We check every person who comes in, and our treatment is non-toxic, enzyme-based and done in one visit. The CDC and AAP guidance below covers what a head check looks for, who else should be checked, and the first two weeks at home. You do not have to diagnose the problem yourself before you arrive.
Head lice are a nuisance rather than a danger. The CDC says head lice do not transmit any disease and are not considered a health hazard, and that getting head lice is not related to cleanliness of you or your environment. It estimates 6 to 12 million infestations each year in the United States among children 3 to 11 years of age. Booking a clinic visit is a practical decision, nothing more.
Confirming It Is Lice Before Anything Else
A head check comes first in the CDC and AAP guidance because treatment is meant only for an active infestation. The CDC calls finding a live nymph or adult louse on the scalp or hair the best way to diagnose a head lice infestation, and it also says misdiagnosis of head lice infestation is common. Adult lice run about 2 to 3 mm long, roughly the size of a sesame seed, and a nymph is about the size of a pinhead. They avoid light and move quickly, which is why a careful look beats a quick one.
Here is what a check is looking for, and where:
- Live crawling lice first, because nits on their own do not settle the question
- Nits attached firmly within 1/4 inch of the base of the hair shafts
- Hair behind the ears and near the back of the neck, where the CDC says you will often see nits
- Nits sitting more than 1/4 inch from the base of the hair shaft, which the CDC says are almost always hatched or dead; if those are the only nits found, the infestation is probably old and does not need treatment
- Particles that are not lice at all, since the CDC lists dandruff, hair spray droplets and dirt particles among the things nits are confused with
That is why we check everyone who comes in. The AAP is direct about the principle: head lice medicine should be used only when it is certain that your child has living head lice. If you want the detail before you arrive, read how professional lice screening works.
What Happens Once Live Lice Are Found
When the check finds live lice, our non-toxic, enzyme-based treatment is done in one visit.
Combing is the part that takes patience. The CDC’s guidance for anyone treating lice is to use a nit comb to remove nits and lice from the hair shaft, and the AAP describes the method it gives parents: wet the hair, comb through small sections with a fine-toothed louse or nit comb, wipe the comb on a wet paper towel after each pass, examine the scalp, comb and paper towel, and repeat until all the hair has been covered.
Two expectations are worth setting before you sit down. Nits may stay in the hair after treatment, the CDC says, while successful treatment kills crawling lice, so a shell spotted later is not automatically a failure. Our post on how long lice treatment takes covers timing in more detail. If the solution itself is what you are curious about, enzyme-based lice treatment explains the approach.
Who Else in the House Should Be Checked
Everyone living with the person who has lice should be checked, not only the child who was scratching. The CDC says to check all household members and other close contacts, and to treat everyone infested, plus the people they share a bed with, at the same time. The AAP gives the same instruction. Treating one head while another goes unchecked is how a household passes lice back and forth.
A clear head today is not proof of a clear house, because symptoms lag behind the lice. The CDC says people with head lice may not have symptoms, particularly with a first infestation or when an infestation is light, and that it may take four to six weeks for itching to appear the first time a person has head lice. The AAP names the main route of spread plainly: close, prolonged head-to-head contact. A child who is not scratching can still be carrying lice.
In practice that means bringing the household in together instead of one person at a time. Schedule a head check for the whole household and nobody gets skipped.
Why Home Treatment Sometimes Leaves Lice Behind
Home treatment fails for reasons that are known and listed, not mysterious. The CDC’s list of reasons treatment for head lice can fail names five: misdiagnosis, recent application of a combination shampoo and conditioner or of conditioner to the hair, not following treatment instructions, head lice resisting the medication, and reinfestation after successful treatment. Any one of them sends a family back to the beginning.
Resistance is real, and it is local. The AAP says head lice can be resistant to the active ingredients in over-the-counter treatments in some communities and that the likelihood of resistance varies across the country. It also notes that parents sometimes treat their children with over-the-counter treatments up to 5 times before seeking help from their pediatrician. Confirming live lice before another round is what the AAP’s advice asks for.
Both sources are firm about the shortcuts, too. The CDC says there is no scientific evidence that suffocating head lice with mayonnaise, olive oil, margarine, butter or similar substances is an effective form of treatment, and the AAP says not to use home remedies such as petroleum jelly, essential oils or tub margarine because no studies prove they work. The AAP is blunter about the dangerous end of the shelf: never use gasoline or kerosene or medicines made for use on animals, and never place a plastic bag on a child’s head. Its standing advice is to check with your child’s doctor before beginning any head lice treatment, and again before beginning a second or third medicine. Why lice treatment fails sometimes digs into the mechanics.
Your First Two Weeks at Home
Plan on short, regular checks rather than a deep clean. After each treatment, the CDC says to check the hair and remove nits and lice every 2 to 3 days for the next 2 to 3 weeks, and the AAP describes the same comb-out rhythm. Spending much time and money on housecleaning activities, the CDC adds, is not necessary to avoid reinfestation, and the risk of getting lice from a louse that has fallen onto a rug, carpet or furniture is very small. Lice that fall off a person and cannot feed die within two days.
| Item | What the CDC says to do |
|---|---|
| Clothing, towels and bed linens worn or used in the two days before treatment | Machine wash and dry them, using the hot water (130 degrees Fahrenheit) laundry cycle and the high heat drying cycle |
| Items you cannot wash or dry clean | Seal them in a plastic bag and store them for two weeks |
| Combs and brushes used by a person with lice | Soak them in hot water (at least 130 degrees Fahrenheit) for 5 to 10 minutes |
| Floors and furniture | Vacuum the floor and furniture, particularly where the infested person sat or lay |
| Fumigant sprays and fogs | Do not use them; they are not necessary to control head lice and can be toxic if inhaled or absorbed through the skin |
One last expectation saves a lot of worry: the AAP notes that itching caused by head lice can last for weeks, even after the lice are gone. How often to comb after lice treatment covers the schedule in more detail.
Frequently Asked Questions
How can I tell nits from dandruff?
Nits are firmly attached to the hair, and dandruff, dirt and hair spray droplets are not; that is the test the AAP gives parents. Nits look like small white or yellow-brown specks close to the scalp, and MedlinePlus suggests a magnifying lens and a fine-toothed comb when they are hard to see.
Can lice spread at a swimming pool, or from a pet?
Neither is a realistic route. The CDC says head lice can survive under water for several hours but are unlikely to spread in a swimming pool, and that chlorine levels in pool water do not kill head lice. It is equally clear about animals: they do not get or spread head lice.
Does anything need to be done before the appointment?
The CDC counts recent application of a conditioner or a combination shampoo and conditioner among the reasons a lice medicine fails, and it says not to use either before lice medicine. Beyond that, what helps is information: which products were used, when, and who else in the house has been scratching.
What if the scalp is sore from a product used at home?
Tell your child’s doctor. The CDC notes that some lice medications may cause itching or a mild burning sensation. Our treatment is non-toxic and safe for all ages.
We found one louse days later. Do we treat again?
Treat again only if live, crawling lice are there. The CDC says to repeat treatment only when live lice are seen several days after treatment, and that a few lice moving slowly 8 to 12 hours after treatment do not call for reapplying the medicine. It also says to talk to a healthcare provider before re-treating.
Do we have to throw out hats, helmets and hairbrushes?
No. The AAP says you do not need to throw these items away, and that washing them applies if they were used within 2 days before head lice were found and treated. It also puts the risk in proportion: there is a very small chance that head lice will spread by sharing items such as combs, brushes, hats and sports helmets.
How Lice Lifters of Mercer County Can Help
We check the whole family. The treatment itself is non-toxic and done in one visit, and same-day appointments are available when a household needs to be seen quickly. Our 30 Day Guarantee applies when the whole family is checked, which is the same reason we ask everyone to come in together. To see what the visit covers before you commit, read about professional lice treatment, then book a head check for everyone in the house. Bring your questions. A calm, confirmed answer is what a first appointment is for.
