A nit comb can help flush out lice and remove any eggs attached to the hair shaft. (For Spectrum Health Beat)

Your child’s head is constantly itching.

You hope it’s just dandruff or allergies to shampoo.

But then you look close.

You see something scurry through your child’s hair.


According to the Centers for Disease Control and Prevention, an estimated 6 million to 12 million head lice infestations occur each year in the United States among children ages 3 to 11.

Erin Ross, DNP, CPNP, from Spectrum Health Ludington Hospital Pediatrics, said kids and parents should not be embarrassed if they get lice.

“Lice are fairly common and we see it quite a bit in our office,” Ross said. “It doesn’t mean the child is dirty or that their house is dirty.”

Lice are parasitic insects that feed on blood from the human scalp. There are many misconceptions about these tiny bugs and how they spread.

“First and foremost, people need to understand that lice cannot jump or fly,” Ross said. “They are mainly spread through direct head-to-head contact with someone who already has lice.

“It’s rare to have lice spread through things like hats or combs because once they are off the human head, they don’t live very long,” she said. “Despite the fact that the chance is small, it’s still not recommended for people to share objects that come in direct contact with a person’s head.”

Lice can only live for about a day once they fall off a person’s head. Lice eggs, called nits, cannot hatch once they fall off a person’s head.

Ross also reminds people that lice only live on humans. They cannot live on pets.

She also said lice do not need a lot of hair on which to live. They attach to the hair at the base of the scalp, which makes them a common problem for both boys and girls, long or short hair.

What should I look for?

Lice are small and they move quickly. They aim to avoid light, too, which can often make them hard to find.

“Children will usually complain about their head itching or they may feel a tingling sensation on their head,” according to Ross. “Because lice are more active when it’s dark, children may have a hard time sleeping at night if they have lice.”

When parents are checking their children for lice, it’s important to use a nit comb. These fine-toothed combs are able to remove the eggs, which are small and hard to see.

The nits are frequently mistaken for dandruff, Ross said.

While lice can be a problem anytime of year, it’s more common during the school year.

“When kids are around each other more, it’s easier to spread,” Ross said. “When they are on the playground, playing sports or having play dates, it’s easier for their heads to come in contact with each other and to have the lice spread.”

How are lice treated?

Lice can be difficult to get rid of, but vigilance can effectively kill a pesky infestation within a matter of days.

“When a child comes to our office with lice, we start with over-the-counter medication,” Ross explained. “The topical medication will usually kill the lice. If that doesn’t work, there are prescription medications we can offer.”

Along with the medication, it’s also important to comb through the child’s hair with the nit comb several times a day to remove any eggs attached to the hair.

Because lice cannot live very long off the human head, excessive home cleaning isn’t required.

However, it’s recommended you wash pillow cases, bedding and clothing worn or used by the infested person in the two days prior to the start of treatment. Anything that cannot be laundered can be placed in a plastic bag for two weeks to kill the lice nits, Ross said.

If a child does have lice, it’s also important to check all members of the household and apply treatment as needed.

Should my kid stay home from school?

While some school districts require students to be lice- and nit-free before they return to class, other districts may allow students to attend class if they have nits, but not if they have lice. Other districts may allow them to attend no matter the circumstance.

The American Academy of Pediatrics and the National Association of School Nurses have both advocated to eliminate the no-nit and no-lice policies in schools. Proper treatment takes care of a problem quickly under most circumstances, which means kids shouldn’t have to skip school if they’re treated properly. 

“Because treatment is effective and lice cannot fly or jump off a child’s head, we recommend children return to school the day after they begin treatment,” Ross said.

Parents who are vigilant about treatment will find that their child won’t have to miss school if treatment begins the same day the infestation is discovered.