5 Steps to Combing for Head Lice

By

Chris Iliades, MD

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Even saying the words "head lice" can make parents squirm. However, these tiny, blood-sucking parasites have nothing to do with being dirty or being a bad parent. To be at risk, a child merely has to come in contact with another child who has head lice. That’s the most common way to catch head lice, even if your child has the cleanest head in the room.

Each year, head lice get into the hair of six to 12 million kids, ages 3 to 11. Kids can pick them up at school, camp, day care, or even at home, if someone brings them into the house. The insects are each about the size of a sesame seed. They lay eggs, called nits, which they glue to hairs, close to the scalp. Head lice can’t jump or fly, but they are fast crawlers.

Combing for Head Lice

Head lice are not dangerous, but they can make the scalp itch — and excessive scratching can lead to a scalp infection. There are many effective treatments available for head lice, including over-the-counter (OTC) and prescription shampoos, creams, and lotions. But combing for head lice is also an important part of controlling head lice. There are three reasons you should know how to do a head lice comb-through correctly:

  • To discover if head lice are present

  • To treat head lice

  • To check for head lice after treatment

Combing for head lice is a completely drug-free and safe way to treat head lice. People have used this method for thousands of years. Nit combs, which are very fine-toothed combs, have been found in ancient Egyptian tombs. You can get a modern version at your local pharmacy. Even if you opt to use an OTC or prescription lice product, you still need to comb well to remove the dead lice and nits after treatment.

5 Steps to a Good Head Lice Comb-Through

Before starting, you will need a nit comb, hair clips (for long hair), a large towel, facial tissues, a bowl of soapy water (use a squirt of dish soap), some hair conditioner, bright lighting, and possibly a magnifying glass. It may also help to have something to keep your child occupied, such as a favorite show or book. 

1. Wrap the towel around your child’s shoulders. Wet the hair with water and a little conditioner. This makes it easier to see lice and nits. Lice look like light brown sesame seeds that move. Nits are clear, yellow, brown or tan specks attached to the hair shaft near the scalp. You can tell the difference between nits and other debris because it’s easy to remove dandruff or other debris in the scalp. Nits stick to the hair.

2. Under a bright light at eye level, start the comb-through in sections. Pay attention to favorite lice spots — behind the ears and at the nape of the neck. Hold a section of hair with one hand and insert the nit comb as close to the scalp as possible. Comb through several times, checking for lice or nits. Use a magnifying glass if it helps. Dip the comb in soapy water and use the facial tissue to remove any debris.

3. After finishing each section of hair, pin it with a hair clip.

4. Clean up by flushing the liquid and tissue down the toilet. Clean the nit comb by soaking it in a solution of 2 cups of hot water and 1 teaspoon of ammonia. You can clean a metal nit comb in boiling water for 15 minutes.

5. After the cleanup is done, shampoo the hair thoroughly and let it dry. Then do a final dry check. If any nits are still attached to any hairs, carefully clip these off with small scissors at scalp level.

If you use an OTC product, be sure to follow the directions carefully. Some products require retreatment within a specific time period. Also, be aware that some products are not suitable for children younger than age 2. After treatment, keep checking for lice and nits for about two weeks. See a doctor if two home treatments have not worked.

Medical Reviewers: Bass III, Pat F., MD, MPH Last Review Date: Jul 6, 2013

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View Sources

Medical References

  1. Head lice: Diagnosis, treatment, and outcome, American Academy of Dermatology (http://lancaster.unl.edu/pest/lice/headlice018.shtml);
  2. Managing Head Lice, University of Nebraska-Lincoln (http://www.aad.org/dermatology-a-to-z/diseases-and-treatments/e---h/head-lice/diagnosis-treatment);
  3.  Treating Head Lice, DFA (http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM173526.pdf);


Learning About Lice

5 Steps to Combing for Head Lice

Combing for head lice is an important part of controlling head lice. Learn how to do a head lice comb-through correctly.

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