Head Lice When Does it Stop

Lice. It makes my head itch just thinking about it! It is a word that children, parents, and teachers dread to hear. I am sure most of you have experienced lice first hand – whether it was a family member you were trying to treat or if you were someone who frantically checked your child’s hair repeatedly because you received a note from school that lice was going around the classroom.

Lice (plural for louse) are small, microscopic bugs that can live on people’s scalp at the hair shaft and feed off of human blood. The itchy sensation occurs with each bite the lice take. Some key things that people see in someone who has lice are the bugs themselves (sometimes it looks like a piece of dirt that is jumping or crawling), the eggs – also called nits (can be mistaken for dandruff), and the person constantly scratching or saying something is tickling his or her head.


School nurses are usually the ones who most often check for lice, and they either tell the family to treat at home or be seen by their pediatrician if they are concerned. Usually once someone in the class is diagnosed with lice, the school nurse examines everyone in the classroom. This is because lice are simply that contagious. It is easy for a louse to jump from one head to another if the people are in close proximity. A louse will then lay multiple eggs that will hatch in 1-2 weeks.


There are two main types of treatment: pediculicidal medications (creams that alter the parasite’s cell membrane function to kill the actual louse) and ovicidal therapy (creams that inhibits cholinesterase which kills the eggs). Some are a one time treatment that you rub into the scalp like a shampoo, and others you apply two or three times at one to two week intervals. Some kits come with nit combs and some do not.


The nit combs do not actually treat or eradicate the problem. Quite honestly, the only reason to need a nit comb is so that others do not think that you still have lice. The eggs/nits are small and can only survive on the hair shaft very close to the scalp. Once the egg hatches, the casing of the egg remains on that part of the hair follicle and has the hair grows, the casing moves farther from the scalp and becomes more noticeable. These are especially difficult to remove if someone has long, thick hair. The school can mistakenly think a child has not been treated when they see these casings and may not allow them back in school. This is the tricky part, because yes – sometimes the lice can be resistant to the medications and can require multiple treatments, but sometimes it is just the casings from eggs and lice that have already been killed.


If you are concerned that you or a family member has lice, seek medical attention. Depending on the extent of the infestation, the single person or the whole family might be treated. It is also best at the time of treatment and again in 1-2 weeks to thoroughly clean the house and wash the sheets. This is because lice survive on human blood so are normally on a scalp, but they can survive up to two days out in the open. I hope this is helpful, but I hope for most of the readers, you do not have to deal with lice!


Jennifer Adair M.D.

Jennifer Adair, M.D., was born and raised in Mobile. She graduated from Davidson High School in 2002 and received her Bachelor of Science in Chemistry at The University of Alabama in 2006. She completed her medical training at the University of South Alabama College of Medicine, and pediatric residency at the University of Nevada College of Medicine – Las Vegas and the University of South Alabama. She joined Children’s Medical Group in July 2013 and currently practices at their Airport office. Jennifer and her husband, Cory, reside in Mobile with their dogs, Fitz and Barkley.