A photo of a girl holding her hair up because her head itches. She has lice!

Understanding lice: Symptoms and treatment

Just the thought of lice might make one itch but if it turns out to be the real thing, experts say not to panic. While it might be stressful, the condition is treatable. A Baylor College of Medicine primary care physician discusses the spread of lice and how to treat it.

“Lice spread almost entirely by head-to-head contact: your hair touching someone’s hair who is infested,” said Dr. Mike Ren, primary care physician and assistant professor at Baylor. “Young children play closely together and put their heads together often, which creates the direct head-to-head contact lice need to spread. Household members and caregivers of these children are the next most commonly affected.”

While the spread through shared objects, such as pillows or hats, is possible, it is less likely than hair-to-hair contact. An itchy scalp is the primary symptom of lice, which could take weeks to develop. Lice might not present symptoms in some so it’s important to inspect the scalp. A live, moving louse confirms an active lice infestation. Lice can affect anyone with any hair type, length or color.

Treatment entails using a shampoo containing permethrin 1% or pyrethrin, which can be purchased over the counter. If shampoo treatments fail to remove the lice, a physician can prescribe stronger medication. 

“Prevent spread by treating the infested person ASAP. Avoid head-to-head contact and avoid sharing items that touch the head of the infested person. Promptly treat the infection to prevent the spread,” Ren said.

Lice rarely survive off the scalp for long, so when cleaning items, focus on the ones that touched the infested person’s head in the last three-to-four days, such as hats, pillows and towels. Wash these items with hot water. Ren says it is not necessary to throw things away; things that cannot be washed, such as large pillows or stuffed animals, can be vacuum sealed for two weeks or dry cleaned.

“For the general public, lice is a nuisance, not a danger. Lice do not spread additional disease,” Ren said. “Call your doctor if you are not sure whether or not it’s lice, if treatment isn’t working after being used correctly or if the scalp looks infected (spreading redness, pus, crusting, pain).”

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