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Lice Infestations Guide

Lice are wingless parasitic blood-sucking insects. There are species of pubic, body, and head lice, the latter are the most common. A grown louse is 2 to 4 mm in size. They suck human blood from the scalp and attach themselves to the hair with the help of hook-like claws on their legs. In this article, we are talking about head lice infestations: the main aspects you need to know, and how to recognize, treat, and prevent them.

What is Lice Infestations

Lice infestation is called pediculosis, a condition when the parasite lives in one’s hair. When neglected to the level of the worst lice infestation ever, the number of living insects can increase so much that their eggs become easily visible on the hair.

How Lice Infestations Occur

Even a full-grown louse does not have wings, and its legs are designed for clinging onto hair, not for jumping. Nevertheless, lice are very fast crawlers: under normal conditions, the grown species crawl at a pace of 23 cm per minute. Therefore, there are two main ways for lice to spread.

Direct Contact

The insect can crawl from one person to another when they have close enough contact. Note that domestic pets and other animals do not carry lice.

Shared personal items

Hair brushes and combs, hats, and other accessories worn on the head can transfer lice if the person with pediculosis shares them with others.

Who is under the higher risk

Any person can contract pediculosis. Children, however, have lice more often than adults. This is because kids spend more time together in schools, summer camps, or kindergartens, and they are often in close contact with their peers during games and other activities. Children are also less hesitant about sharing personal space or possessions.

Symptoms of Lice Infestations

Pediculosis can run asymptomatically. In other cases, the symptoms can be, while not particularly dangerous for one’s health, but very frustrating and affecting quality of life.


Itching occurs of the person’s organism is sensitive to the saliva of a louse that gets into the bite when the insect feeds. The itching can become so bad it will disrupt one’s sleep.

Visible Lice or Nits

An adult louse moves quite quickly in the hair and is hard to notice. Lice eggs, however, also known as nits, can be spotted on the hair shafts. They are tiny white objects that can look like dandruff but are hard to remove. Checking for nits is how a lice infestation in hair is diagnosed.

Feeling of Something Moving in the Hair

While crawling, the insect moves through the hair which may cause a somewhat tingling sensation. Head lice infestations could be also detected by the feeling of something moving on the head skin if the person is sensitive enough. The symptom can become more intense if the infestation is untreated for a long time and the amount of live lice in the hair grows.

Sores and Rash

The skin can become sore from itching and scratching. An individual reaction to allergens in the louse saliva or a secondary infection can manifest with a rash.

Swollen Lymph Nodes

If the skin of the scalp is damaged enough, inflammation and infection can cause lymph nodes to grow as a part of an immune reaction. Together with the fever, swollen lymph nodes are serious signs that you should consult a healthcare professional about.

Health Consequences of Lice Infestations

One cannot find death from lice infestation. Pediculosis can be annoying and have unpleasant consequences, and the process of dealing with is indeed unsavory, but the condition is very manageable and not life-threatening.

Physical health implications

The bites from lice damage the person’s scalp. As mentioned above, it can cause sores and rash. Scratching it can lead to secondary infections: when the skin is damaged enough, the spot loses its natural protection against bacteria.

Psychological impact

Unlike body lice, head lice are not a sign of uncleanliness or marginal lifestyle. However, public education regarding the subject is still not enough to break the stigma surrounding it. This is especially important to children that can be bullied in their community.

The impact on mental health can also include anxiety connected to the symptoms. Itching or tingling sensations in the hair can be associated with re-infestation. And the desire to prevent it can manifest in an aggressive urge to clean.

Treatment of Lice Infestations

Lice infestation treatment usually includes a product that kills live lice, thorough hair combing, and aggressive cleaning to prevent re-infestation. In this section, we are overviewing important details regarding dealing with pediculosis.

Over-the-counter treatments

OTC products of various forms can be obtained in your local pharmacy. FDA-approved medications contain permethrin or pyrethrins as an active ingredient. They are allowed to be applied to children.

Note that these products only kill live lice, not the nits that have not yet hatched. Therefore, on the 9th day after the first treatment time, it is necessary to repeat treatment.

Some products, such as Lyclear, claim that they are able to kill lice eggs as well.

In any case, always carefully read and follow the instructions provided by the manufacturer to ensure the most effective use of the remedy.


Anti-lice shampoos are applied the same way as regular shampoos which is a bonus for the simplicity and convenience of use. However, the person who conducts the treatment should be careful to ensure that every strand of hair is handled.


Lotions are liquid solutions of the active components that kill lice. With lotions, it is easier to treat long and thick hair, as you can simply soak it in the product.

Some lotions, such as permethrin 1% lotion, are effective both for the head and pubic lice.


Sprays are meant to simplify the process of applying the remedy, They also ensure that the product is applied uniformly. Tiny parts of the liquid created by the sprayer are able to get through the thickest hair strands and to hair roots.

Prescription treatments

If you notice living lice after treatment with OTC products, it is possible that you are infested with so-called “super lice” that developed resistance against standard treatment methods. Visit the doctor to obtain a prescription.

Malathion (Ovide)

A 0,5% malathion lotion can be found under the brand name Ovide. It has pediculicidal (kills live lice) and partly partially ovicidal (kills some nits) effects. The lotion can irritate the skin and is not allowed for children under the age of 6.

Ivermectin (Sklice)

A 0,5% ivermectin lotion (brand name Sklice) is not ovicidal but is associated with a lower survival rate of nymphs (newly hatched eggs). When applied once to dry hair without nit-combing, it is successful in the majority of patients.

Benzyl Alcohol (Ulesfia)

Benzyl alcohol 5% lotion can be used for children at the age of 6 months and older. It is pediculicidal and not ovicidal. Requires a repeat treatment after a week.


Lindane shampoo is a second-line-only treatment method used if every other approach failed. It is FDA-approved but has many side effects and contra-indications. Lindane is not recommended for repeated treatment.

Home remedies

Many people try to eradicate lice infestations by using home remedies but these methods have limited success rates, especially in comparison with OTC FDA-approved medications.

Wet combing

The method name speaks for itself. The method requires washing hair with ordinary shampoo, untangling it using the hair conditioner and wide comb, and thoroughly combing it with a lice comb. In a small study of wet combing against head lice infestation, the method was 40% less effective than treatment with malathion.

Essential Oils

Tea, eucalyptus, lavender, and some other essential oils are believed to repel lice but they were not researched and do not have scientific evidence.

Olive Oil or Mayonnaise

The application of thick substances, such as certain gels, oils, etc. is considered to obscure the parasite’s ability to breathe and, therefore, kill it. However, topical insecticides have much higher proven efficiency.


Vinegar is supposed to help separate a louse or a nit from the hair shaft but is completely ineffective and can only cause a sensitivity reaction due to its strong smell.

Prevention of Lice Infestations

Here are three simple ways to reduce the risk of having a lice infestation in the house.

Regular hair and scalp checks

Lice are easily found through a visual check-up: regular examinations will help you catch pediculosis in time when the amount of live parasites is minor.

Avoid sharing personal items

Avoid sharing hair combs and brushes, accessories, and headwear; do not use other’s personal items.

Proper hygiene practices

To eliminate lice in bedding, conduct laundering at a high temperature (60°C is recommended) and use hot drying and ironing. If an infested person was in your house, vacuum the floor and furniture in the area where they were sitting (lying, playing, etc).

Role of Schools and Communities in Managing Lice Infestations

Restricting children with pediculosis from visiting school is not necessary. However, school authorities and parents in the kid’s class should be notified to provide control measures and help the child avoid close contact with their peers.

Regular visual check-ups. education, and practicing proper hygiene are necessary to reduce the risk of lice infestations in communities.


Lice infestation is an unpleasant but not dangerous problem. Its treatment is not an issue with the right approach and does not require drastic measures, such as shaving your hair or social isolation. OTC medications are effective in the majority of cases; the resistant lice can be eradicated with products prescribed by a doctor.


What causes lice infestation?

Lice are transferred through close contact or infested personal items.

What is the fastest way to get rid of lice infestation?

Proper treatment with FDA-approved OTC medications.

What is the difference between lice and bed bugs?

Bed bugs, scabies, and lice infestations are issues associated with entirely different species.

How do lice infest your house?

Lice can appear in the house with a person who has been infested.

Can you die from a lice infestation?

No, pediculosis is not a life-threatening issue.