Atlanta parents dealing with head lice have countless questions, and getting accurate answers can mean the difference between quick resolution and months of frustration. Here are the 50 most frequently asked questions about lice treatment, answered with current medical evidence and Atlanta-specific insights.

Basic Lice Information

1. What exactly are head lice?

Head lice (Pediculus humanus capitis) are tiny, wingless parasitic insects that live exclusively on human scalps. Adult lice are about the size of a sesame seed (2-3mm) and feed on blood every few hours. They cannot jump, fly, or survive more than 24-48 hours away from the human scalp.

2. How common are lice in Atlanta?

The CDC estimates 6-12 million lice infestations occur annually in the US, with metro Atlanta seeing peak cases during August-October (back-to-school) and January (post-holiday exposure). Atlanta's year-round warm climate and dense population create ideal transmission conditions.

3. Are lice dangerous or do they spread disease?

No. Head lice do not transmit diseases and pose no serious health risks. The main concerns are itching, scratching-related skin irritation, and potential secondary bacterial infections from excessive scratching. Lice are more of a nuisance than a medical emergency.

4. How do you get lice?

Over 95% of lice transmission occurs through direct head-to-head contact. Lice crawl from one person's hair to another's during activities like taking selfies, playing sports, sharing beds, or hugging. Environmental transmission (from furniture, clothing, etc.) accounts for less than 5% of cases.

5. Can adults get lice?

Yes, though it's less common. Adults typically get lice from close contact with infected children. Parents, teachers, childcare workers, and anyone in regular close contact with children are at higher risk.

Detection and Symptoms

6. What are the first signs of lice?

• Persistent itching, especially behind ears and at the nape of the neck

• Small red bumps or sores from scratching

• Feeling of something moving in the hair

• Difficulty sleeping (lice are most active at night)

• White or brown specks (nits) attached to hair shafts

7. How soon after exposure do symptoms appear?

Itching typically begins 2-6 weeks after initial exposure as people develop sensitivity to lice saliva. However, live lice may be present before symptoms develop, making regular screening important.

8. How do you properly check for lice?

Use bright lighting and systematically part hair into small sections. Focus on the nape of the neck and behind the ears where lice concentrate. Look for moving lice (size of sesame seeds) and nits (oval eggs) attached firmly to hair shafts within ¼ inch of the scalp.

9. What's the difference between lice and nits?

Lice are the living insects that crawl and reproduce. Nits are the eggs that lice lay, which appear as small oval specks firmly attached to hair shafts. Live nits are brown or tan and close to the scalp, while hatched nits appear white or clear and may be further from the scalp.

10. Can you mistake other things for lice?

Yes. Dandruff, hair product residue, scabs from scratching, dirt, or sand can be mistaken for lice or nits. True nits are firmly attached to hair and require significant force to remove, while dandruff and debris brush away easily.

Atlanta School Policies

11. What is Gwinnett County's lice policy?

Gwinnett County maintains a strict "no-nit" policy requiring complete removal of all lice and nits before students can return to school. Students are excluded immediately upon discovery and must pass re-screening by the school nurse before readmission.

12. How does Fulton County handle lice?

Fulton County follows a more moderate approach, allowing students to complete the school day when lice are discovered and requiring treatment verification rather than complete nit removal before return.

13. What about Atlanta Public Schools?

APS integrates lice management into comprehensive urban health services, emphasizing same-day treatment coordination and reduced stigma protocols while providing family support services.

14. Do private schools have different policies?

Most Atlanta private schools (Westminster, Lovett, Pace Academy) maintain stricter policies than public schools, often requiring medical clearance and complete nit removal before readmission.

15. Can schools legally exclude children for lice?

Yes, Georgia law allows schools to exclude students with communicable conditions, though the American Academy of Pediatrics recommends against exclusion for lice, stating "no healthy child should miss school time because of head lice."

Treatment Options

16. Why don't over-the-counter treatments work anymore?

Research shows that 82% of lice populations now carry genetic mutations making them resistant to pyrethroid-based treatments (NIX, RID). These "super lice" have evolved resistance over 30+ years of treatment use.

17. What are the most effective treatments in 2025?

• Professional mechanical removal: 99%+ effectiveness

• Spinosad (Natroba): 84-89% effectiveness against resistant lice

• Ivermectin lotion (Sklice): 73-78% effectiveness

• Heat treatment (AirAllé): 99.2% egg mortality rate

18. Are prescription treatments worth the cost?

Yes, especially given OTC failure rates. Prescription treatments cost $150-300 but often succeed where multiple OTC attempts ($100-200 each) fail. The total cost of failed DIY attempts typically exceeds professional treatment costs.

19. How effective is manual removal?

When performed systematically by trained professionals, manual removal achieves 99%+ success rates. DIY manual removal is less effective (60-70%) due to technique limitations and missed nits, but remains better than resistant OTC treatments.

20. What is heat treatment?

FDA-cleared devices like AirAllé use controlled heated air to dehydrate lice and eggs. The process takes about 30 minutes and kills 99.2% of eggs through precise temperature and humidity control, not available with home hair dryers.

Professional Services

21. How much do professional lice services cost in Atlanta?

Professional services typically charge $175-225 per person, with family packages ranging $400-650 for multiple people. Mobile services may add $25-50 for travel within metro Atlanta.

22. Are professional services worth it?

For most families, yes. Professional treatment success rates (99%+) combined with time savings and reduced stress make them cost-effective compared to multiple failed DIY attempts averaging $1,400-2,200 in total costs.

23. What should I look for in a professional service?

• Local experience with Atlanta school policies

• Service guarantees (30-day warranties)

• Proper business licensing and insurance

• Educational component about prevention

• Mobile capability for convenience

24. How long does professional treatment take?

Most professional treatments require 90-120 minutes per person. Families can often schedule multiple people simultaneously to minimize time investment.

25. Do professional services provide documentation for schools?

Yes, reputable services provide treatment verification receipts and documentation that meet school readmission requirements across different Atlanta districts.

DIY Treatment

26. If I try DIY, what's the best approach?

Skip OTC treatments and use systematic wet combing with a quality metal comb and conditioner. Comb thoroughly every 3 days for 2-3 weeks, checking all family members. However, success rates remain lower than professional treatment.

27. How often should I apply OTC treatments?

Follow package directions exactly, but understand that 75-80% of lice in Georgia are now resistant to OTC treatments. If live lice remain 7-10 days post-treatment, the population is likely resistant.

28. Can I use home remedies like mayonnaise or olive oil?

These methods lack scientific evidence and can be messy and time-consuming. Some may suffocate a few lice but rarely eliminate entire infestations, especially eggs, leading to reinfestation.

29. Should I cut my child's hair?

Hair cutting isn't necessary and won't eliminate lice close to the scalp. However, shorter hair can make detection and treatment easier. Avoid shaving, which can cause skin irritation and doesn't guarantee lice elimination.

30. How do I know if treatment worked?

Check for live, moving lice 7-10 days after treatment. Finding dead lice immediately after treatment is normal. New nits appearing within ¼ inch of the scalp indicate ongoing infestation or reinfestation.

Environmental Cleaning

31. How should I clean my house?

Focus on items that had direct head contact in the 24-48 hours before treatment: wash bedding and recently worn clothing in hot water (130°F), vacuum furniture where the infested person sat, and store non-washable items in sealed bags for 2 weeks.

32. Do I need to fumigate or spray my house?

No. The CDC explicitly warns against fumigant sprays, which are unnecessary and potentially harmful. Lice cannot survive more than 24-48 hours off the human scalp.

33. Should I wash everything in the house?

No. Focus only on items with recent head contact. Excessive washing wastes time and money without improving treatment outcomes. Environmental transmission risk is minimal.

34. Can lice live in carpets or furniture?

Lice may survive 24-48 hours on furniture but cannot reproduce or thrive away from human scalps. Vacuuming areas of recent head contact is sufficient precaution.

35. What about car seats and headrests?

Vacuum car seats and wipe headrests where the infested person recently sat. Consider disposable seat covers during active treatment if multiple family members use the same vehicle.

Prevention

36. How can I prevent lice?

Focus on behavioral modifications: teach children to avoid head-to-head contact, don't share personal items (brushes, hats, headphones), style long hair in braids or buns, and conduct weekly family head checks.

37. Do lice prevention products work?

No FDA-approved lice prevention products exist. Essential oil shampoos and sprays lack scientific evidence for prevention and may cause skin irritation without providing protection.

38. Should I treat family members who don't have lice?

Only treat people with confirmed live lice. However, check all family members carefully, as early infestations may be missed. Close family members often become infected before symptoms develop.

39. Can lice be prevented with certain hair products?

No specific hair products prevent lice. However, hair styling that reduces exposed surface area (tight braids, buns) may reduce transmission risk during high-exposure activities.

40. How often should I check my children for lice?

Weekly 5-minute head checks are recommended, especially during peak transmission seasons (August-October, January). Increase frequency during known outbreaks in schools or camps.

Complications and Concerns

41. What if my child keeps getting lice?

Recurrent infestations suggest either incomplete initial treatment, resistance to chosen treatment, or ongoing exposure. Consider professional treatment and evaluate family's exposure patterns and prevention practices.

42. Can scratching cause problems?

Excessive scratching can lead to secondary bacterial skin infections requiring antibiotic treatment. Keep fingernails short and discourage scratching. Consult healthcare providers if scratching leads to open sores.

43. Are some people more susceptible to lice?

All hair types can get lice, but people with more hair-to-hair contact opportunities (young children, people with long hair, those in close-contact environments) face higher exposure risk.

44. Can lice cause hair loss?

Lice themselves don't cause permanent hair loss, but excessive scratching and harsh treatment applications may temporarily damage hair. Hair grows back normally after successful treatment.

45. What if lice treatment doesn't work after multiple attempts?

After 2-3 failed attempts, consider professional treatment or consult healthcare providers for prescription alternatives. Continued DIY attempts with the same methods rarely succeed and waste time and money.

Myths and Misconceptions

46. Are lice a sign of poor hygiene?

No. Lice actually prefer clean hair because it's easier to attach to. The FDA states "no matter how good your hygiene, you can get head lice." Lice infestations have no relationship to cleanliness.

47. Can you get lice from swimming pools?

No. Chlorinated pool water doesn't kill lice, but transmission in pools is extremely rare because lice hold tightly to hair and rarely let go in water. Pool transmission would require direct head contact underwater.

48. Do lice prefer certain hair types?

Lice can infest any hair type, texture, or length. However, they may have slightly easier attachment to fine, straight hair. Thick, curly hair doesn't prevent lice but may make detection more challenging.

49. Can pets get or spread human head lice?

No. Human head lice are species-specific and cannot survive on pets. Dogs, cats, and other animals cannot catch or transmit human head lice.

50. Will lice go away on their own?

No. Without treatment, lice continue reproducing, with females laying 6-8 eggs daily. Infestations typically worsen over time and don't resolve without intervention.

Getting Help in Atlanta

For families dealing with lice in metro Atlanta, professional help is available throughout the region. Lice Happens has served Atlanta families since 2015, providing effective treatment with guaranteed results and comprehensive education about prevention and school policies.

When to seek professional help:

• After any OTC treatment failure

• When facing strict school no-nit policies

• For families with multiple infected members

• When time constraints require immediate resolution

• If previous DIY attempts have failed

Professional services typically include:

• Complete lice and nit removal in single session

• School readmission documentation

• Family education about prevention

• Service guarantees and follow-up support

• Mobile treatment options throughout metro Atlanta

Remember: getting professional help early often costs less than multiple failed DIY attempts and gets families back to normal routines quickly and effectively.

For professional lice treatment serving all of metro Atlanta with guaranteed results, contact Lice Happens. Our experienced team provides same-day treatment with comprehensive family education and school policy documentation.