When your kids have head lice, it often throws family life into chaos: They miss school, you miss work, and you’ve got to do laundry and spend long, tedious hours picking nits (lice eggs) out of their hair. Perhaps you feel embarrassed and don’t want to tell anyone else, especially if your kids keep getting lice.

Head lice is incredibly common. The Centers for Disease Control and Prevention estimates that 6 to 12 million kids ages 3 to 11 get lice every year. Yet there’s a lot of misinformation, stigmas and lice and nit myths

Lice Symptoms & The Difference Between Lice and Dandruff

The primary symptom is an itchy scalp, and you may not feel it until you’ve had lice for several weeks. Once you’ve had lice before, the itching tends to occur sooner, Wong says.

Live lice are large enough to see with the naked eye but can be elusive. Nits, or lice eggs, are tiny, and some people confuse them with dandruff. The difference is that dandruff will flake away, while nits cling to the hair shaft. Wong recommends using a head lamp to check; the nits will reflect the light.

Ways to Get Rid of Lice and Nits

There are several effective lice treatments. Whichever one you use, you’ll need to repeat the treatment after 7-10 days, in case you miss nits and they hatch.

Wet Combing

Combing the hair to remove lice doesn’t involve any chemicals, but it’s not as effective and is a lot of work, Wong says.

Cetaphil Cleanser

You can also try coating the hair and scalp completely with Cetaphil cleanser, drying the hair thoroughly, and leave it on overnight, which smothers the lice. This method is appealing to parents who want to avoid putting toxins on their child’s hair and scalp. Here’s what you do:

• Coat the hair and scalp completely with Cetaphil

• Dry the hair

• Leave it on overnight with a shower cap

• Wash the hair and remove the nits

Rosemary and Tea Tree Oil

Another over-the-counter treatment with rosemary and tea tree oil claims to dissolve nit glue, but it doesn’t kill lice. Wong recommends using products to prevent infestations — tea tree oil acts as a natural lice repellent.

Combing Out Lice and Removing Nits

Regardless of which treatment you use, you’re still going to need to pluck lice and nits out of your child’s hair. Most combs won’t remove nits completely, so you might need to pull them off the hair. Wong says live nits tend to be very close to the scalp; what looks like a nit farther away from the scalp may actually be an empty egg casing.

Most parents agree that pulling off the nits is the worst part of a lice infestation. But “if they do all that work up front, it really makes it less likely that it’s either going to be persistent or recurring,” Wong says.

Removing Lice from Your House

Lice don’t survive for very long off humans. But to avoid spreading them or becoming re-infested:

• Wash all bedding and sleepwear

• Bag stuffed animals and soft items that can’t be washed for two weeks to kill any lice on them

• Vacuum your furniture

What to Do If Lice Keep Coming Back

Does it seem like your child just gets lice again and again? There are several things that could be happening:

• You never treated the lice adequately the first time.

• Your child has treatment-resistant lice.

• Your child keeps becoming reinfested, perhaps because of a friend or classmate with chronic lice.

In cases of resistant lice, Wong uses one of the prescription treatments. She also suggests trying tea tree oil to prevent lice reinfestation. But another effective treatment? For parents to talk to each other and talk to their child’s teacher, so they can detect other children who have lice and treat them.

“I think we probably would be able to control lice better if there wasn’t this stigma,” Wong says.