.
Vacuum carpets, upholstered furniture, and vehicle seats; discard vacuum bags immediately.
Treat all household members simultaneously, even if they show no symptoms, to prevent cross‑contamination.
Replace personal items such as combs, brushes, hats, and hair accessories with clean equivalents.

When over‑the‑counter products fail, obtain a prescription from a healthcare professional. Options may include oral ivermectin or topical spinosad, both proven effective against resistant strains.

Document each treatment date, product used, and observed outcomes. Share this record with the prescribing clinician to guide further interventions.

If the problem persists despite rigorous measures, request an evaluation for underlying factors such as scalp conditions, resistance to pediculicides, or reinfestation from close contacts outside the home. Adjust the management plan accordingly, incorporating environmental controls and possibly alternative medications.

Allergic Reactions to Treatments

When treating head lice in a child, be alert to possible allergic reactions. Reactions may appear within minutes to a few hours after applying a pediculicide. Common signs include redness, swelling, itching, hives, or difficulty breathing. Immediate discontinuation of the product is required if any of these symptoms develop.

First‑aid measures:

Rinse the affected area with cool water to remove residual medication.
Apply a soothing, hypoallergenic moisturizer or a cold compress to reduce skin irritation.
Administer an oral antihistamine if the child can tolerate it and a healthcare professional has approved its use.
Call emergency services if the child experiences breathing trouble, throat swelling, or dizziness.

Medical evaluation is essential. A physician will assess the severity of the reaction, may prescribe corticosteroids, and will advise on safe alternative treatments. Options for children with known sensitivities include:

Manual removal of lice and nits using a fine-tooth comb, performed daily for at least ten days.
Prescription‑strength topical agents that contain different active ingredients, such as ivermectin, after confirming no allergy.
Non‑chemical approaches like heated air devices that dehydrate lice without contacting the scalp.

Before any treatment, verify the child’s allergy history. Document any previous adverse responses to insecticides, detergents, or topical medications. Keep the product label handy to provide precise ingredient information to healthcare providers.

If an allergic reaction occurs, document the incident, including the brand, active ingredient, amount used, and timing of symptoms. Share this record with the pediatrician to guide future lice‑control strategies and to prevent repeat exposure.

Unsure About Diagnosis

When a child’s scalp shows possible signs of lice but the diagnosis is uncertain, take a systematic approach before initiating treatment.

First, examine the hair closely. Use a fine‑toothed lice comb on a well‑lit surface, preferably over a white towel or a tray. Separate sections of hair, pulling them taut, and run the comb from the scalp to the ends. Look for live insects, translucent nits attached within ¼ inch of the scalp, or empty nits that have already hatched. If any of these are found, the diagnosis is confirmed.

If the comb inspection yields no lice or nits, consider these possibilities:

The child’s scalp may be irritated by dandruff, seborrheic dermatitis, or allergic reactions, which can mimic itching.
Recent contact with a person who has lice may cause heightened awareness without actual infestation.
Environmental factors such as dry air or heat can increase scalp sensitivity.

When uncertainty persists, repeat the examination after 24–48 hours. A second inspection often reveals early-stage lice that were missed initially. In parallel, consult a healthcare professional—pediatrician, dermatologist, or school nurse—who can perform a thorough assessment and rule out other dermatological conditions.

While awaiting confirmation, avoid unnecessary pesticide exposure. Wash the child’s bedding, hats, and personal items in hot water (≥130 °F/54 °C) and dry on high heat. Vacuum upholstered furniture and car seats. Keep hair tied or braided to reduce the likelihood of lice spreading if present.

If a professional confirms an infestation, follow a proven treatment regimen: apply an FDA‑approved pediculicide according to label directions, repeat the application after 7–10 days to eliminate newly hatched nits, and continue daily combing for at least two weeks. Document the process and inform close contacts to prevent re‑infestation.