Head lice do not have preferences for clean or dirty hair. Anyone can get lice if they come into close contact with someone who has them. However, some research suggests that certain groups may be more prone to head lice than others.

Head lice, which many people refer to simply as lice, primarily transmit between people through direct hair-to-hair or head-to-head contact.

This article examines who might get head lice, treatment options, and how to prevent head lice. It also answers some common questions about lice.

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Anyone can get head lice, but they are widespread among children.

The Centers for Disease Control and Prevention (CDC) estimate that 6–12 million children ages 3 to 11 get head lice each year in the United States. Doctors and other officials do not need to report cases, so the exact figure is unclear.

Head lice are not an indicator of a person’s cleanliness and occur across all socioeconomic groups.

According to studies cited in a 2023 review, in industrialized countries, head lice infestations tend to occur in school-age children, as they often engage in close social contact. Additionally, more girls get head lice than boys.

People of all races and ethnicities can get head lice. However, the CDC notes that they occur less frequently in African Americans compared to other races. The CDC suspects that this is because head lice have claws that are better adapted to attach to the width and shape of the hair shafts of other groups.

In a 2018 study conducted in southern Jordan, researchers looked at 500 primary school students to assess the prevalence of head lice infestations, which they found to be about 20% overall. They also noted that some populations tended to get head lice more often than other people. These include:

  • girls compared to boys
  • rural residents
  • individuals living in shared rooms
  • people with lower monthly incomes
  • people with long hair
  • families of more than five people living in a home
  • people living in homes with less than three rooms
  • individuals who share personal care items with others
  • people who experienced an infestation in the previous year
  • children with parents who cannot read

The CDC recommends that all people in a family receive head lice treatment if one family member has them. It also suggests that other people in close contact with the person receive treatment and that everyone has treatment at the same time.

Medications that treat head lice are available over-the-counter (OTC) and by prescription.

A person can purchase medications for head lice OTC at most pharmacies. Medications include pyrethrins combined with piperonyl butoxide and permethrin lotion. Neither option can kill nits, or lice eggs.

If OTC medications do not fully get rid of the head lice, a doctor can prescribe medications such as:

  • ivermectin lotion
  • benzyl alcohol lotion
  • spinosad topical suspension
  • malathion lotion

Since no medication reliably destroys all lice eggs, experts often recommend repeat treatment 7 to 10 days after the first treatment.

A person should consider seeing a doctor if head lice do not go away after a second treatment with medication. A healthcare professional can recommend another treatment or advise about how to use the treatment correctly.

Head lice can transmit easily between people in close proximity to each other through direct hair-to-hair contact.

To help prevent the transmission of lice, the CDC recommends people take the following steps:

  • Avoid sharing clothing, such as hats and scarves.
  • Avoid laying on pillows, mattresses, couches, or other surfaces a person with lice has recently used.
  • Vacuum the floor and other hard surfaces.
  • Avoid sharing personal care items, such as combs or brushes.
  • Machine wash and dry any clothing or bedding that a person with lice used in the 2 days before beginning lice treatment on a hot cycle.

A person should not use fumigant products to remove lice. Fumigation uses toxic chemicals that may cause harm if they breathe it in or their skin absorbs it.

Below are some of the most common questions and answers about head lice.

What type of hair do head lice prefer?

Head lice do not prefer any particular type of hair. Anyone can get them. However, the study in Jordan suggests that people with longer hair may get lice more frequently.

African Americans may have less risk of having head lice due to the shape and size of their hair shafts.

Does regular shampoo kill lice?

Lice can survive regular shampooing and washing.

A person should treat head lice with OTC or prescription treatments, which some people call lice shampoo. However, some lice eggs may survive the first treatment application. Doctors often recommend two rounds of treatment to ensure it kills all the lice and their eggs.

How long do lice live on clothes?

Lice typically die within 1 to 2 days once they can no longer feed on a person’s scalp.

Head lice do not have a preference for dirty hair. Anyone who comes into direct contact with someone with head lice can get them, primarily through head-to-head contact.

People should treat head lice with OTC or prescription medications. Doctors typically recommend two rounds of treatment to ensure the medication kills all the lice and nits.

A person can take steps to prevent head lice, such as avoiding sharing clothes, washing clothing and bedding that a person with lice has used, and not sharing personal care products.