Author’s Bio: Ria Ellendula is an incoming college freshman who is passionate about public health and healthcare policy 

Lice are parasitic organisms that can live in the hair on your body. They are described as small, wingless insects that feed on blood through your skin. Typically, a louse is as big as a sesame seed and a nit (louse egg) is the same size as a dandruff flake. 

Types of Lice

The three most common types of lice are head lice, body lice, and pubic lice. 

Head Lice

Head lice cannot survive without a human host and can only live on human hosts (cannot survive on other animals). They typically lay about six eggs per day closer to the shaft of your hair.

They can settle anywhere on the scalp but are most usually found at the back of the neck and around the ears. These regions are known to be warmer, which attracts lice.

Body Lice

Unlike head lice, who lay their eggs on the scalp, body lice lay their eggs on clothing. They typically live on clothing and migrate to the body during their feeding time. One major risk of body lice is their ability to carry diseases, such as:
  • Louse-borne Typhus
  • Relapsing Fever
    • This type of fever is a febrile disease that is transmitted and carried by parasites like lice or ticks. Symptoms of the disease are episodes of headaches, vomiting, and myalgia. The episodes last 3-5 days with intervals in between, which is exhibited as a type of “relapse”
  • Trench Fever
    • This is a bacterial disease that includes relapsing fevers, muscle aches, severe headaches, joint pain, rash, liver and spleen enlargement, shin pain, and pain behind the eyes

Pubic Lice

Also known as “Crabs” due to their crab-like appearance, pubic lice are known to live in the hair of the host’s genital region. They are usually transmitted through sexual activity and can cause itching. 

What Causes Lice?

Head lice is contagious and is passed on in several ways. The three main routes through which head lice is passed on are:

  1. Your head coming in contact with the head of someone with head lice
  2. Sharing personal hair care items with someone with head lice (headbands, combs, etc.)
  3. Using a fabric item after a person with head lice (bedding, pillows, etc.)

Lice have also been found to live on inanimate objects for a short period of time (headphones, has, etc.) If you wear one of these items after someone with lice does, you are at risk for having lice yourself.

Body lice can be passed on by sharing clothes with someone who has body lice. Pubic lice is transmitted through sexual contact.

Among all of these ways for getting lice, the biggest is head-to-head contact, which is mostly seen with young children. Young children (specifically those in preschool and elementary school) are at the highest risk for getting head lice due to their tendency to remain close together. This also increases the risk for those who live and work with small children.

Lice Symptoms

  • Extreme itchiness of the scalp (or other affected regions)
  • Sores, red spots, or scabs on the scalp or other affected regions (from scratching and bites)
  • If head lice, feeling like something is crawling near the scalp

You can identify head lice by simply looking near the scalp. Usually, you will be able to see lice or nits near the scalp of the head. You can run a fine-toothed comb through the hair to catch these lice and nits.

Regularly, nits tend to be brown or darker in color, whereas lice are usually white. One common indicator of nits is the ease with which they can be removed from your hair. Other particles in your hair (such as dandruff flakes or debris) are easily removable, while nits seem to be “glued” to the hair.

Lice Treatment

Head lice can be treated through prescribed lice treatment or over-the-counter treatments.

Over-the-counter (OTC) treatments typically use two types of chemicals:

  • Pyrethrin: a pesticide that is approved for use in children 2 years and up. This chemical is made from chrysanthemum flowers, so do not use it if you’re allergic to ragweed or chrysanthemum.
  • Permethrin: a synthetic pesticide that can be used in people 2 months and older.
  • Malathion: an organophosphate pesticide that should be used in people 6 years or up. It is advised to not be used on women who are breastfeeding or pregnant.
  • Benzyl alcohol lotion: an aromatic lotion that can be used to treat head lice in those over 6 months of age.

For those who wish to treat head lice in a chemical-free manner, there are alternatives available. You can use a fine-toothed lice comb to remove lice. For this, experts recommend that you apply coconut or olive oil to your hair prior to combing. After this, start combing from the scalp all the way through the end of the hair. Repeat this every 2-3 days until all signs of lice and nits are gone.

Since body lice reside on clothes when they are not feeding, they can be treated by improving personal hygiene habits and cleaning. The clothing, bedding, and towels of the infested person should be put in the laundry with hot water (at least 130 degrees Fahrenheit) and machine dried using a hot cycle.

People with body lice can also use a pediculicide; however this is not necessary unless the aforementioned steps seem to not be working. If you are using a pediculicide, consult your physician or follow the steps on the bottle precisely.
The CDC has set out guidelines for the proper way to treat pubic lice:
  1. Wash the infested area and then dry with a towel
  2. Precisely follow the rules written out on the OTC/prescribed treatment that you get.
  3. Thoroughly cover the pubic hair and other infested areas with the lice medication. Leave the medication on for the recommended time in the instructions and then remove it in the procedure listed on your treatment plan.
  4. Treatment will remove lice. Nits can be removed with a fine-toothed comb. They will be found closer to the hair shaft.
  5. Wear clean undergarments and clothing following the treatment.
  6. To kill any remaining lice or nits, wash all clothing, towels, bedding that you have come into contact with over that period.
    1. To wash, use hot water (above 130 degrees Fahrenheit and machine dry with a hot cycle)
  7. If lice are still found, repeat treatment in 9-10 days.
Since pubic lice is transmitted sexually, it is important to notify all sexual partners if you are infested with public lice. This way, they can take their own precautions if they are infested as well.

If you have pubic lice, it is important to fully abstain from any sexual activity until you have been completely treated. You should also be evaluated for STDs, as having public lice puts you at a higher risk for contracting STDS.

Lice Prevention

To avoid a lice infestation, there is a short but simple set of rules to follow:

  1. Avoid head-to-head contact
    1. Be especially careful when playing sports with others, sharing dorms, etc.
  2. Do not share clothes without washing in between
    1. This especially applies to hats, scarves, and other hair/headgear
  3. Be careful when trying on hats and other hair/headgear in stores
  4. Do not share combs, brushes, or towels without disinfecting before use
    1. Disinfect by putting items in hot water (at least 130 degrees Fahrenheit) for 5-10 minutes
  If someone in your household has been infested, take the proper steps to avoid getting lice yourself:  
  1. Wash clothes, bed linens, and other items the person has used in the last 3 days before treatment
  2. Vacuum the floor and clean all furniture the person may have come in contact with

Online Doctor Consultation For Lice

If you or someone in your family have concerns about lice, please contact and seek help from our doctors online. At Home Urgent Care provides telehealth services so you can safely and confidently keep your health in check with our primary and urgent care services and get treatment online. Book an online doctor appointment today with our health care experts available at your convenience 365 days a year and get your prescription/medication available online.

Book an Appointment

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Step 1

Call or Book your online Doctor Visit

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Step 2

Talk to a doctor over the Phone/ Tablet

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Step 3

If needed pick up your medication at the pharmacy