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Lice

(Pediculosis)

What are lice?

Lice are tiny insects that can infest the skin anywhere on the body. Lice infection is characterized by intense itching.

Lice are highly contagious, spreading from person to person by close body contact, shared clothes, and other items (such as hats, hairbrushes, and combs). There are 3 types of human lice:

  • Head lice

  • Body lice

  • Pubic lice

Facts about lice

Head lice

  • Head lice are seen mostly in child care settings and among school-aged children. Infestations cross geographic and socioeconomic boundaries.

  • The child usually has itching in the head area.

  • Lice, or the eggs (called nits), can usually be seen on the hair, behind the ears, and on the neck. Lice can also be found in the eyebrows and eyelashes.  

Body lice

  • Body lice are usually seen in people with poor hygiene.

  • Body lice are rare in children.

  • Body lice cause severe itching, which is often worse at night.

  • With body lice, in some cases lice and eggs can be found in the seams of clothing.

Pubic lice

  • Pubic lice are very contagious and can be transmitted through sexual contact or by contaminated items, such as towels and clothes.

  • Pubic lice can affect the pubic hair, but can also cause infections of the hair on the chest, abdomen, thighs, and eyebrows.

  • Itching of the affected area is a common symptom of pubic lice.

How are lice diagnosed?

The eggs laid by lice are usually visible to the naked eye, making it easy for your child's health care provider to diagnose. Pubic lice leave small brown spots on the parts of clothing that come in contact with the genitals or anus.

Treatment for lice

Specific treatment for lice will be determined by your child's health care provider based on:

  • Your child's age, overall health, and medical history

  • Extent of the infestation

  • Your child's tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the infestation

  • Your opinion or preference

Lice are treatable. Treatment may include:

  • For head lice and pubic lice:

    • Application of a medicated cream rinse or shampoo is usually effective treatment for head and/or pubic lice. Specific instructions need to be followed. Discuss this with your child's health care provider. Examples of medicated cream rinses or shampoos include:

      • Malathion. This is a new treatment that is safe and effective for lice and nits.  

      • Lindane. Because of toxicity, do not use if there are open sores on the head.

      • Pyrethrins. This treatment does not kill nits (lice eggs).

      • Permethrin cream rinse. This treatment does not always work due to lice resistance.

    • Nits need to be removed from the hair with a fine-tooth comb.

    • Combs and brushes should be soaked in hot water with the shampoo for a period of at least 15 minutes.

    • Children can return to school or day care the day following their first treatment for head lice.

  • For body lice:

    • Medications are usually not needed to treat body lice.

    • Treatment for body lice usually consists of improving hygiene and washing clothes.

    • Bed sheets and blankets should be washed in hot water and dried in a hot dryer.

  • Check all other household members closely to see if anyone else needs to be treated.  

  • Wash all bedding and clothing in hot water (130° F or 54° C), or seal items that cannot be washed in a plastic bag for 2 weeks.  

  • Do not use 2 forms of treatment at the same time. If a treatment does not work, use a different treatment, or contact your health care provider.

Lice - WellSpan Health

Online Medical Reviewer: Freeborn, Donna, PhD, CNM, FNP
Online Medical Reviewer: Berman, Kevin, MD, PhD
Last Review Date: 2015-04-30T00:00:00
Last Modified Date: 2015-05-10T00:00:00
Posting Date: 2008-11-30T00:00:00
Published Date: 2015-05-10T00:00:00
Last Review Date: 2007-03-30T00:00:00
© 2015 WellSpan Health. All Rights Reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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