The myth that head lice prefer unwashed hair has fueled plenty of stigma. In reality, there’s no link between these tiny parasites and personal hygiene. Anyone can get them, and the right treatment can help.

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Getting head lice doesn’t mean your hair — or any other part of your body — is “dirty.”

Even though some insects are attracted to unclean places, that’s not the case for head lice. These parasites feed on blood, and anyone can acquire them. According to experts, it doesn’t make a difference if you recently washed your hair or not.

Lice are incredibly common around the world. Estimates suggest that each year, between 6 and 12 million infestations affect kids ages 3 to 11 in the United States.

Read on to learn more about head lice spread, how to treat infestations, and what you can do to avoid getting head lice.

While you can get head lice at any age, lice do tend to affect children more often than adults. This may be because children tend to play closely, with their heads touching — and lice move from one scalp to the next through close head-to-head contact.

Lice also tend to be more common in girls. Experts say this may happen because girls are more likely to play with their heads close together. Hair length doesn’t have any impact on your risk of getting head lice.

That said, you may have a harder time finding lice and their eggs (nits) in thick, long, natural, or curly hair. This has fueled a myth that people with coiled, curly hair can’t get them. In reality, people with any hair type or texture can get lice.

That said, the type of head lice most common in the United States may have a harder time grasping coily hair.

Head lice don’t care how often you shower or wash your hair. There’s no tried-and-true way to prevent head lice, but you can take steps to lower your risk:

  • Avoid close head-to-head contact: Lice may more often spread due to close contact at slumber parties, contact sports, and children’s games. Just keep in mind, you won’t get lice simply by standing near someone who has lice.
  • Avoid sharing clothing or accessories that touch your hair: It’s possible to transmit lice by sharing hats, hair ties, barrettes, scarves, and coats — anything that has prolonged contact with your head and hair.
  • Avoid sharing brushes, combs, or other hair styling accessories: These items may also transmit lice, but this is less common. If you do share these items, you can kill lice by soaking them in hot water (at least 130°F, or 54°C) for 5 to 10 minutes.
  • Avoid lying on communal couches, beds, pillows, and stuffed animals: Lice can live in bedding and furniture for up to 2 days.
  • Always wash and dry bedding, clothing and other items: If someone in your home has head lice, you can kill any lice in these items by washing them in hot water and drying them on high heat. If you can’t wash something, you can dry clean it, or seal it in a plastic bag for 14 days to make sure all the nits die.
  • Vacuum your furniture and floor: Pay careful attention to carpeted areas and rugs, along with furniture like sofas and chairs.

You can’t kill head lice by washing your hair with shampoo. If you have live lice or eggs in your hair, you’ll need to use a special lice treatment.

Over-the-counter (OTC) options approved by the Food and Drug Administration (FDA) include:

  • Permethrin 1% (Nix): Permethrin 1% is safe for children of all ages, including babies more than 2 months old. If your child under 2 months has lice, consider consulting a pediatrician.
  • Pyrethrins and piperonyl butoxide (Pronto, Rid): You can use pyrethin treatments for children ages 2 and up, but avoid this option if you’re allergic to chrysanthemums or ragweed.

Both of these treatments kill live lice, but not unhatched eggs. Doing a second treatment roughly a week after the first treatment can kill newly hatched lice.

You can also ask a doctor about prescription treatments, such as:

  • Benzoyl alcohol 5% (Ulesfia): This treatment kills lice but not unhatched eggs. You’ll need to treat again about a week later.
  • Ivermectin 0.5% (Sklice): This treatment kills lice and seems to prevent newly hatched lice from living.
  • Malathion 0.5%: This treatment kills live lice and some lice eggs. You may need a second treatment to kill any lice still living 7 to 9 days after treatment. It’s only approved for use on those ages 6 and up.
  • Spinosad 0.9%: This treatment kills live lice and unhatched eggs. Re-treatment isn’t usually necessary. It’s only approved for use on those ages 6 and up.

If these methods don’t get rid of head lice, your doctor may recommend trying lindane 1%. As this treatment is strong, experts only recommend it if others treatments are ineffective. If you use too much, or swallow some by mistake, it may harm your brain or nervous system. Use this treatment once.

This treatment isn’t safe for:

  • babies or children
  • pregnant or nursing people
  • older adults
  • people who weigh under 110 pounds
  • those living with HIV or seizures
  • individuals who have sores or skin irritation on the application site

Whichever treatment option you choose, consider checking your hair every 3 to 14 days after applying a treatment to make sure the treatment is effective.

What about home remedies?

As an alternative to OTC or prescription treatments, you can manually comb out the lice and nits with a fine-toothed comb or a specially designed lice comb. Applying olive oil to the hair can help capture the lice and nits.

You’ll need to repeat this at least every 2 to 3 days until all lice and eggs disappear — but keep in mind that experts say this may not work as a standalone treatment.

Learn more about home remedies for head lice.

Anyone can get lice — no matter where you live, how old you are, or how often you wash your hair. Since lice feed on blood in your scalp, it doesn’t matter whether your hair is freshly shampooed or not.

If you or child has lice, washing your hair with shampoo won’t make any difference. An effective OTC or prescription treatment can help you get rid of head lice, though certain treatments may require more than one application.

A doctor or pediatrician can offer more guidance when it comes to treating stubborn head lice infestations.