Head Lice Prevention and Treatment: Separating Fact from Fiction
As children return to school, parents are concerned about the potential for head lice infestations. According to the Centers for Disease Control and Prevention (CDC), head lice infestations are most common among preschool and elementary-age children, with up to 12 million cases annually in the U.S. alone. With the rise of online searches for information on head lice, it’s essential to separate fact from fiction and provide accurate guidance on prevention and treatment.
Experts, such as Dr. Danilo C. Del Campo, a dermatologist in Chicago and a fellow of the American Academy of Dermatology, emphasize that head lice are parasitic insects that feed on human blood, but are difficult to find due to their small size and ability to avoid light. The hallmark symptom of an infestation is new and onset itching of the scalp. The eggs, or nits, can be yellow, brown, or tan and resemble tiny seeds, but when hatched, will appear clear.
How to Identify a Head Lice Infestation
Becky Boudreau, a head lice technician in New Hampshire, notes that parents may notice their children scratching more at night or having difficulty sleeping due to the presence of lice. However, it may take longer to recognize an infestation in children with a high pain tolerance or those who are less reactive to insect bites. There is no set number of lice that would classify as an infestation; either you have lice, or you don’t, experts say.
Jacob Anthon demonstrates the use of an FDA-cleared device that uses a combination of airflow temperature, speed, and direction to kill lice and eggs at Lice Clinics of America in Sugar Land, Texas, Monday, Sept. 22, 2025. (AP Photo/Lekan Oyekanmi)
Treatment Options for Head Lice Infestations
Treatments for head lice include medication and manual removal of eggs and adult lice. Dr. Krista Lauer, national medical director for Lice Clinics of America, notes that their clinics use an FDA-cleared medical device that uses a combination of airflow temperature, speed, and direction to kill lice and their eggs. Boudreau, who uses shampoo, olive oil, and a special comb to assist in combing out the insects, warns that many over-the-counter kits “are designed to fail” and often require multiple uses.
Guidelines from the American Academy of Dermatology Association recommend retreating for any product that can be bought without a prescription, and that no approved method can kill lice and their eggs during the first treatment. Del Campo emphasizes that many of these products have been tested and approved by the Food and Drug Administration, including benzyl alcohol lotion, ivermectin lotion, malathion lotion, and lindane shampoo, which can be toxic if used incorrectly.
Managing a Head Lice Infestation
Adult lice can live for about 30 days on their hosts’ heads, but will die within two days if they fall off a person and cannot feed. Their eggs can take up to nine days to hatch and another seven days to mature into adult lice. Lice cannot hop, jump, or fly and are mostly spread through head-to-head contact where the parasites can crawl from one host to another.
The CDC suggests machine washing and drying clothing, avoiding the use of infected hair products, furniture, or toys, and cleaning areas where infested people were. However, their guidance also notes that it is less likely that lice could be spread through used products.
Del Campo notes that parents need to be advocates for their children, as many outdated school policies force them to miss more school than necessary. “Lice are not dangerous. They don’t spread disease. There’s no medical reason to remove a child immediately from a classroom,” he says.
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