Getting the nits out means combing wet hair in very small sections with a fine-tooth louse comb, starting at the scalp, wiping the comb on a wet paper towel after every pass, and repeating every two to three days for two to three weeks. The eggs are attached to the hair with a sticky substance that holds them firmly in place. The steps below cover the setup, the passes, the timeline, and the point where the comb alone stops being enough.
What You Need Before the First Pass
Four things do the work: a fine-tooth louse or nit comb, water, a wet paper towel, and strong light. The CDC says a fine-toothed louse comb may help you find lice, and that a magnifying lens may help you find crawling lice or nits even though both can be visible with the naked eye; MedlinePlus names the same pair. Lice are small, move quickly and avoid light, which the CDC gives as the reason they are hard to find, so work where the light is best and pull each pass slowly.
Skip the conditioner. If lice medicine is part of the plan, the CDC says not to use a combination shampoo/conditioner, or conditioner, before using it, and lists recent use of either among the reasons treatment fails. If the only fine-tooth comb in the house is a flea comb made for a cat or dog, the CDC says those are also effective.
The Comb-Out, One Small Section at a Time
The comb-out the AAP describes is four steps that repeat until the whole head is covered. Seat the child in a brightly lit room and part the hair first.
- Wet the child’s hair.
- Comb through the hair in small sections with a fine-tooth louse or nit comb.
- After each comb-through, wipe the comb on a wet paper towel, then examine the scalp, the comb and the towel carefully.
- Repeat until you have combed through all of the hair.
Two details decide what those passes find. Part the hair all the way down to the scalp in very small sections, as MedlinePlus puts it, because the AAP places eggs within 4 to 6 mm of the scalp. Start where finding is easiest: the AAP names the hairline at the back of the neck and behind the ears, and the CDC says you will often see nits in those same two places. For the mechanics of a single pass, how to use a lice comb to remove nits goes tooth by tooth; if sitting still through weeks of passes is the real obstacle, comb-outs with a child who cannot sit still takes that on.
When the Comb Is Not Pulling the Eggs Out
If the comb comes away empty while specks are still on the hair, check three things before buying a different comb: whether the teeth started at the scalp, whether the section was too wide, and whether the speck is a live egg at all. The AAP says nits attach to the hair with a sticky substance that holds them firmly in place, so the comb has to catch them at the base of the shaft and carry them out. Sliding over the hair will not move them.
| What you see | How it looks | What it means |
|---|---|---|
| Egg near the scalp | Oval, 0.8 mm by 0.3 mm, about the size of a knot in thread, yellow to white, firmly attached | Usually found within 4 to 6 mm of the scalp; eggs do not survive farther away |
| Nit more than 1/4 inch out | Still stuck to the shaft after hatching | Almost always hatched or dead; if these are the only nits found, the infestation is probably old |
| Nymph or adult louse | Pinhead size, 1.5 mm, up to sesame-seed size, 2 to 3 mm; pale and gray | A diagnosis usually comes from seeing a louse or nit |
| Dandruff, dirt, hair spray droplets | Similar specks, not firmly attached | Nits are often confused with these; attachment is the difference |
Two rows change what you do next. The CDC says nits more than 1/4 inch from the base of the hair shaft are almost always hatched or dead, so a stubborn speck well down the shaft may be an empty shell. The CDC also calls misdiagnosis of head lice infestation common, and the test is attachment: a nit is firmly attached, dandruff and dirt are not. Our guide to telling a real nit from debris on your lice comb works through the comparison.
One limit is worth stating plainly: the AAP says the comb-out method usually doesn’t work on its own to get rid of head lice, and calls head lice medicine the most effective treatment, to be discussed with the child’s doctor first. If days of combing have not made the picture clearer, book a head check and let someone else look.
What Kills Lice Eggs, and What Does Not
No pantry remedy has been shown to kill lice eggs. The CDC’s treatment guidance says it does not have scientific evidence that suffocating head lice with mayonnaise, olive oil, margarine, butter or similar substances is an effective form of treatment, and MedlinePlus says there is no clear scientific evidence for suffocation by home remedies like those. The AAP is blunter about the dangerous end: never use gasoline, kerosene or medicines made for use on animals, which are flammable and carry substantial risk. Oils keep coming up anyway, which is why we wrote separately about why coconut oil doesn’t get the nits out of hair.
What acts on the eggs is medicine, and which ones do is a label question. The CDC says some medicines kill lice and eggs, so retreatment is usually not required for those, while others kill lice but not eggs, which is why treating again about a week later, 7 to 9 days depending on the drug, is recommended. Follow all provided instructions, use only one product at a time unless your health care provider says otherwise, and check with the child’s doctor before beginning any treatment. The AAP notes that some prescription products do not call for nit combing at all, which is worth asking about.
Nit Combing Your Own Hair
You can comb your own head, with one honest limit: the two places the AAP calls easiest for finding lice, the hairline at the back of the neck and behind the ears, are the two you cannot see. Part down to the scalp in very small sections, pull each pass from the scalp outward, and wipe the comb on a wet paper towel every time, because the towel is the surface you can study closely, with a magnifying lens if you have one. A mirror covers the sides; the nape is worth asking another adult to check. The CDC and MedlinePlus both say all household members and other close contacts should be checked, and treated if necessary, so your own comb-out is one part of a household check.
How Many Days of Combing Is Enough
Comb every two to three days for two to three weeks, counting from each treatment. That is the CDC’s instruction after treating, the AAP’s schedule for the comb-out method, and what MedlinePlus says to keep up until all lice and nits are gone. The eggs set the length, not your patience: the AAP says eggs hatch in 7 to 12 days depending on the surrounding temperature, the CDC puts hatching at about a week with a range of 6 to 9 days, and nymphs become adults about 9 to 12 days after hatching.
Finding a speck at the end of that stretch is not automatic failure. The CDC says nits may stay in hair after treatment, but successful treatment will kill crawling lice, and that you should treat again only if live, crawling lice are there several days later, after talking with a healthcare provider about whether re-treatment is needed. How often to comb after lice treatment lays the same schedule out day by day.
Frequently Asked Questions
What home remedies will kill lice eggs?
None that the AAP or the CDC can point to evidence for. The AAP’s do-not-use list includes petroleum jelly, mayonnaise, tub margarine, essential oils and olive oil, because no studies prove they work. It also warns that placing anything made of plastic on a child’s head is dangerous, and that a plastic bag should never go there.
Will head lice eventually go away?
Not on a timeline worth waiting out. The AAP says the cycle can repeat every 3 weeks if head lice are left untreated, and that an adult female louse can lay up to 10 eggs a day. The CDC puts an adult louse’s life on a person’s head at about 30 days.
Can you kill lice by squishing them?
Crushing a louse you have caught kills that louse and nothing more. The eggs stay glued to the hair, and any lice still on the head keep laying. The CDC says finding a live nymph or adult louse on the scalp or hair is the best way to diagnose an infestation, so treat what you catch as information, and let that drive the treatment decision with the child’s doctor.
How do you get the nits out of a lice comb?
Wipe the comb on a wet paper towel between passes, then clean it properly when the session ends. The CDC says to soak combs and brushes used by an infested person in hot water, at least 130 degrees Fahrenheit, for 5 to 10 minutes, and MedlinePlus gives the same 5 to 10 minute soak. The CDC also says not to share combs, brushes or towels.
What do combed-out nits look like on a tissue?
Small white or yellow-brown specks that were firmly attached to the hair until the comb moved them, in the AAP’s description. Some nits blend in with a person’s hair color, which makes them hard to see and easy to mistake for dandruff or hair spray droplets. That is why the method has you check the scalp, the comb and the paper towel on every pass.
How Lice Lifters of Mercer County Can Help
If the combing has gone on for days and you still are not sure what you are looking at, a trained second opinion is a reasonable next step. At our clinic we check the whole family first, which is what the CDC advises for household members and close contacts, and when we find an active case we give a non-toxic treatment in one visit. Same-day appointments are available, and our 30 Day Guarantee applies when the whole family is checked. You can read how professional lice treatment works at Lice Lifters of Mercer County, or book a head check for the household and stop guessing at specks on a paper towel.
