It’s a parent’s nightmare: the call that your child has lice. Or, worse, being told that both of your daughters have lice, and wait…you do too! (True story from the week before Christmas, 2012.) So – how do you treat head lice?

Based on my own experiences at home, 19 years of teaching, and my professional research skills (I scoured all the most reputable medical sites), I have gathered together information to guide you through this trying time.

Here’s what you need to know:

Lice are the live bugs, about the size of a sesame seed (2 – 4 mm) and brownish in colour. (When we were at Live with Regis and Kelly years ago, during the commercial break Kelly Ripa was lamenting dealing with head lice, and pointed out they are hard to get out of a brunette’s head, because they are the exact colour of – pointing at me – “that lady’s hair”.)

Nits are the eggs, which are whitish grey, tan or yellow. They stick to the hair close to the scalp. They can look like dandruff, but are much harder to budge. (If you can move the flake very easily, it’s probably dandruff.) It takes 7-10 days for them to hatch, which is very important information to keep in mind.

Removal is a multi-step process. (Stop scratching your head and read carefully!)

Chemical treatments from drug stores (over the counter or prescription) can be used to kill the live bugs. Apologies to my all-natural friends, but this is a highly recommended first step. There is little evidence to indicate that all-natural remedies work completely, though there is also some evidence to indicate that lice are becoming resistant to some of the popular chemical ingredients, so it’s a tricky game.

That said, complete physical removal of lice and nits without chemicals can be successful, but I would leave that to professionals or at least someone experienced. Most chemicals do not kill the eggs, but there are some treatments now that do claim to kill the eggs too, so read your package information carefully. (When it comes to natural remedies, many swear by the suffocation method, where you coat the hair completely in some sort of oil, etc., but this requires at least 8 hours – i.e., under a shower cap overnight – and still does nothing to kill the eggs.)

Next, you want all bugs combed out of the hair so that any surviving live ones don’t have an opportunity to lay any more eggs. A very narrow-toothed lice comb is really helpful for this You also want to try to remove (pull out) as many of the nits near the scalp as possible, but it can be a tricky, overwhelming process. (Apparently now there are some chemical treatments which say you don’t need to comb out the hair after, but I’m not sure why you wouldn’t still want to do it just in case?)

Then what?

Daycare and school board policies can vary widely, and I know our local health unit says that lice are a nuisance but not a health concern, and students should not be excluded from school because of them. In my opinion, a parent is responsible for all of the steps above before sending a child back to school.



Keep in mind, it is very possible that you will miss a nit or two (or many more). The good news is that it takes 7-10 days for them to hatch, and then 7-10 days for a new louse to mature and lay eggs of its own. For that reason, you will want to continue combing the hair out for new bugs that have hatched from the missed nits. There is no need to panic and repeat a chemical treatment if another bug is spotted; as long as they are being combed out before they can lay any more eggs, the cycle will be stopped. Most chemical products recommend a repeated dose after 7-10 days to remove any newly hatched bugs.

Personal tip: I found white conditioner comb-outs to be very effective at this phase. Here are the steps.

1. Dampen the hair, 2. Coat it in white conditioner, 3. Use the nit comb to do small sections, starting at the front, wiping the comb on a white paper towel after each pass so you can easily see if you’ve caught any bugs. Repeat this every couple of days for at least two weeks.

I also want to mention (not sponsored) that when our family was hit years ago, we went to Nitwits (they do a complete physical removal of lice and nits with a 100% guarantee) and they were fantastic; I know most communities now have services where either you go to them or they come to you for lice removal, and if it’s in your budget it’s great to have the professional touch.

Nitwits also gave us a mint spray to use to help repel lice in the future (it does NOT kill them; they just don’t like the scent and tend to stay away from heads that smell minty).

Now, what to do with all your “stuff”:

Note that lice cannot live away from the scalp for more than 1-2 days. Blankets, pillows, coats, clothing and stuffed animals that haven’t been used in a while are FINE.

To be on the safe side, wash any bedding or clothing (including outerwear) that has been used within the last few days (hot wash, high heat dryer setting). Items like stuffed animals can be placed in an airtight bag for 2 weeks. You can also vacuum surfaces like mattresses, rugs, upholstered furniture and car seats for peace of mind.

“Fun” facts:

I hope everyone knows this by now, but nits and lice are no indication of cleanliness; some sources say lice actually prefer clean hair.

Lice spread through hair-to-hair contact or by sharing items such as brushes and hats. Lice do not fly, just crawl very quickly.

If you think your child got lice “again” it’s extremely likely that it is more a case of having lice “still” – though I know parents hate to hear that!

Kids with lice tend to have itchy heads (due to the allergic reaction that occurs to the saliva secreted by the lice when they bite the scalp) but every itchy head is not indicative of lice! (You’re still scratching, aren’t you?)

2 comments on “How To Treat Head Lice: A Complete Guide”

  1. In my experience, the white conditioner method with a METAL lice comb done every three days for two weeks or so is what worked for us. NO chemicals needed at all. This is so much healthier. The girls in my daughter’s grade two class who used the chemical method and combed out a time or two continued to have lice problems a month later because they hadn’t been able to remove all the nits and (unfortunately) felt confident in the over the counter chemicals.

    • That’s great your method worked with no chemicals! Interesting point about people feeling overconfident in the chemical treatments – I know from experience that the combouts are essential!

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