As children return to classrooms, families are preparing for new routines and activities, but doctors are also warning parents to watch for head lice, a common childhood infestation that is often noticed more frequently in late summer and early autumn.
September is recognised as National Head Lice Prevention Month in the United States. Dr. April Armstrong, chief of dermatology at the University of California, Los Angeles, said cases can occur throughout the year but are often identified more frequently when children return to school and resume close-contact activities.
The US Centers for Disease Control and Prevention estimates that up to 12 million head lice infestations occur each year among American children aged three to 11.
Head lice are tiny, wingless insects that feed on human blood and are usually found on the scalp. Adults are about the size of a sesame seed and can range in colour from tan to grayish-white. Their eggs, known as nits, are attached to hair shafts close to the scalp with a glue-like substance.
Doctors stress that having head lice is not related to poor hygiene or an unclean home. The insects do not spread disease, but they can cause considerable itching, irritation and anxiety because of the stigma surrounding infestations.
Head lice usually spread through direct head-to-head contact because the insects crawl but cannot jump or fly. This makes children particularly susceptible as they frequently play or interact at close range. Lice can occasionally spread through objects such as combs, hats, helmets and pillowcases, although this is considered less common because the insects generally survive for less than a day away from the scalp.
An itchy scalp, especially around the ears and the back of the neck, is the most common symptom. However, people experiencing their first infestation may not develop itching for several weeks. The most reliable way to identify an infestation is to find live crawling lice during a careful examination under bright light. A fine-toothed lice comb can help.
Treatment can include over-the-counter or prescription products approved for head lice, including medications containing permethrin or pyrethrin. Careful combing is often used alongside medication, and some treatments require a second application after seven to 10 days.
Doctors warn against repeatedly treating an itchy scalp without confirming an infestation. Dandruff, dirt, scabs and other substances can sometimes be mistaken for lice or nits, while unnecessary treatments can cause skin irritation.
Cutting or shaving hair is generally unnecessary. Long or thick hair may require additional treatment and careful combing but can be treated without removal.
There is no completely reliable way to prevent head lice. Parents can regularly check children’s hair, discourage head-to-head contact during known outbreaks and teach children not to share combs, hats or similar personal items.
If lice are confirmed, clothing, towels and bedding used during the previous two days can be washed and dried with heat, while combs and brushes can be soaked in hot water. Extensive household cleaning, fumigation and pesticide sprays are not considered necessary.
Doctors also stress that children with head lice should not be shamed, isolated or routinely kept away from school. Head lice are considered a nuisance rather than a serious health threat, and prompt identification and appropriate treatment can help limit their spread.
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