Help, my child has head lice! What you should know now
- Johanna
- Jun 24
- 5 min read
Updated: Jul 4
Lice are annoying but treatable and have nothing to do with poor hygiene. Almost all children experience them at least once. It's important to be well-informed and to act calmly and purposefully.
What are head lice?
Head lice are small, wingless insects that live exclusively on the human scalp. They rely on close contact with the scalp to feed on blood. Outside the hair and away from the human body, they typically die within one to two days.
Children between 4 and 11 years of age are particularly affected by head lice, millions of them worldwide every year.
2. How are head lice transmitted?
Head lice are mainly transmitted through direct head-to-head contact, for example, while cuddling or playing together. This is why lice spread so quickly in daycare centers and schools. Transmission via hats, pillows, or upholstered furniture is very rare.
Head lice do not transmit disease, but often cause social stress and embarrassment.
Pets are not carriers.
How do I know if my child has lice?
The most common sign is
Itching , especially behind the ears or on the neck. The itching often doesn't begin until weeks later; some children don't notice it at all.
Gray-brown, fresh nits on the scalp. Live lice are light-shy and fast, and therefore not so easy to see.
Sometimes small red dots on the neck, behind the ears or on the scalp.
The safest way to find lice is to comb them wet with a lice comb :
Wash your hair, then apply conditioner and do not rinse.
The conditioner prevents the lice from moving and makes combing easier.
Carefully comb through strand by strand.
After each stroke, wipe the comb on a white cloth and check for lice or eggs (nits).
Rinse hair.
Color and assessment of lice eggs
Freshly laid eggs are grayish to brownish in color and adhere very close to the scalp, usually less than a centimeter from the hairline. This color indicates that an embryo is developing inside—they are therefore considered viable and require treatment.
Empty egg shells, called nits, appear whitish to transparent . They are often located farther from the hairline because they remain attached to the hair after the larvae hatch and grow out with the hair. A distance of more than one centimeter from the scalp usually indicates that these are old, empty shells. These no longer require treatment.
In cases of doubt, for example in the case of greyish eggs with unclear spacing, it should be assumed that the eggs are capable of development and act accordingly.
Treatment plan
If your child is diagnosed with head lice, the question often quickly arises: Which remedy really helps and do I need a prescription?
There is no method that guarantees the safe removal of all head lice. Therefore, patience, calm, and consistent action are required to effectively treat an infestation.
Day 1 - DISCOVERY
Treat with a suitable lice treatment and then comb the hair while wet. ( For the method, see Diagnosis 3. >>>). Check all family members.
Physical Medicine:
For example, dimethicone. It forms a film over the lice and suffocates them. This is particularly effective, even against resistant lice, and is well tolerated.
Neurotoxic Medicine:
For example, pyrethrum, permethrin, or allethrin. These act on the lice's nervous system and paralyze them.
There are effective remedies, and you can usually get them directly from the pharmacy without a prescription . Almost all approved lice remedies are available only in pharmacies, but do not require a prescription . If your child is under 12 years old, you can get a statutory health insurance prescription from your pediatrician's office (usually at the counter). Your statutory health insurance will then cover the cost of the recommended medication. Important: The prescription is not mandatory, but it can be a financial relief.
The egg shells of lice are very resistant – many treatments don't kill them completely, and resistance can develop. Be sure to follow the second application and comb out regularly!
Day 2
Use wet combing again to check whether any live, adult lice are still present. If you find any, the treatment likely didn’t work effectively. One possible reason could be that the lice are resistant to the treatment used.
Day 5
Repeat wet combing to remove newly hatched lice.
Day 9
A second application of the lice treatment to kill newly hatched lice before they can multiply and spread further. Follow with another round wet combing.
Day 13
Control by careful wet combing .
Day 17
If the infestation was severe: a final check by wet combing to be on the safe side.
>>>Download the treatment plan to check and print<<<
Home remedies like mayonnaise, vinegar, or oil often appear as insider tips. While they sometimes produce partial success, these methods are not reliable. Since herbal remedies have not yet been sufficiently studied, nothing can be said about their effectiveness or possible side effects.
There's no need to cut the hair very short. Such measures are often stressful for children and provide no additional benefit in treating lice.
When should I go to the pediatrician’s office?
Infants and toddlers (not all products are suitable)
Pregnancy/Breastfeeding
Sore scalp/scalp disease
Severe cases/frequent recurrences (oral medicine could be prescribed here)
MCS syndrome (multiple chemical sensitivity, i.e. increased sensitivity to various chemical substances)
Chrysanthemum allergy: Some lice treatments contain pyrethrum or pyrethrins, which are derived from chrysanthemums. Using these products can cause an allergic reaction.
Do I have to disinfect everything?
No. You don't need a major clean, as lice don't survive long without the human head. Here are some important steps :
When starting treatment and during the second application: wash bed linen, pajamas, towels, hats and cuddly toys at 60°C.
After use, rinse combs and brushes with hot soap.
Store non-washable items such as stuffed animals, blankets, bicycle helmets, etc. in an airtight bag for three days.
There is no need for insect sprays or disinfectants.
Can my child go to school or daycare?
With lice NO
After the first treatment, your child can usually return to the facility.
Be sure to inform the school or daycare center so that other children can also be checked. This will prevent the spread of the virus.
Inform those around you, especially your daycare center or school. Lice are a group issue!
A certificate confirming the treatment is not required and can be issued by the parents. Whether this should be done verbally or in writing depends on local regulations.
And if it comes back?
Unfortunately, this happens often, sometimes it is due to:
forgotten eggs in the hair
incorrect application of the products (too little, too short exposure time)
forgotten second treatment
untreated contact persons
Resistances
Contact your pediatrician and ask for advice.
This is how the life cycle of a head lice works
The life cycle of a female head lice lasts about three to four weeks. Males live only two to three weeks. After a female lays her eggs (nits) close to the scalp, the young lice hatch after about seven to ten days. These develop through several stages within eight to twelve days into sexually mature adults. From the twelfth to fifteenth day, they can lay eggs again, about four to eight per day, totaling up to 300 over the course of their lifetime.
Conclusion: You are not alone!
Lice are annoying, but treatable. Show your child that they haven't done anything wrong. They need your calm and reassurance right now – no drama.
With a little patience and the right approach, you will soon get rid of the little critters.
Status: 06/2025
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