Lice are parasites that feed on human blood and can be found on people’s bodies. Head lice (Pediculus humanus capitis) live on the scalp and in the hair.
Other types of lice that live on humans include:
- Pubic lice (Pthirus pubis): also called “crabs,” lives in pubic hair, eyebrows, eyelashes, armpits, facial hair, and other areas
- Body lice (Pediculus humanus corporis): feeds on the body, can live in clothing (uncommon), and are the only type known to spread disease
Lice are unable to survive more than 24 hours without a human host. Though it is possible for head lice to get onto pillows at night, they generally stay in a person’s hair and on the scalp. There is a small risk of reinfection with head lice that transfer to pillowcases but this can be mitigated by changing the pillowcase and washing it in hot water or running it through a hot dryer.
What Are Symptoms of Head Lice?
Symptoms of head lice include:
- Itching on the scalp
- Feeling something moving, crawling, or tickling in the scalp and hair
- Difficulty sleeping: head lice are most active in the dark
- Sores on the head from scratching that may become infected
- Seeing bugs
- Finding lice eggs (nits)
- Swollen lymph nodes in the neck
- Pink eye
How Do You Get Head Lice?
- Head lice are usually transmitted through direct head-to-head contact with an infected person. This often occurs in children during playtime at home or school, participating in sports, at the playground, sleepover parties, and camp.
- Less commonly, head lice may be transmitted by sharing items from an infected person such as clothing (hats, scarves, uniforms), bed linens, furniture, brushes and combs, barrettes or hair ribbons, towels, pillows, and stuffed animals and toys.
How to Check for Head Lice?
- Head lice are diagnosed by visualization of lice or nits (louse eggs), which sometimes can be seen with the naked eye, however, lice may be difficult to see unless filled with blood from a recent meal.
- If head lice are suspected but are not able to be visualized, a fine-toothed louse comb may help identify live lice. In some cases, use of a magnifying lens may be necessary to see them. The presence of nits can be confirmed by a special lamp that causes nits to glow a pale blue color, or by dermoscopic examination.
What Is the Treatment for Head Lice?
Home remedies can treat itching caused by head lice bites but they do not get rid of the infestation. The infestation needs to be treated.
Lice infestations are first treated by improving the personal hygiene of the infested person. Clothing, bedding, and towels used by the infested person should be laundered in hot water (at least 130°F) and machine dried using the hot cycle.
After that, head lice treatment includes both over-the-counter (OTC) and prescription shampoos and medications.
Over-the-counter lice medications include:
- Pyrethrins combined with piperonyl butoxide (A–200, Pronto, R&C, Rid, and Triple X)
- Permethrin lotion, 1% (Nix)
Prescription head lice medications include:
- Benzyl alcohol lotion, 5% (Ulesfia lotion)
- Ivermectin lotion, 0.5% (Sklice)
- Malathion lotion, 0.5% (Ovide)
- Spinosad 0.9% topical suspension (Natroba)
- Lindane shampoo 1%
Excessive scratching can lead to sores and infections which may need antibiotics. See a dermatologist if you suspect you have head lice bites.
There are some home remedies that recommend applying oils, mayonnaise, or vinegar to the head overnight to suffocate the lice. These remedies don’t always work and can be messy and time-consuming. Talk to your doctor before trying any home remedy to get rid of head lice.
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https://www.uptodate.com/contents/lice-the-basics?search=lice&source=search_result&selectedTitle=1~92&usage_type=default&display_rank=1
https://pubmed.ncbi.nlm.nih.gov/12890107/
https://www.aad.org/public/diseases/a-z/head-lice-symptoms