Losing the Louse: How to Manage this Common Infestation in Children

Vicky R. Bowden, DNSc, RN


Pediatr Nurs. 2012;38(5):253-254. 

In This Article

Abstract and Introduction


This article aims to provide an overview of the symptoms, diagnosis, and treatment for lice infestations in children. Management of the condition by parents in the home is presented, as well as ways to prevent spread in the community. Nurses in acute care, outpatient, and school settings may use this information to teach families how to prevent a lice infestation and treat an infestation when it occurs.


Lice (plural), louse, pediculosis, nits, ectoparasitic insects of the order Phthiraptera, Pediculosis capitis, head lice, Pediculosis corporis, Pediculus humanus humanus, body lice, Pediculosis vestimenti, Pediculosis pubis, pubic lice, crabs. All are names associated with a 2 to 3 mm, gray-white insect that has been in existence for 10,000 years and is known to infest the human body. When uncontrolled, this tiny bug lives on the skin of human bodies, proliferates in large quantities, and spreads to those in close contact with the "host" (Araújo et al., 2000).

While this may sound like part of a science fiction script, the reality is that lice infestations impact children and adults worldwide, and remain indiscriminate to gender, age, and socio economic status. Lice are considered the most common infestation occurring in children, with the prevalence increasing in every country over the past three decades (Falagas, Matthaiou, Rafailidis, Panos, & Pappas, 2008).

Humans host three different kinds of lice: head lice (Pediculosis capitis), body lice (Pediculus humanus humanus, sometimes called Pediculus humanus corporis), and pubic lice (Pthirus pubis). The female louse lives approximately 30 days, during which time she will lay 3 to 10 eggs (nits) per day. These nits attach firmly to the hair shaft regions close to the scalp and other body regions. After 6 to 10 days, the nits hatch as nymphs, become adults in 10 to 15 days, and the new females begin laying eggs. Adult lice live for about 10 days; however, adult lice live only about 48 hours if not in contact with a human host.

Transmission of lice occurs by direct contact with an infested person or transferred by fomites. Carpeting, pillows, bed linens, hats, brushes, and ribbons from infested children are all possible fomites or sources of transmission. Pets and other animals are not fomites. Lice have been known to transmit diseases, such as typhus, trench fever, and relapsing fever.