Head lice facts
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I am concerned about head lice at school, what should I know?
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MPS students must be free of head lice. It is important for parents to routinely check their children's hair for lice. Lice are small insects about the size of sesame seeds. Nits are tiny yellowish-white oval eggs attached to the hair. Nits don't come off easily like dandruff or lint.
Lice do not jump hop or fly. They are transmitted via head-to-head contact, and personal articles such as hats, combs, and pillows. Please remind your children not to share such things with others.
When head lice are identified at school, the health office notifies parents of affected students and provides information on treatment of the hair and the household. Students may not return to school until treatment has commenced and the student is free of symptoms.
Anyone can get head lice. Head lice do not cause illness and are NOT highly transferable in the school setting. These parasites infect over 10 million Americans per year.
Screening programs (head checks) have NOT been proven to have a significant effect on the incidence of head lice in the school population.
Children do NOT get lice from school. They get lice from other children whom they have “head to head" contact with (sharing hair brushes, barretts, hats, towels, bedding, sleep-overs, & headphones).
The school health office does not do classroom screenings. They are strongly discouraged by the American Academy of Pediatrics and the National Association of School Nurses
Screening should be performed only when students demonstrate symptoms.
Head lice is not an unusual condition in children and has nothing to do with cleanliness. Anyone can get head lice. Head lice are very small, tan-colored insects (less than 1/8" long) which live on human heads. They lay their eggs (nits) close to the scalp. The nits are tiny (about the size of the eye of a needle) and gray or white in color.
CAUSE: Pediculus humanus capitis, a louse
SYMPTOMS: Itching of the scalp and neck. Look for: 1) crawling lice in the hair, usually a few in number; 2) eggs (nits) glued to the hair, often found behind the ears and at the back of the neck; 3) scratch marks on the head and back of the neck at the hairline.
SPREAD: Lice are spread by direct head-to-head contact and by sharing personal items such as combs, brushes, barretts, hats, head phones, scarves, jackets, blankets, sheets and pillowcases.
Lice do not jump or fly, they crawl. They cannot live off a human host for more than 48 hours. They only lay their eggs while on the head. Lice are not spread to or from pets.
INCUBATION: It takes 7-10 days from when the eggs are laid until they hatch.
CONTAGIOUS PERIOD: Until treated with lice-treatment product.
EXCLUSION: Until first treatment is completed and no live lice are seen.
The most commonly prescribed treatments for head lice are pediculicide shampoos. These products contain insecticides and must be used with caution (do not overuse these products). See your pharmacist or doctor for more information and product recommendations. Daily combing and removal of nits (lice eggs) prevent a re-infection. Nit removal throughout a three-week period (the life cycle of the lice) should greatly help remove the lice completely.
• Step 1: Use a pediculicide Use an over-the-counter pediculocide shampoo or rinse to kill most of the lice.Read the labels carefully and discuss the product with your doctor or pharmacist. directions will vary depending on the product.
For resistant cases consult your medical provider for prescription medication.
• Step 2: Clean the environment vacuuming carpet and upholstered furniture as well as sweeping floors will help avoid re-infestation. Launder clothes, bedding and towels in hot water and use a hot dryer for at least 20 minutes. Soak combs and brushes at least 20 minutes in hot water. Anything that cannot be washed, such as stuffed toys should be put in a plastic bag and tied securely for 2 weeks.
• Step 3: Comb out the nits Comb the hair in sections using a metal nit comb. It may be necessary to pull nits out with a fingernail “one by one”. Carefully inspect the entire scalp.
Follow up: Check dry hair in bright light and remove all nits you may have missed. Nits are about the size of a sesame seed --grayish white to light brown, generally within ½" of scalp (and stuck to the hair shaft).
Sending Your Child Back to School?
When you have completed one treatment, recheck for live lice as some are resistant to the over the counter treatment (YOU MAY NEED TO DO A SECOND TREATMENT WITH A DIFFERENT PRODUCT), then do a thorough nit combing, nit check and have cleaned your environment, it should be safe to send your child back to school. As long as you continue to check for and remove any previously missed nits over the next three weeks your child should not infest anyone else.
More information is availbale on the following web sites:
American Academy of Pediatrics Policy Statement on Head Lice-
click to go to site
What can I do at home?
CDC recommended: Home management of head lice
Treatment for head lice is recommended for persons diagnosed with an active infestation. All household members and other close contacts should be checked; those persons with evidence of an active infestation should be treated. Some experts believe prophylactic treatment is prudent for persons who share the same bed with actively-infested individuals. All infested persons (household members and close contacts) and their bedmates should be treated at the same time.
Some pediculicides (medicines that kill lice) have an ovicidal effect (kill eggs). For pediculicides that are only weakly ovicidal or not ovicidal, routine retreatment is recommended. For those that are more strongly ovicidal, retreatment is recommended only if live (crawling) lice are still present several days after treatment (see recommendation for each medication). To be most effective, retreatment should occur after all eggs have hatched but before new eggs are produced.
When treating head lice, supplemental measures can be combined with recommended medicine (pharmacologic treatment); however, such additional (non-pharmacologic) measures generally are not required to eliminate a head lice infestation. For example, hats, scarves, pillow cases, bedding, clothing, and towels worn or used by the infested person in the 2-day period just before treatment is started can be machine washed and dried using the hot water and hot air cycles because lice and eggs are killed by exposure for 5 minutes to temperatures greater than 53.5°C (128.3°F). Items that cannot be laundered may be dry-cleaned or sealed in a plastic bag for two weeks. Items such as hats, grooming aids, and towels that come in contact with the hair of an infested person should not be shared. Vacuuming furniture and floors can remove an infested person’s hairs that might have viable nits attached.
Treat the infested person(s): Requires using an Over-the-counter (OTC) or prescription medication. Follow these treatment steps:
- Before applying treatment, it may be helpful to remove clothing that can become wet or stained during treatment.
- Apply lice medicine, also called pediculicide, according to the instructions contained in the box or printed on the label. If the infested person has very long hair (longer than shoulder length), it may be necessary to use a second bottle. Pay special attention to instructions on the label or in the box regarding how long the medication should be left on the hair and how it should be washed out.
Do not use a combination shampoo/conditioner, or conditioner before using lice medicine. Do not re–wash the hair for 1–2 days after the lice medicine is removed.
- Have the infested person put on clean clothing after treatment.
- If a few live lice are still found 8–12 hours after treatment, but are moving more slowly than before, do not retreat. The medicine may take longer to kill all the lice. Comb dead and any remaining live lice out of the hair using a fine–toothed nit comb.
- If, after 8–12 hours of treatment, no dead lice are found and lice seem as active as before, the medicine may not be working. Do not retreat until speaking with your health care provider; a different pediculicide may be necessary. If your health care provider recommends a different pediculicide, carefully follow the treatment instructions contained in the box or printed on the label.
- Nit (head lice egg) combs, often found in lice medicine packages, should be used to comb nits and lice from the hair shaft. Many flea combs made for cats and dogs are also effective.
- After each treatment, checking the hair and combing with a nit comb to remove nits and lice every 2–3 days may decrease the chance of self–reinfestation. Continue to check for 2–3 weeks to be sure all lice and nits are gone. Nit removal is not needed when treating with spinosad topical suspension.
- Retreatment is meant to kill any surviving hatched lice before they produce new eggs. For some drugs, retreatment is recommended routinely about a week after the first treatment (7–9 days, depending on the drug) and for others only if crawling lice are seen during this period. Retreatment with lindane shampoo is not recommended.
Supplemental Measures: Head lice do not survive long if they fall off a person and cannot feed. You don’t need to spend a lot of time or money on housecleaning activities. Follow these steps to help avoid re–infestation by lice that have recently fallen off the hair or crawled onto clothing or furniture.
Machine wash and dry clothing, bed linens, and other items that the infested person wore or used during the 2 days before treatment using the hot water (130°F) laundry cycle and the high heat drying cycle. Clothing and items that are not washable can be dry–cleaned
sealed in a plastic bag and stored for 2 weeks.
- Soak combs and brushes in hot water (at least 130°F) for 5–10 minutes.
- Vacuum the floor and furniture, particularly where the infested person sat or lay. However, the risk of getting infested by a louse that has fallen onto a rug or carpet or furniture is very small. Head lice survive less than 1–2 days if they fall off a person and cannot feed; nits cannot hatch and usually die within a week if they are not kept at the same temperature as that found close to the human scalp. Spending much time and money on housecleaning activities is not necessary to avoid reinfestation by lice or nits that may have fallen off the head or crawled onto furniture or clothing.
- Do not use fumigant sprays; they can be toxic if inhaled or absorbed through the skin.