Signs and symptoms of lice include:

• Intense itching.
• Lice on the scalp, the body, clothing, or pubic or other body hair. Lice can be 0.08 to 0.16 inches (2 to 4 millimeters) in size.
• Lice eggs (nits) on hair shafts. Nits resemble tiny pussy willow buds. Nits can be mistaken for dandruff, but unlike dandruff, they can't be easily brushed out of hair.
• Small, red bumps on the scalp, neck and shoulders.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

You can get lice by coming into contact with either lice or their eggs. Eggs hatch in about one week. Lice can't fly or walk on the ground. They spread by:

• Head-to-head or body-to-body contact. This may occur as children or family members play or interact closely.
• Close proximity of stored belongings. Storing infected clothing in closets, lockers or on side-by-side hooks at school, or storing personal items such as pillows, blankets, combs and stuffed toys in close proximity at home can permit lice to spread.
• Sharing items. These may include clothing, headphones, brushes, combs, hair decorations, towels, blankets, pillows and stuffed toys.
• Contact with contaminated furniture. Lying on a bed, sitting in furniture or even using a toilet seat recently used by someone infected with lice can spread them. Head lice live for up to two days off the body.
• Sexual contact. All three forms of lice can spread in this manner.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

Usually you can get rid of lice by taking self-care steps that include using nonprescription shampoo that's specifically formulated to kill lice.

However, see your doctor if:

• Nonprescription shampoo doesn't kill the lice (your doctor can prescribe a stronger, prescription shampoo)
• You're pregnant (don't use any anti-lice shampoo until you talk to your doctor)
• You have any infected hives or skin abrasions from scratching

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

Head lice
Over-the-counter lotions or shampoos (Nix, Rid, others) are usually the first line of defense against head lice. However, if nonprescription products don't kill the lice, your doctor can prescribe a stronger shampoo or lotion.

• Malathion (Ovide). This has been re-approved as a prescription drug for treating head lice. Malathion is flammable, so keep it away from heat sources such as hair dryers, electric curlers and cigarettes. If you're pregnant or breast-feeding, talk to your doctor before using this product.
• Lindane. Another type of prescription treatment for lice contains the medication lindane. Your doctor may not recommend lindane if you weigh less than 110 pounds, have used it in the past few months or if you're a women who is breast-feeding. Side effects may include skin irritation, seizures and, rarely, death. Using lindane in higher than recommended amounts, or for longer than recommended, increases the risk of side effects.

Use these medications only as directed. Applying too much can cause red, irritated skin.

Self-care important, too
Whether you use over-the-counter or prescription shampoo to kill lice, much of the treatment involves self-care steps you can take at home. These include making sure all the nits are removed and that all clothing, bedding, personal items and furniture are decontaminated. In most cases, killing lice on your body isn't difficult. The challenge is getting rid of all the nits and avoiding contact with other lice at home or school.

Body lice
If you have body lice, you don't need treatment, yourself. However, you must take the same self-care measures, such as treating clothing and other items, as you would for head lice.

Pubic lice
Pubic lice can be treated with the same nonprescription and prescription treatments used for head lice.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

It's difficult to prevent the spread of head lice among children in child care and school settings. There's so much close contact among children and their belongings that lice can spread easily. It's no reflection on your hygiene habits or those of your children, and it's not a failure on your part as a parent if your child gets head lice. The best approach is simply to take thorough steps to get rid of the lice — and their eggs — so that you don't have more lice to deal with.

Ask your child not to share personal belongings such as:

• Hats
• Scarves
• Coats
• Combs
• Brushes
• Hair decorations
• Headphones

However, it's not realistic to expect that you and your child can eliminate all the types of contact that may result in the spread of lice.

Your child may have nits in his or her hair but not necessarily develop a case of head lice. Some nits are empty eggs. However, nits that are found within 1/4 inch of the scalp should be treated — even if you find only one — to prevent the possibility of hatching. Nits that are farther away from the scalp are probably from an old infestation and don't need to be treated.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

You can get rid of lice with a patient, thorough approach that involves cleaning yourself or your child and any personal belongings that may be contaminated.

These steps may help you eliminate lice infestations:

• Use lotions and shampoos. Choose from among several over-the-counter lotions and shampoos (Nix, Rid, others) designed to kill lice. Apply the product according to package instructions. You may need to repeat treatment with the lotion or shampoo in seven to 10 days. These lotions and shampoos typically aren't recommended for children under age 2.
• After shampoo treatment, rinse your hair with vinegar. Grasp a lock of hair with a cloth saturated with vinegar and strip the lock downward to remove nits. Repeat until you've treated all the hair in this way. Or soak hair with vinegar and leave it on for a few minutes before combing. Then towel-dry the hair. These methods can help remove nits from the hair shaft. Cutting hair very short also can help.
• Comb wet hair. Use a fine-toothed or nit comb to physically remove the lice from wet hair. Repeat every three to four days for at least two weeks. This method may be used in combination with other treatments and is usually recommended as the first-line treatment for children under age 2.
• Wash contaminated items. Wash bedding, stuffed animals, clothing and hats with hot, soapy water — at least 130 F (54 C) — and dry them at high heat for at least 20 minutes.
• Seal unwashable items. Place them in an airtight bag for two weeks.
• Vacuum. Give the floor and furniture a good vacuuming.
• Cover furniture. Use a plastic painter's dropcloth to cover furniture for two weeks to prevent acquiring another case of lice. Don't do this if have a toddler who may become tangled in a plastic sheet and suffocate.
• Wash combs and brushes. Use very hot, soapy water — at least 130 F (54 C) — or soak them in rubbing alcohol for an hour.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.