Skip to content
  • About
  • Contact
  • Contribute
  • My Book
  • Careers
  • Podcast
  • Transcripts
  • Speaking
KevinMD
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • My Book
    • Careers
    • Podcast
    • Transcripts
    • Speaking
KevinMD
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • My Book
    • Careers
    • Podcast
    • Transcripts
    • Speaking
  • About Kevin Pho, MD, Founder of KevinMD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Custom enhanced author page pricing
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Privacy Policy
  • Recommended services by KevinMD
  • Subscribe to the newsletter
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • Upgrade to the KevinMD enhanced author page

Common sense guidelines for children with lice

Roy Benaroch, MD
Conditions and Diseases
May 25, 2015
Share
Tweet
Share

A new clinical report from the American Academy of Pediatrics is a rare beacon of coherent thought about lice and children.

Rather than humiliating children and driving them away like lepers, the AAP recommends common-sense steps to identify and treat lice. Some facts really shouldn’t be in dispute:

  • Lice is not a serious illness or a significant hazard to health. They don’t make anyone sick, and they do not spread any disease.
  • Lice is not a sign of poor hygiene or parental failure.
  • Lice cannot jump or fly from person to person — they’re only transmitted by close and prolonged personal contact.
  • Transmission via objects — combs, hats, and pillowcases — is uncommon.
  • Most lice transmission occurs in neighborhoods and households, notin schools.

Nonetheless, a case of lice in a school seems to cause hysteria and panic. Children are marched through the “nurse’s office”, examined by a (sometimes) poorly trained parent, and sent home — usually because of a few flecks of dandruff or debris. Most kids sent home because of lice don’t even have them. Parents miss work, kids are humiliated, and households are turned upside down with washing and spraying and vacuuming and combing and worrying. There are whole industries, now, of people who can comb your child’s hair or use special treatments guaranteed to rid them of the pesky varmints.  To treat what is, at most, an itchy scalp.

Here’s what parents should keep in mind when they suspect their child has lice:

  • Lice are not difficult to diagnose. They run around the scalp. Look. If they’re there, you’ll see them. You can also “catch” them on a comb.
  • Lice are not little fluffy bits of fuzz or little flakes of nothing.
  • Lice eggs (nits) look like sesame seeds, and they’re literally glued to individual hairs, down near the scalp. The live ones, ones that will hatch, are within ½ inch of the scalp. Any nits further out are dead or already hatched.
  • OTC lice treatments (like “Nix”) work very well when used as directed. Repeat the treatment in 9 days to kill newly hatched eggs before the little ones have a chance to mature and lay more eggs.
  • Most treatment failures are from improper use, failure to repeat treatment, or from re-infestation. True resistance to OTC products does occur, but it is not common. The people yelling about resistance are usually the same people who are trying to sell you something.
  • Combing can help treatment work (by dislodging viable eggs and removing live lice.)
  • Nit removal is not necessary for effective treatment, but some misguided schools insist that a child be nit-free before returning. That’s stupid, and it’s not recommended by legitimate health authorities. But, hey, I don’t make the rules.
  • It’s prudent to change and wash pillowcases — though even that is probably not necessary, as only 4 percent of pillowcases harbor live lice, even when someone with lice sleeps in the bed. Live lice cannot live off of a warm body for very long.
  • Consider washing items that have recently (within 2 days) come in contact with a child’s head, like hat or hair accessories, but exhaustive and widespread cleaning and vacuuming efforts are not needed. Widespread use of chemical sprays in the house is dangerous and unnecessary.

Most importantly, as the AAP says, it doesn’t make any sense to exclude children with lice or nits from school. That doesn’t decrease transmission, and it doesn’t prevent any important illness. Children with lice should be (correctly) identified and (correctly) treated, but they don’t need to be embarrassed, excluded, or humiliated.

Lice can make you or your child itch, and that’s not pleasant. But, really, they’re just another thing that you shouldn’t worry about. Safe treatment isn’t very difficult, and it usually works. It’s only our own sense of ick that’s turned lice and lice-removal into a big deal.

Now, excuse me while I scratch my head … writing this has made me itchy.

Roy Benaroch is a pediatrician who blogs at the Pediatric Insider. He is also the author of A Guide to Getting the Best Health Care for Your Child and the creator of The Great Courses’ Medical School for Everyone: Grand Rounds Cases.

Prev

Bruce Jenner is evolving the birds and the bees talk

May 25, 2015 Kevin 4
…
Next

This is why it's so hard to rein in mammogram screenings

May 25, 2015 Kevin 16
…

Tagged as: Pediatrics

< Previous Post
Bruce Jenner is evolving the birds and the bees talk
Next Post >
This is why it's so hard to rein in mammogram screenings

ADVERTISEMENT

More by Roy Benaroch, MD

  • Goodbye, Benadryl: It is time for you to retire

    Roy Benaroch, MD
  • Telemedicine overprescribes antibiotics: Are you really receiving the best care over the phone?

    Roy Benaroch, MD
  • No, phones don’t cause horns to grow on skulls

    Roy Benaroch, MD

More in Conditions and Diseases

  • Underage gambling thrives on offshore betting sites

    Kayvan Haddadan, MD
  • The emotional weight of choosing food allergy treatment

    Amanda Whitehouse, PhD
  • How AI is reshaping applied behavior analysis care

    Brad Smith, PhD
  • What the polycystic ovary syndrome name change means

    Sathya Narayanan, PharmD
  • Loneliness in successful men hides behind abundance

    J.H. Lynn
  • How anchoring bias in medicine missed a heart attack

    Dr. Ahmed Azab
  • Most Popular

  • Past Week

    • When men falling behind unravels families and futures

      Osmund Agbo, MD | Physician
    • Generalist physicians and AI are a comparative advantage

      Jeremy Fish, MD | Health Technology
    • 1 in 12 medical billing companies just vanished

      GetPracticeHelp | Physician Finance
    • The health care workforce crisis we keep ignoring

      Narinder Singh Parhar, MD | Health Policy
    • Why a malpractice lawsuit follows you after you win

      Tim Brocklehurst, MBA | Conditions and Diseases
    • Patients are turning to AI because doctors lack time

      Arthur Lazarus, MD, MBA | Health Technology
  • Past 6 Months

    • The MCAT requirement persists as a norm, not as a tool

      Aniruth Ananthanarayanan | Medical Education
    • Polycystic ovary syndrome is more than ovarian

      Oluyemisi Famuyiwa, MD | Conditions and Diseases
    • DEA fear is reshaping how doctors prescribe

      Ronald L. Lindsay, MD | Physician
    • Metrics got you into medicine and are making you unhappy in it [PODCAST]

      The Podcast by KevinMD | Podcast
    • 3 fixes for primary care access in the ChatGPT era

      Payam Zamani, MD | Health Technology
    • The residency personal statement is an identity problem

      Kathleen Muldoon, PhD | Medical Education
  • Recent Posts

    • A hard week is not a verdict on a physician’s career

      Sofia Dobrin, MD | Physician
    • Underage gambling thrives on offshore betting sites

      Kayvan Haddadan, MD | Conditions and Diseases
    • Who are you when the white coat is off?

      Seleipiri Akobo, MD, MPH, MBA | Physician
    • The emotional weight of choosing food allergy treatment

      Amanda Whitehouse, PhD | Conditions and Diseases
    • How to use patient wearable data in cardiology visits

      Tarpan Patel | Health Technology
    • How AI is reshaping applied behavior analysis care

      Brad Smith, PhD | Conditions and Diseases

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • When men falling behind unravels families and futures

      Osmund Agbo, MD | Physician
    • Generalist physicians and AI are a comparative advantage

      Jeremy Fish, MD | Health Technology
    • 1 in 12 medical billing companies just vanished

      GetPracticeHelp | Physician Finance
    • The health care workforce crisis we keep ignoring

      Narinder Singh Parhar, MD | Health Policy
    • Why a malpractice lawsuit follows you after you win

      Tim Brocklehurst, MBA | Conditions and Diseases
    • Patients are turning to AI because doctors lack time

      Arthur Lazarus, MD, MBA | Health Technology
  • Past 6 Months

    • The MCAT requirement persists as a norm, not as a tool

      Aniruth Ananthanarayanan | Medical Education
    • Polycystic ovary syndrome is more than ovarian

      Oluyemisi Famuyiwa, MD | Conditions and Diseases
    • DEA fear is reshaping how doctors prescribe

      Ronald L. Lindsay, MD | Physician
    • Metrics got you into medicine and are making you unhappy in it [PODCAST]

      The Podcast by KevinMD | Podcast
    • 3 fixes for primary care access in the ChatGPT era

      Payam Zamani, MD | Health Technology
    • The residency personal statement is an identity problem

      Kathleen Muldoon, PhD | Medical Education
  • Recent Posts

    • A hard week is not a verdict on a physician’s career

      Sofia Dobrin, MD | Physician
    • Underage gambling thrives on offshore betting sites

      Kayvan Haddadan, MD | Conditions and Diseases
    • Who are you when the white coat is off?

      Seleipiri Akobo, MD, MPH, MBA | Physician
    • The emotional weight of choosing food allergy treatment

      Amanda Whitehouse, PhD | Conditions and Diseases
    • How to use patient wearable data in cardiology visits

      Tarpan Patel | Health Technology
    • How AI is reshaping applied behavior analysis care

      Brad Smith, PhD | Conditions and Diseases

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Common sense guidelines for children with lice
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...