Head lice are tiny bugs that live in your hair and feed on blood from your scalp. They only move by crawling — they don’t fly or hop.

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Head lice move from person to person via direct contact.

You can get head lice if you make head-to-head contact with someone who has an active infestation, or if you share personal items that contain live lice.

While head lice can feel itchy and uncomfortable, they don’t carry disease.

Here’s what to know about how lice move and spread, plus tips to treat and prevent head lice.

Head lice can’t leap from one human to another, and they don’t have wings, so they can’t fly. They have to crawl, which means they’re typically only transmitted via extended, close, head-to-head contact.

In other words, you won’t get head lice simply by standing near someone who has lice. Generally speaking, your heads need to touch. This is one reason why lice tend to be more common among preschool and elementary-aged kids — they often play with their heads close together.

It is possible to transmit head lice by sharing clothing and accessories like hats, scarves, scrunchies, towels, and combs, but this is less common.

Only live lice can spread from one head to the next. Nits, aka lice eggs, stick to the strands of hair. They don’t spread from person to person.

Even though kids tend to get head lice more often, anyone can get them. They’re found in every country and across socioeconomic classes and cultures.

To put it simply, head lice have nothing to do with personal hygiene. Lice feed on blood from your scalp, and they don’t care whether you have clean hair or dirty hair.

Again, they most often move from person to person when heads touch. Even then, the risk of transmission remains fairly low unless the exposure is prolonged — for instance, when sleeping head-to-head at a slumber party.

Head lice don’t infect pets or other animals, only people. So, there’s no need to treat your pets for lice.

Possible signs of head lice include:

  • Itchiness of the scalp: This is the most common symptom. You’ll generally notice an irritating and persistent itch, but it typically won’t hurt. This itching sensation may begin about 4 to 6 weeks after the lice are transmitted. Your scalp will eventually become sensitive to lice saliva and begin to itch, especially around the back of the neck and ears. Even after the lice are gone, the itching might persist for weeks.
  • Eggs in the hair: You may see these more easily than the live lice. Nits look like tiny, whitish flecks near the scalp, especially behind the ears and along the hairline around the neck. You won’t be able to shake them off — unlike dandruff.
  • A scalp rash, scabs, or sores: Some people with lice may also have these symptoms. You might notice an itchy, inflamed rash or wounds, especially near the back of the neck.

FYI

Head lice live in cycles of about 28 days. They progress from eggs to nymphs to adult lice.

Without treatment, this cycle can repeat every 3 weeks.

If you have lice, an effective over-the-counter (OTC) or prescription topical medication will kill them. Shampooing your hair won’t work.

Prescription treatments include:

  • ivermectin lotion
  • spinosad topical suspension
  • benzoyl alcohol lotion
  • malathion (Ovide) lotion

OTC treatments include:

  • permethrin lotion
  • pyrethrins combined with piperonyl butoxide

Many treatment regimens involve applying a second treatment 7–9 days after the first one to kill any remaining lice.

If live lice remain after a second treatment, a doctor may recommend the prescription shampoo Lindane, 1%. This shampoo is typically only prescribed when needed for serious infestations. It’s not safe for use on babies, children, anyone who’s immunocompromised, or anyone pregnant or nursing.

As an alternative to harsh chemicals, you can use a flea comb, or fine-toothed lice comb to remove them manually.

Applying olive oil to the hair first can help the lice and nits stick to the comb. You’ll need to keep doing this every 3 days, at least, until you remove them all.

Learn more about home remedies for head lice.

You can take steps to lower the chances of you or your child getting lice in the first place.

A few helpful tips include:

  • Don’t touch heads. Sports, sleepovers, and day-to-day playing are common ways that lice spread among children.
  • Don’t lie on couches, beds, pillows, or sleeping bags used by someone with head lice.
  • Don’t share clothing, accessories or objects that have been in contact with your head. Hair ties, hairbrushes, scarves, and hats may potentially spread lice. Play it safe by boiling these items for 5–10 minutes to kill lice.
  • Do wash and dry bedspreads, sheets, stuffed animals, and other items used by someone with head lice. Set the washer and dryer to the highest heat setting. Have an item that will be damaged in the washer? You can also kill the lice by getting it dry-cleaned or sealing it in a plastic bag for 14 days.
  • Do vacuum your furniture and floor if someone in your home has head lice. Lice tend to live in carpeted areas and rugs.

Head lice can’t hop or fly. They only move by crawling from one head to the next, typically through prolonged, scalp-to-scalp contact. It’s rare — but possible — to transmit lice by sharing combs, brushes, hats, or other clothing or accessories.

To prevent the spread of lice, it’s most important to avoid head-to-head contact — but as a precaution, it’s also best to avoid sharing items that touch your head, like hats, scarves, and hair bands.