Head lice live off blood. Their bites itch and can cause irritation and infection. Sometimes lice are hard to see. However, their egg sacks, or nits, can typically be seen attached to the bottom of hairs, especially at the nape of the neck.

Experts say the best prescription is education. Children should be taught never to share hats, combs and brushes, or pillows. Care also is indicated around surfaces that have been in contact with other heads, such as movie theater seats, other people’s carseats and plane seats.

“Families always have been reactive, but it’s more effective to be proactive,” says Dr. Casey Drake, a pediatrician on the medical staff at Children’s Medical Center Dallas. “Treatment usually involves using medicated rinses or shampoos in conjunction with environmental cleaning. When nits are not killed by these measures, they are best removed using a fine-tooth comb and a big dose of patience. This is a time-consuming process. To be successful, it needs to be done correctly, as lice are becoming resistant to routine topical medications.”

1. Tell your children never to share any hair items.
2. Watch for head scratching, especially at the hairline on the neck.
3. Check children for lice and nits (attached egg sacks) once a week.
4. Don’t confuse dandruff or dirt for nits.
5. Consult your pharmacist or physician for recommendations of lice treatments.
6. Use any product correctly and with caution.
7. Remove all visible nits with a half-vinegar, half-warm water mixture, and a fine-tooth comb or fingernails.
8. Wash bedding and recently worn clothing in hot water and dry it in a dryer. Seal items that can’t be washed in plastic bags for three weeks.
9. Sprays for carpets and furniture are unnecessary, but thorough vacuuming and dusting are helpful.
10. Work with school nurses and other professionals if your child or your child’s friends have head lice. Notification can alert other parents.