Symptoms of Lice: How Do I Know If My Child Has Lice?

Head lice are parasites that live in your hair and feed off the blood from your scalp. Although head lice are harmless and don’t spread disease, they can cause a great deal of discomfort and distress.

Transmitted by close contact and known to spread quickly, head lice are most common among children ages 3 to 11. In fact, up to 12 million head lice infestations occur each year in the United States within that age group alone. To keep your family head-lice-free, learn how to spot the signs and symptoms of infection such as itchiness, discolored bumps, and visual cues.

Frequent Symptoms

Lice move very quickly so they’re not always easy to see. To detect a head lice infestation look out for the following symptoms:

• extreme itchiness in your scalp

• a tickling or crawling sensation on your head

• small red bumps on your scalp or neck

  If you think your child may have head lice, watch for the following signs:

• frequent head-scratching

• sores on the head (the result of frequent scratching)

• small red bumps on the scalp or neck

Because lice are particularly active in the dark, they may also disrupt your child’s sleep. Therefore, difficulty sleeping and daytime irritability may be a sign.

Head lice are highly contagious, especially when sharing hairbrushes, hats, and other personal belongings. Therefore, it’s a good idea to check everyone in your family (and other close contacts) if someone in your household is found to have them.

Visual Signs

About half of people with head lice will not scratch their head, so the best way to detect an infestation is to look for signs of an infestation. By parting the hair and examining the scalp in bright light (ideally with a magnifying glass and fine-tooth comb), you may be able to get a close look at head lice. The insects are generally easier to see near the ears and the nape of the neck.

Head lice are wingless and have three forms: the egg (or “nit”), the nymph, and the adult. Here’s how to spot each form.

Nits

Oval-shaped and extremely small (i.e., just about the size of a knot in thread), nits are frequently found on the back of your neck or behind your ears. Since they often appear white in color, they’re sometimes mistaken for dandruff. Unlike dandruff, however, nits are attached to individual hairs (often close to the scalp) and won’t fall out when the hair is shaken.

Nymphs 

A type of louse that’s recently hatched from the nit, a nymph resembles an adult louse (often grayish white to tan in color) but is smaller in size. It takes nine to 12 days after hatching from the nit for a nymph to mature into an adult.

Adult Lice

Adult head lice are about the size of a sesame seed. They have six legs, featuring hook-like claws that allow them to cling tightly to the hair shaft. Often grayish-brown or tan in color, adult head lice may appear darker in people with dark hair than in people with light hair.

Note that while head lice are found almost exclusively on the scalp, it’s possible (though very rare) to find lice on the eyebrows or eyelashes as well.

Complications

Along with emotional distress and sleep disturbance, head lice can lead to a number of complications when left untreated. For example, frequent scratching can cause breakage of the skin, which can leave you vulnerable to infection.

Since lice feed on human blood, severe and chronic infestation can lead to blood loss and iron-deficiency anemia. In addition, an allergic reaction to louse feces or bites may trigger a rash in some individuals.

Know that in most cases these complications are rare. Lice are generally harmless, but they are important to get rid of.

Coping With Head Lice

Finding head lice can often lead to anxiety and worry, and—if it's your child that's affected—maybe even guilt. You can take steps to cope with these emotions and make treatment as non-stressful as possible for your family while doing all you can to keep lice from spreading. Explore positive ways to get through this episode.

Emotional

While some people may take the news of lice in stride, others may become anxious or upset by it. Many parents may also experience feelings of guilt that they may not have done enough to protect their child or that they did something wrong to cause the problem. It's important to remember that ​anyone can get lice. All it takes is head-to-head (or hair-to-hair) contact with someone who has it.​

While feeling this way is quite natural, it may negatively influence the situation. For instance, panic can cause you to fail to follow treatment manufacturers’ instructions and over-treat, which can lead to serious medical problems in children. Moreover, parents who are feeling stressed about the lice infestation may worsen any anxiety their children may already have about having lice.

How to Handle Your Own Anxiety

These tips may help:

• Get the facts. Knowing the facts about lice can help you feel more in control and understand how to handle the problem, which can greatly help reduce your stress about the situation. In particular, know that head lice are very common, especially among school-age children. And although they may take some time and effort to get rid of, they are not known to carry disease. If you are against the use of medicated treatment products, there are alternatives you can consider.

• Cut yourself some slack for feeling anxious. Often, we know the medical facts but still feel anxious about something. This is perfectly normal, especially for parents who are dealing with their child’s discomfort.

• Breathe. Something as simple as deep breathing can be a great stress-reliever. Also, try finding a yoga class or video to help yourself feel calmer and more centered. Try similar relaxation techniques for children to help relieve your child's stress.

  How to Help Your Child Relax

  Helping your child understand the problem can help reduce any worries they may have about it. Don't assume that young children cannot understand the facts about lice. Simply work to explain what's going on in basic terms.

  Here are some suggestions for doing just that:

• Tell your child that head lice are common and that many children and their families have this problem.

• Reassure them that they didn’t do anything wrong to get it.

• Explain that the lice will go away and that you will make sure you keep checking their hair and treating the problem until it is gone.

• Steer clear of some of the more unsettling details that may be distressing to a child, such as the fact that the lice are feeding on their blood.

• Help your child understand that it may take patience and time to remove the lice, but that the problem will go away.

• Try some quick stress relievers for kids to help your child relax. Some breathing and relaxation exercises, massage, and even playing a game together can do wonders to relieve kids' stress and tension.

  Physical

  No matter which treatment method you use, combing and nit picking is necessary. When treating kids, make time spent doing this as fun as possible. Put on a favorite video or a new kids’ movie your child hasn’t yet seen to keep him occupied while you comb out the lice and nits. You can also make this part of bath time so that it’s an extension of a routine you already have.

  The American Academy of Pediatrics (AAP) advises against shaving a child's head due to lice as it is not necessary and can be "traumatizing to a child and distressing to the parent." If you opt for a shorter hairstyle to make combing and checking for nits easier, present this in a positive way and make it a stylish choice.

  If lice have been spreading at your child's school or within your family, you can instill new habits to prevent head-to-head contact. Discuss ways she may have contact and explore alternatives. If playful head bumps, napping with head contact, or games that have head contact are common, you may suggest alternatives. Also discuss not sharing combs, brushes, barrettes, hair ribbons, and hats.

  You don't have to undertake exhaustive cleaning measures of your home or fumigation if a family member has lice. You can machine wash and dry (hot water and high dryer temperature) any items that have been in contact with the head of the person with the infestation. Vacuum furniture, carpeting, and fabric-covered items that can't be machine washed. Clean any hair care items in hot water.

  If there is anything that you are still worried about, you can bag it in a plastic bag for two weeks. That is sufficient time for any eggs to have hatched and died and the item will be safe. If a beloved stuffed animal is taken away for this purpose, present this in a loving and positive way to a child, as it may initially be distressing.

  Social

  Despite efforts to educate people about how head lice is transmitted and who gets it, there are still many myths and misunderstandings about head lice. If you encounter someone who seems to be under the impression that head lice are caused by poor hygiene or that lice can jump from one person to another, steer them toward the real facts.

  Sometimes this stigma fuels a code of silence about head lice. However, you or your child got lice from someone else. Spread ing between children is common, but it's possible for adults too, so you should review ways you or your child may have had head-to-head contact and alert those involved to screen for lice.

  It is ultimately in your best interest to inform the school nurse or daycare administrator if you detect lice on your child. While you may treat it effectively, you or your child will get infested again if lice continue to spread. Alert the parents involved if your child has had a sleepover. Work together toward eliminating the spread of lice. Discuss how to screen family members so those who need treatment can start it.

  You may want to take positive steps to help reduce the opportunities for lice to spread. Observe and ask other parents to watch what is happening during playtime, sports, and during sleepovers. Explore ways to reduce head-to-head contact and sharing of hair care items and headgear.

  Practical

  Your school, daycare, or business may have a policy on head lice. The American Academy of Pediatrics and the Association of School Nurses both advise that students should be allowed to return to school once they've begun treatment for lice. However, some schools have a "no nit" policy and your child won't be allowed to return until he is clear of both live lice and nits. You may want to advocate for a revision of the policy based on the recommendations of those two organizations.

  These rules and guidelines may apply to adult staff and volunteers as well. If you have lice, you should return to work and social activities after you have begun treatment unless there is a no nit policy in force.

  If you can't get a change or exception to a no nit policy, you will need to arrange child care or stay home from work in the interim. This can be a challenge for a family. Diligent wet-combing and checking is the best thing you can do to get back to your normal routine as quickly as possible. While only nits near the scalp should be of concern, it will be reassuring if you are able to remove all of the nits.

  Remember that it can take time to fully resolve an infestation—and try not to be discouraged while you wait. Talk to your family doctor or pediatrician about the steps you are taking and ask if there are better methods to try. Some communities are seeing lice that are resistant to some forms of treatment, so there may be a better choice than the one you are using.

3 KEY DIFFERENCES BETWEEN HEAD LICE AND DANDRUFF

An itchy scalp and white objects in your hair can mean dandruff, or it might be head lice. To make sure you get it right, use our guide to spot the difference.

While they share certain similarities – an itchy scalp being the most obvious – there are key differences that distinguish head lice from dandruff.

Let’s look at three differences you can use to tell them apart.

Cause

The major difference between these two conditions is their cause. Head lice are small parasitic creatures that feed off human blood. Saliva secreted by lice irritates the scalp, and is the cause of the itchiness and sores that characterize a lice infestation.

Dandruff, on the other hand, is caused by sensitivity to oleic acid. This acid is a by-product of the malassezia microbe, which we all have on our scalps. Not everyone is sensitive to oleic acid, but in some cases it can cause irritation, itching, and flakes.

Appearance

While there are similarities, it’s not that hard to spot differences in the way dandruff and head lice look:

• The white flakes caused by dandruff are excess skin flakes, and as such will not be attached directly to the hair – by contrast, teardrop-shaped lice eggs are directly adhered to the follicle, often very close to the scalp.

• Adult head lice can actually be spotted, although it’s a bit difficult. Use a head lice comb on wet hair under good lighting for the best effect

Location

Because malassezia is distributed across the entire scalp, dandruff is not a localized problem: flaky dandruff patches can be found all over the scalp.

By contrast, head lice have definite preferences for their home. They’ll usually be found behind the ears and on back of the neck, both areas where they like to lay their eggs. Head lice symptoms are usually focused on these areas as well.

Now that you’ve done the hard work and know which of these conditions you have, it’s time to talk about treatment. First up: dandruff.

Treating dandruff

Compared to head lice, dandruff is fairly simple to deal with. A proven dandruff shampoo will help soothe the symptoms of dandruff, while helping to neutralize the cause and washing away any flakes.

For best effect, use your dandruff shampoo every time you wash your hair. Dandruff is a chronic condition which will come back if untreated.

Dealing with head lice is an entirely different story.

Treating head lice

Head lice hatch every seven to ten days, with a total life cycle of about four weeks. Any treatment, therefore, needs to take this into account.

Start with an over-the-counter head lice solution. Most of these will target the hatched lice, so you’ll need to repeat the process every week or so to make sure you get them all.

While you do this, you should also invest in a metal lice comb. These fine-tooth combs are designed to remove the eggs from the hair follicle. You should use your comb every day for about an hour, cleaning the comb of nits and lice on a disposable tissue or towel between strokes.

Unfortunately, as we’ve mentioned, the lifecycle of head lice is about four weeks, so you’ll need to keep up treatment for at least this long to make sure you’re completely louse free.

Or you can always call us at Larger Than Lice, we’ll be more than happy to assist you!

Moms and Pros Tackle Lice

Head lice is one of the top reasons children miss school, yet there's no single, foolproof remedy.

One of the most time-honored approaches is nitpicking. This involves picking lice eggs, known as nits, out of hair. 

Robin Meigher of Potomac, Md., became a nitpicker after her 8-year-old daughter, Natalie, was sent home from school with head lice. She just never imagined that she'd still be picking a year later.

"They like to hang out close to the hairline," Meigher says of the nits as she searches through Natalie's hair using a pet comb with long metal teeth. 

When she spots one, she isolates the strand of hair. The tiny egg is no bigger than the tip of a ballpoint pen, and it's cemented to the hair with a natural glue-like substance made by the mother louse. 

"You can feel this little bump on the hair, and it doesn't come off easily at all," says Meigher. To remove the egg, she yanks out the strand of hair.

'No Nits' Policy Flawed?

Meigher hopes her diligent work will pay off. The goal is to keep Natalie in school. She's been sent home five times since her initial head-lice outbreak last year. School administrators enforce a "no nit" policy in an effort to contain the spread of head lice, yet there's little evidence to suggest that the policy is effective. Nationwide, it's estimated that 12 million to 24 million school days are lost annually.

During the initial outbreak, parents are encouraged to use over-the-counter head lice shampoos. Studies show these work well to kill off the live bugs, yet recent research has found that the bugs may have become resistant to the medicated shampoos.

Lice expert Richard Pollack of the Harvard School of Public Health says there's no real trick to prevention, short of isolating a child. 

“The more social your child is, the more friends he or she may have. If there's lots of head-touching, rug wrestling, these sorts of things, the more likely they may encounter head louse," Pollack says. 

This is why elementary school children seem to pass it around. Lice are blood-sucking parasites that live only on the hair of people, explains Pollack. They spread through direct head-to-head contact.

"The commonly held belief, which is folklore, is that lice are shared through things like combs and brushes and hats and helmets," Pollack says. 

Some authorities believe these personal items can help transmit head lice from one person to another. But Pollack explains the bugs cannot fly or jump. And studies show that once the lice are off the scalp, they die within hours. 

Since head lice don't transmit disease, Pollack views them as a nuisance. Usually, the only symptom is an itchy scalp. Pollack argues that school administrators should abandon their "no-nits" policy, and the nation's leading pediatric groups agrees.

In 2002, the American Academy of Pediatrics revised its head-lice position, stating that no healthy child should be excluded from or allowed to miss school because of head lice, and that "no nit" policies for return to school should be discouraged.

Myths about Head Lice

Head lice and humans go way back; the parasites have been found with their little claws locked around prehistoric mummy hair. And our eons-long relationship has given us plenty of time to build up myths about lice, too. Here, Harvard lice expert Richard Pollack dispels some of the most persistent folklore:

• Dirty Kids Spread Lice: Head lice have no preference for dirty hair or clean hair. "If you wash your hair three times a day or more, the lice on your head will just be clean lice," Pollack says.

• Pets Spread Lice: Human head-lice infestations don't come from pets -- our lice only like our blood.

• Brushes Spread Lice: Combs, brushes, headphones, hats and helmets have very little role in spreading lice. It's all the tumbling, playing and hugging that does it. In the vast majority of cases, lice are spread by direct head-to-head contact.

• Clean House to Get Rid of Lice: If your house is dusty or dirty, go ahead and clean, says Pollack. But that won't prevent or cure a lice infestation. The parasites can't survive for more than a day without a meal of human blood, and they generally aren't going to let go of your hair to hang out on your couch. Changing bed linens or vacuuming a car seat can only help, but chances of a louse being on a bed or a car seat are incredibly small.

• Shave Heads: "It's like using a cannon to kill a housefly," Pollack says. Completely shaving a head will get rid of lice eggs, but Pollack says that's a needless tactic when there are so many other effective and less drastic ways to solve the problem.

• Head Lice Can Kill: Nope, that would be body lice. Those parasites do thrive in dirty environments and are perhaps most infamous for spreading deadly typhus in the 19th century. Head lice just make you itch.

• Coat Your Head in Vaseline: Some people swear by the Vaseline or olive-oil treatments -- the idea is to suffocate the lice. But lice are extremely hard to suffocate, and to date, no studies have evaluated the efficacy of either substance. "Why not chose something that's been tested and shown to work?" Pollack says.

Head Lice Epidemics Are Breaking Out in Schools Across the U.S.

Head lice are nothing new, but the recent uptick in lice outbreaks could be due in large part to new policy changes.

Head lice in children are rampant in schools throughout the country. The CDC reports that an estimated six to 12 million young people get head lice each year, and there are indications that these itchy bugs are growing widely resistant to the insecticides commonly used to treat them.

A head lice outbreak earlier this month in the Harrisburg, Pennsylvania, school district was called “unprecedented,” as 100 children were found to have active lice infestations.

While head lice are nothing new and affect children regardless of socioeconomic status or geography, the recent uptick in lice outbreaks could be due in large part to new policy changes that encourage children to attend school with active head lice.

In 2015, the American Academy of Pediatrics (A.A.P.) issued a report on head lice urging school districts to abandon their previous “no-nit” policies that prevented children from attending school when they had active “nits,” or louse eggs. The A.A.P. argued that these “no-nit” policies potentially infringed on the civil liberties of students by keeping these children out of school for what is not technically an “infectious” medical issue. Lice infestations can occur when people are in close proximity, share articles of clothing, or otherwise come into contact with someone with active lice, but lice are not “infectious” in strict medical terms.

An October New York Times article on head lice reports: “The A.A.P. has fought hard against ‘no nit’ policies in schools, in the interest of reducing the school absence associated with head lice; the C.D.C. agrees, and schools are increasingly unlikely to exclude children for nits…”

These new lice policies can lead to widespread outbreaks, as schools often avoid checking for lice or notifying parents if there is an infestation. A Washington Post article this week on the topic reveals the current lackadaisical attitude toward lice: “Because of [the new policy], they no longer checked students, did not call parents to pick up their children and did not notify the parents there had been a report. My daughter’s teacher did not send out a note, email or even include the infestation in the newsletter that week.”

Parents are increasingly fed-up with these new school district policies that they feel contribute to mounting lice infestations. In Nevada this week, nearly 6,500 parents signed a petition demanding that the Washoe County School District change its new lice policy that the Reno Gazette-Journal reports, “allows students with lice or louse eggs to ride school buses and participate in all activities even if lice are not treated.” 

A mom who treated her daughter for head lice 15 times in the last school year started the petition, frustrated by the new district policy that allows children with active lice to continue to attend school.

It really comes down to accountability. Lice can be a common part of childhood, but parents need to take responsibility for effectively treating their children’s lice before sending them back to school, and school districts need to re-examine absurd policies that unnecessarily spread these bugs to others.

Lice On The Plane: Grounds For Grounding Passengers? It Happened To One Family On Delta

Here’s a word of advice if you’re planning to fly Delta Air Lines:

Do not scratch your head during the flight, except in the privacy of a restroom.

If you’re scratching your head as to why you shouldn’t scratch your head in public aboard a Delta jet, here’s a cautionary tale for you:

On a Delta flight from Paris to Nashville by way of Minneapolis last weekend, flight attendants told a family of five that they could not board the plane for the last leg of their trip home until they went to a Minneapolis hospital emergency department to be treated for head lice, all because the 6-year-old middle son began scratching his head mid-flight while waiting to use the bathroom.

The boy's mother checked to see why he was scratching and concluded that he had lice, and then several flight attendants rushed over to peer at the kid's head and gasp, "Oh, my God, he has lice." When the plane landed in Minneapolis, the flight attendants forced the family to stay on the plane while all the other passengers got off. The family was allowed off only after two "medical personnel" came on board to take the children's temperature. Huh?

I know all this because the kid's father, Clay Travis, happens to be both a lawyer and a writer, so, of course, he wrote and posted an approximately 2,500-word piece about the incident on Outkick the Coverage. (I emailed Travis to check in on his family, but he didn't respond.)

UPDATE

Travis emailed me Sunday afternoon. In his column, he had written that he and his youngest son, who's 2, were examined for head lice after the plane landed in Minneapolis and found to have none. I had asked Travis who examined them, and he said he had no idea. "It was an examination that was forced upon us by the Delta flight attendant," he told me. "There's no way Delta can defend that decision or suggest their employees should be in the business of demanding medical examination of minor children who fly on their airplanes."

Delta spokesman Anthony Black supplied me with a prepared statement about the Travis family's experience, but it raised more questions than it answered:

“Delta flight attendants are trained to [perform] a first-responder role as outlined by the FAA [Federal Aviation Administration]. Direct examination of a passenger outside of [the] first-responder emergency role is not within their scope.

So Delta considers head lice to be an emergency? "There is not a specific policy on dealing with lice," the airline's statement went on to say.

If there's no specific policy about lice, weren't the flight attendants acting outside of their scope, to use the airline's language, when they banned the Travis family? "Our flight attendants rely on their broad skill sets to make recommendations around passengers' fitness-to-fly," Black told me in an email. "I do not have specific details on what the flight attendants did with the child. It appears the flight was met by local paramedics."

Paramedics? Seriously?

Black also directed me to Delta's "conditions for passenger removal," a.k.a. Rule 35, "Refusal to Transport," Section F, "Passenger's Conduct or Condition"

"Delta may refuse to transport any passenger, or may remove any passenger from its aircraft, when refusal to transport or removal of the passenger is reasonably necessary in Delta's sole discretion for the passenger's comfort or safety, for the comfort or safety of other passengers or Delta employees," Section F states. It then lists 11 situations in which "Delta may refuse to transport or may remove passengers from its aircraft." It includes "when the passenger is barefoot" (No. 2) and "when the passenger has a malodorous condition" (No. 6).

As Black said, there is no mention of lice, but he cited situation No. 5 to explain Delta's treatment of the Travis family: "When the passenger has a contagious disease that may be transmissible to other passengers during the normal course of the flight."

Contagious disease? Sorry, but I think the Centers for Disease Control and Prevention is more of an authority than Delta Air Lines on what constitutes a contagious disease, and this is what the CDC has to say: "Head lice are not known to transmit any disease and therefore are not considered a health hazard." And the American Academy of Pediatrics says children should not be kept out of school just because they have head lice or nits (eggs) in their hair. I have to assume that the pediatricians, if asked, would also say that children should not be kept off of airplanes just because they have head lice or someone suspects they do.

Delta's actions made little sense to me, so I contacted my go-to head lice expert, Richard Pollack, a public health entomologist—bug specialist—based at the Harvard T. H. Chan School of Public Health. As Pollack describes it, his main day job is senior environmental public health officer for Harvard University, which occupies more than 300 buildings in several different cities. He helps set policies about how to deal with such issues as head lice. He is also the president and chief scientific officer of a company called IdentifyUS, which, as you might have guessed, is in the business of identifying pests and providing guidance on how to manage them.

Pollack and I go way back, probably to the time my now 18-year-old daughter was kicked out of school in second grade—on picture day, no less—because she had dead lice eggs, or nits, in her long brown hair (yes, they were dead—I’d treated her with malathion, a pesticide sprayed on crops to prevent mosquito infestation that’s relatively safe and virtually 100% effective in killing head lice and nits). But that’s a story for another day. (If you're interested, I, like Travis, felt compelled to write about my child's lice incident.)

“I had seen some references to this curious and troubling incident, but I wasn’t sure it was genuine,” Pollack said in response to my sending him the link to Travis’s column. “I’ve dealt many times with creatures found on planes, passengers and luggage."

In those cases, typically, a flight crew member notified airline officials that someone on the aircraft had or was suspected of having head lice, Pollack said. "Mass hysteria broke out." Once, a 747 sat parked on the end of the tarmac for three or four days because none of the flight crew or cleaning crew would dare to step foot on it. What could they spray to kill the lice? the airline asked. Oh, Pollack reassured the company, probably nothing could survive inside a plane that had sat for days on a hot tarmac.

"Rarely have logic and good sense prevailed," Pollack told me. "If lice could laugh, they’d be in absolute hysterics.”

Lice That Can Resist Drugs Have Infested Half the States in the U.S.

Head lice season has begun—the time of year when millions of creepy, crawly itchy bugs take up residence in kids’ scalps. A parent's immediate reaction to a lice epidemic might be to head to the drugstore for a fine-tooth comb and an over-the-counter remedy. But one biologist begs you to reconsider.

Kyong Sup Yoon at Southern Illinois University Edwardsville has devoted much of his career to figuring out how to tackle the lice infestation that’s been picking up steam in the U.S. in recent years. According to his preliminary numbers, at least 25 states play host to lice that are resistant to commonly available over-the-counter treatments.

The trouble is widespread use of pyrethroids, a family of insecticides used to kill indoor and outdoor pests from mosquitoes to bed bugs. The more often insects get exposed to these compounds, the greater the chances some will mutate and develop resistance to the drugs, then go on to pass that resistance to their offspring. In fact, says Yoon, it's hard to come by lice that lack pyrethroid resistance these days.

“Do the math,” says Yoon: Just one louse that manages to survive a pyrethroid treatment can live for up to a month and lay five eggs a day. “Multiply that by an elementary school, a community, and soon you’ve got plenty of resistant lice.”

Lice prevention is nothing new. Archaeologists have found evidence of lice combs at pre-Columbian sites in Chile, and U.S. pioneers made lice combs out of bone in the early 19th century. A 1916 medical journal even recommends dousing the head in “gasoline, or kerosene and vinegar, equal parts” to get rid of head lice.
To collect the thousands of modern lice needed for his research, Yoon turned to the professionals. With the help of expert Katie Sheperd, who trains people in the art and science of lice removal, Yoon created a nationwide network of volunteer pickers, who use combs and ethanol-filled vials to collect samples and record demographic information. Yoon and his team then study the lice in the lab to look for drug-resistant mutations.

While Yoon’s team has confirmed resistance in only 25 states, they believe the reality is likely much worse, as they report in a paper presented today at the 250th National Meeting & Exposition of the American Chemical Society. In 104 out of 109 lice populations already analyzed, they found high levels of gene mutations that make lice indifferent to drugstore treatments. The team is still analyzing data from the other 25 states.

“Parents who go to the drugstore to treat lice are part of the problem,” cautions Yoon. Overuse—and occasional misuse—of the same drug type only ups the odds that resistant bugs will develop and thrive. “Resistant genes are oversaturated in this nation.”

He acknowledges that newer, non-pyrethroid treatments are more expensive and more difficult to obtain; parents can only purchase them with a prescription from lice pros and dermatologists. But he adds that while body lice act as a disease vector, head lice do not. Getting them probably won’t give a kid much more than a case of the itchies and a day off of school, so it's worth it to take the time to seek prescription treatments. At the same time, we need to make sure our best weapons stay effective. Even now, Yoon’s colleagues are exploring ways to improve access to newer lice treatments without watering down their efficacy over time.

Next, Yoon and his team will focus on whether drug-resistant lice in the United States have also developed metabolic changes that can make future outbreaks even harder to control. He won’t be surprised if those changes are already well underway. After all, says Yoon, when humans overuse head lice remedies, they contribute to real change in the bugs' genes—no matter how good our itchy intentions. 

The truth about lice and how to protect your kids

Many of us remember whispering about the classmate who left school early because they had lice, the evasive bug that make scalps their homes. The unlucky, banished kid considered dirty and unkempt, the object of our pity and disgust.

The idea lice are the direct consequence of poor personal hygiene is one of the many myths about the age-old condition. Krista Lauer, medical director of Lice Clinics of America, said lice do not discriminate between the clean and dirty members of our society, or the rich and poor.

Lice are "equal opportunity infesters," said Lauer, who argues it's about time we dispel those stigmas.

Lice infect millions each year

Lice infestations are most common in young children, who often contract the bugs through the way they play and interact with one another.

The U.S. Centers for Disease Control and Prevention reports about 6 million to 12 million infestations occur in kids ages 3 through 11 years old each year. 

'Super lice' are more prevalent

Odds are if you get lice, you'll get what is colloquially called “super lice”, an evolved type that has grown resistant to over-the-counter treatments after years of exposure to the chemicals. 

Lauer said research published last year in the Journal of Medical Entomology found 98% percent of head lice collected in 48 states were resistant to lice treatment products. 

Lice do not jump, swim or fly

Lice crawl. They can't jump, fly or swim.

They're bugs of opportunity, Lauer said, spreading mostly through head-to-head contact. 

"That's why we see lice more commonly in young children," Lauer said. "Whenever there's an opportunity for one head to another, that provides the opportunity for lice to move from one head to the next."

Lice are spread in children by playing in close proximity, at sleepovers, while playing video games closely, and even, posing for group pictures.

What about selfies?

Lauer said selfies can be a cause of spreading lice. Anecdotally, she explained, doctors are seeing lice in older kids.

Hats, helmets and hairbrushes

Lice latch onto human hair follicles and rely on sucking blood from a patient's scalp in order to survive. If they're removed from a scalp, they can't live very long. 

Therefore, Lauer said, it's "extremely rare" a person will get lice by putting on someone's hat, using someone else's hairbrush or putting on a helmet.

In fact, when it comes to athletics, Lauer said people should use another person's helmet if the alternative is no protection. Why? Head injuries are true medical problems while a lice infestation is a "medical nuisance" with no long-term health effects aside from scratching and poor sleep.

Lice do not carry disease.

What about water?

Taking a swim can't get rid of lice, which go into a type of hibernation state when in water. Lice can survive up to six hours submerged.

What to look for

• Parents doing a head check on their children should look for live bugs living close to the scalp and small eggs attached to hair follicles.

• A scratchy kid is a good indicator of lice. People with lice also may have a hard time sleeping and may have sores on their head from scratching.

• Parents should look for such symptoms particularly after kids have been together, such as after a family vacation or summer camps.

The next step is getting diagnosed by a doctor, pediatric nurse or at lice clinic, which administer a lice removal kit. Removal includes rubbing a gel-like oil on the head, which kills the lice bugs and a special comb to pull the eggs from the hair.

How to avoid lice

Particularly for parents, avoiding head lice is very important. A kid with head lice can easily infect the entire family.

• Parents should try to educate kids about not having head-to-head contact with other children and to avoid sharing hats and helmets if possible. 

• If a lice infestation is found, parents should call the parents of other children who may be infected.

"Don't be embarrassed, this is common," she said. "If anything, it means your kids are engaged with play with other people."