The Nit pickers answers frequently asked questions about head lice*

About lice
Where do head lice come from?
What is a nit?
How many eggs can a head louse lay in a day?
How do I know if a nit is viable?
How are head lice spread?
Is it true that nits closest to the scalp are alive while those away from the scalp are not?
Can head lice carry disease?
When head lice transfer from one head to another, how soon can they start laying eggs?
Are head lice able to fly or jump onto my child’s head?
How long do head lice live?
Is there a head lice season?
Is it possible to get head lice from our dog or cat?

Who is at risk?
Since head lice are not life threatening, why be concerned?
Who is at risk of getting head lice?
Do African American children get head lice?
Do lice prefer a certain blood type?
Are head lice more prevalent in warmer climates?
Why do some people get head lice over and over again while others never do?

Prevention
What can I do to prevent a case of head lice?
Is it true that you should never share a hat or comb?
Can using hairspray prevent head lice?
Is there any way to ensure never getting a case of head lice?
Won’t shaving my child’s head solve the problem?

Symptoms
What are the symptoms of head lice?
How do I know if my child has head lice?
Is it true that itching is the first sign of head lice?
How long can a person have a case of head lice before realizing it?
What is a cryptic infestation?

Treatment
What is the Shepherd Method™?
Does a case of head lice ever go away without intervention?
What is the quickest way to get past a case of head lice?
What should I do if I find head lice on my child?
If a child has head lice, should the whole family be treated?
What treatment options are available for my family?
What types of products should I look for when shopping?
Does Cetaphil work?
Do home remedies work?
Does putting mayonnaise on your head work?
Why didn’t the products we bought at the pharmacy work?
I treated my daughter using an over-the-counter product as directed and spent many hours combing through her very long hair. After about a week, I checked her head again and found a few more nits, so I repeated the treatment process and washed all linens, etc. Should I retreat her?
How do The Nit Pickers' products differ from what I see at the pharmacy?

House cleaning and hygiene
I've heard the worst part of having head lice is all the cleaning. Is this true?
How much cleaning is necessary when my child has head lice?
Does having head lice mean that person lives in a dirty home or has poor hygiene?
Do head lice prefer clean or dirty hair?
I'm shrinking our clothes by washing them with hot water and putting them in the dryer. Is there a better way to kill any lice that might be in our clothing?

School policy
What is a No-Nit Policy?
What is a Live-Bug-Only policy?
Whom should I notify if my child has lice?
If my child has head lice, should I tell the school nurse?
How can I get my child's school more involved in this health issue?

Health Insurance
Does my health insurance pay for nit removal services?


About lice

Where do head lice come from?
They have been around since the beginning of mankind. Nits have even been found on the hair of Egyptian mummies when their tombs were opened.

What is a nit?
Nit is just another name for egg.

How many eggs can a head louse lay in a day?
A single female louse lays eggs twice a day and four to five eggs each time. Multiply that by 10, 20 or even 40 or more lice that might be on the head and it's easy to see how a severe infestation can develop quickly.

How do I know if a nit is viable?
The only way to be certain if a nit is to look at it under a microscope. This is one of the main reasons that no-nit policies exist.

How are head lice spread?
Head lice are spread primarily through head to head contact. That is why communication with those individuals that you've had recent contact with is so important.

Is it true that nits closest to the scalp are alive while those away from the scalp are not?
Lice only know they are on hair, not where they are on the strand. Nits are normally found close to the scalp but may be an inch or more down the hair shaft, especially in warmer climates where lice move more freely throughout the hair.

Can head lice carry disease?
Since head lice have a low morbidity rate and are fairly host specific, the odds are low that they will spread disease. Some researchers believe that they carry disease, and studies are being done in that area to prove it.

When head lice transfer from one head to another, how soon can they start laying eggs?
If the head lice are fertilized females, they may begin laying eggs immediately. Head lice generally travel in harems, often consisting of seven or eight females and one male. As females will lay eight to ten eggs daily, a simple case of head lice can escalate very quickly.

Are head lice able to fly or jump onto my child’s head?
No. Head lice do not jump or fly as they have no hind legs or wings.

How long do head lice live?
An adult head louse can live on a person’s head for up to 30 days. They are not able to survive more than 24 hours off the head. A nit, separated from the head, will die. It needs the warmth of the body to incubate (much like a chicken sifting on an egg).

Is there a head lice season?
It seems that there are more cases of head lice during the school months but this is not because of a lice season. When children have more contact with each other, we see an increase in numbers. Many schools also enforce head lice policies, thereby increasing awareness of the problem.

Is it possible to get head lice from our dog or cat?
Head lice live and reproduce on human heads only. They are not transmitted by any other animals.

Who is at risk?

Since head lice are not life threatening, why be concerned?
Head lice are highly contagious. If we don't rid ourselves of them we will spread them to everyone around us. An infestation may lead to other illnesses and, rarely, death.

Who is at risk of getting head lice?
Everyone is at risk. If you have contact with an infected person, you can get them.

Do African American children get head lice?
Anyone, including African Americans, can get head lice. They are less likely to get head lice because of the shape of their individual hair strands but they are far from immune.

Do lice prefer a certain blood type?
Head lice will feed on any blood type, but some blood types are more attractive than others. Once they begin feeding on a certain type, they need the same blood type to survive. Studies conducted by Terry Meiking, research assistant professor, Department of Dermatology and Cutaneous Surgery at the University of Miami, found that head lice intentionally avoid an incompatible blood type (especially where the Rh factor is different) unless they were starving. When a louse consumes another blood type, its intestinal tract explodes. But if the louse laid nits prior to feeding, those nits are able to feed on the new blood type.

Are head lice more prevalent in warmer climates?
No. The only difference a warmer climate makes is the lice are more apt to move up and down the hair shaft and lay eggs throughout the hair, while in colder climates, they generally stay closer to the scalp.

Why do some people get head lice over and over again while others never do?
There are many reasons why some people seem to get lice repeatedly. They may have not eradicated the first outbreak completely. If the lice were not removed from their living space, they may be re-infested. Studies have shown that head lice leave a scent that is attractive to other head lice—this is one reason to be extra diligent in rechecking someone for three months after the outbreak.

Prevention

What can I do to prevent a case of head lice?
Pulling long hair back is extremely important. Covering the scalp with hair makes it harder for lice to attach themselves to the scalp. If a child has contact with someone carrying lice, take extra care in checking his or her head. Additional measures include running a good lice comb through the hair once a week or more.

Be aware of the signs of head lice:

  • Itching
  • Swollen glands
  • Sleepiness after a good night's rest
  • A rash at the back of the neck

Is it true that you should never share a hat or comb?
Head lice are spread through head to head contact. They cannot live away from a human head for more than 24 hours, but sharing hats, helmets and combs is never a good idea.

Can using hairspray prevent head lice?
Some people believe that lice won’t attach to dirty hair, so they overuse hairspray and gels. But using these products will not prevent head lice.

Is there any way to ensure never getting a case of head lice?
No. Lice feed on blood; we all are potential hosts for head lice. That's why it is so important to always exercise proactive measures.

Won’t shaving my child’s head solve the problem?
Yes, but how many children want bald heads? Shaving to rid lice does not mean the hair is cut short—it means shaving away all the hair on the head.

Symptoms

What are the symptoms of head lice?
Besides itching, symptoms of head lice may include a low-grade fever, swollen glands, a rash at the nape of the neck, bags under the eyes, and feeling tired. Head lice are nocturnal, meaning that they are more active at night than during the day.

How do I know if my child has head lice?
Check your child’s head on a regular basis and run a lice comb through the hair once or twice a week. Be aware of your child's behavior and watch for telltale signs.

Is it true that itching is the first sign of head lice?
Itching is caused by an allergic reaction to the saliva that lice secrete when feeding. The saliva keeps the blood from clotting, making the feeding process easier. About half of those who get head lice are not allergic to the saliva and therefore don’t itch. Even if someone is allergic, it takes approximately two weeks to build up enough lice saliva to cause itching

How long can a person have a case of head lice before realizing it?
It is possible to have head lice for years without knowing it, especially if the person does not experience itching. Generally by the time someone identifies head lice, he/she has had head lice for four to eight weeks.

What is a cryptic infestation?
Occasionally a person believes that he or she has lice, even though none can be detected. The problem could be a biting insect or mite that is not present at the time of examination. Insects like mosquitoes, fleas, or bedbugs may bite and then leave. Hair care and laundry products, industrial fibers, an undiagnosed disease, or even anti-louse treatments may be causing itching and irritation.

Treatment

What is the Shepherd Method™?
The Shepherd Method™ is a safe, non-toxic, strand-by-strand method of nit removal developed by Katie Shepherd. Shepherd founded Lice Solutions RN, Inc. as a nonprofit 501 (c) 3 tax exempt organization whose mission is to provide community awareness, individual and group screenings and complete nit removal.

The Nitpickers staff has been trained to use the techniques developed by Shepherd.

Does a case of head lice ever go away without intervention?
Lice nearly always continue to multiply and to spread to others. Only on a rare occasion would a case of head lice go away by itself.

What is the quickest way to get past a case of head lice?
There is no shortcut. Tedious, time consuming nitpicking and checking everyone with whom the person has had contact is the first step toward eliminating head lice. A good comb (when used properly) can eliminate up to 85 percent of the problem. Even when you think you have done the job right, don't let your guard down. The life cycle of lice is three weeks, so keep checking during that time period.

What should I do if I find head lice on my child?
Start treating your child as swiftly as possible. The sooner treatment begins, the less the chance of it escalating or spreading to others. Check family members to make sure the lice haven’t yet spread. Call the school nurse, your child’s friends’ parents and others he or she has been in close contact with. Don’t be embarrassed, instead act fast to stop the chain.

If a child has head lice, should the whole family be treated?
If one family member has a cold, do you give medicine to everyone? Of course not! What you would do, however, is exercise precautionary measures. The same holds true with lice. Be aware, check, comb, and only if necessary, treat. The Nitpickers would do a head check first, and if evidence of head lice is identified on that person, recommend treatment.

What treatment options are available for my family?
Many safe, nontoxic treatment options are available. If you could use only one tool or product, we would recommend a good lice comb. The most important thing is that you do something, as head lice left unattended will only escalate and spread to others.

What types of products should I look for when shopping?
Get a good lice comb. Look for safe, nontoxic products. Products will not eradicate head lice. They are a means of augmenting the tedious task of nit removal.

Does Cetaphil work?
Cetaphil is a facial cleanser that has been touted as an alternative treatment for head lice. The treatment was reportedly devised as a scam by a doctor in California. The doctor applied an unknown product to test subjects and then shrink wrapped their hair in it. He later admitted that he lied to his peers in hopes of getting rich quick and that the product was nothing more than the facial cleanser, Cetaphil.

Do home remedies work?
There are many home remedies, but in most situations we don't encourage their use. Most are messy and time consuming and are no more effective than the safe products available today.

Does putting mayonnaise on your head work?
Mayonnaise, Vaseline, olive oil and other remedies are messy alternatives for treating head lice. The goal of these treatments is to drown the lice. Because lice can survive for up to two hours without breathing, these treatments are not very effective.

Why didn’t the products we bought at the pharmacy work?
Many products available today have been on the market for about thirty years. Because of the span of time they’ve been used and overused, lice have built up a resistance to them.

I treated my daughter using an over-the-counter product as directed and spent many hours combing through her very long hair. After about a week, I checked her head again and found a few more nits, so I repeated the treatment process and washed all linens, etc. Should I retreat her?
Do not retreat her with the product you used, but instead keep looking and combing. The fact that you found more nits does not mean that she has a new case. It could be nothing more than missed nits. Observe not only how many you find, but whether they are scattered or clustered. If you find three to five nits in the area the size of a quarter, those are considered a cluster.

If you are finding nits in a cluster, you need to comb more and look harder. If, they are scattered (for example, one behind the ear, one in bangs, and one at nape of neck) then more likely these nits were missed.

Keep looking and combing every two to three days for the next several weeks. If you find a nit, pull it and keep checking. Incorporate combing into your regular routine and spend five minutes (with hair wet) combing once or twice a week, forever!

How do The Nit Pickers' products differ from what I see at the pharmacy?
The products you see at the pharmacy are pesticide based products. They are NOT safe for everyday use and lice have built up immunity to them. Our products are made from natural ingredients, are non-toxic and ARE safe for everyday use! Using our products with a good lice comb will take care of lice safely.

House cleaning and hygiene

I've heard the worst part of having head lice is all the cleaning. Is this true?
Cleaning is overemphasized. The parent's time is better spent on the child's head, as well as communicating with the child’s closest friends.

How much cleaning is necessary when my child has head lice?
Concentrate only on items that had direct contact with individuals suffering from head lice during the past 24 hours.

For example:

  • Your child slept in her bed; so change or wash the sheets.
  • Your child took a bath; so wash the towel.
  • Your child brushed his/her hair; so clean or replace the hairbrush.
  • Gather all stuffed toys in the home, bag them up in plastic and move them out of the way until the lice have left your house.
  • Vacuum or lint roll carpets and upholstered furniture and throw an old sheet over your child's favorite chair or seat.

These methods minimize additional housework.

Does having head lice mean that person lives in a dirty home or has poor hygiene?
Absolutely not! Getting a case of lice has nothing to do with the cleanliness of one's home or body. Lice are spread by direct contact. They do not live away from the head, so whether a house is clean or dirty makes no difference.

Do head lice prefer clean or dirty hair?
Head lice find it easier to move around on a clean head of hair, however, that does not mean that an individual with dirty hair won't get lice. Head lice feed on blood and as long as we have blood, we are at risk.

I'm shrinking our clothes by washing them with hot water and putting them in the dryer. Is there a better way to kill any lice that might be in our clothing?
Lice cannot live off the human head for more than two days. Put any clothing you don't need right away into your dirty clothes basket for three days. By waiting three days, any bugs that may be on your clothes will be dead. You may then wash your clothes in cold or warm like you usually do, and any dead bugs will fall off in the wash.

School policy

What is a No Nit Policy?
A school with a No Nit Policy excludes children with nits from school. While The Nit Pickers supports the No Nit Policy, we also believe that it needs some modifications, as one nit generally means that the child must leave school. We believe that when the nurses have searched thoroughly and found one or two nits, they start to pull them~ and allow the children to return to class. However, the nurse should recheck the child at least every three to four days for the next three weeks to ensure no further contact exists and the child is truly past it. It is not a matter of whether a bug or a nit was on the head first, because a nit only exists if a bug has been on the head.

What is a Live-Bug-Only policy?
A live-bug-only policy means that whether the child has nits or not, the child can go to class as long as no one sees adult lice on the child's head. But lice are hard to spot; you could be looking right at a bug and not see it.

Whom should I notify if my child has lice?
Everyone who has had contact with the child in at least the last two weeks, and preferably, during the past month should be notified. Contacts should include the school nurse, daycare director, camp counselor, or other individuals in the position to assist you in notifying and checking those that your child has had contact with.

If my child has head lice, should I tell the school nurse?
Absolutely tell the school nurse! If the nurse isn’t informed, she can't work with you to identify other possible sources. Be willing to communicate with your child’s school to minimize the chance of getting lice again and again.

How can I get my child's school more involved in this health issue?
Talk to the school nurse and your child's teachers. Address your concerns calmly and let them know that fighting head lice is a shared responsibility. Stress that the goal is not to place blame, but rather to work with them to help develop proactive measures to ensure that the school is lice free. Be willing to assist, including checking children's heads, educating families, or helping to raise funds to ensure all children have the necessary tools and resources to fight head lice. You must be willing to do your part if you truly want to make a difference!

Health Insurance

Does my health insurance pay for nit removal services?
Some insurance companies will cover these services as part of your health plan. Upon completion of treatment, we will provide a claim form for you to submit to your insurance provider for possible reimbursement. These services, if covered by your insurance company, will be considered out of network and subject to any deductibles you have with them.

*Adapted from information by the Shepherd Institute for Lice Solutions

 

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