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Head Lice: Fact Sheet for Parents

Each year approximately 6-12 million school age children (about 1 in every 100) are infested with head lice (pediculosis).  It is a community-wide issue, as research has shown that transmission in the school setting is rare. Lice are not a sign of poor hygiene and are not a hazard to one’s health.  Head lice infest all socioeconomic groups, races, ages and genders.  The following helpful information includes an understanding of head lice and how to detect and treat it.

 

What are head lice?

Head lice are parasites that survive by feeding on small amounts of blood from the human scalp.  Lice move by crawling, but they do NOT jump, hop, or fly.  Lice move quickly and shy away from light.  They do NOT harbor or transmit disease.  Lice are generally found on the scalp, often around the ears and at the back of the neck.  The adult louse is about the size of a sesame seed. 

(Go to http://www.cdc.gov/parasites/lice/head/gen_info/faqs.html for pictures of what head lice and nits look like)

 

What are nits?

Nits are eggs laid by the female louse.  An adult female will lay 6-10 eggs a day, attaching them to the hair shaft close to the scalp.  The eggs are tiny, grayish-white oval specks that can be difficult to see.  They are “cemented” to the hair and are not easily removed, therefore you cannot “catch” nits.  Nits hatch in approximately 3-10 days after being laid.  In general, nits greater than ¼” from the scalp are likely to already be hatched or are not viable.

 

How are head lice spread?

Head lice are transmitted by direct head-to-head contact with an infested person’s head, such as during close play, sleepovers, cuddling, etc.  Less likely modes of transmission include sharing personal items such as brushes, hats, scarves, pillows, clothes, etc.  Lice cannot survive more than 48-72 hours off the human head.

 

What symptoms are possible with head lice infestation?

Often (but not always) head lice will cause itching of the scalp.  Red bite marks or sores may also be noticed on the scalp or back of the neck.  One may have a tickling feeling like something is moving on their head, or possibly trouble sleeping or irritability. 

 

I found head lice (or nits) on my child.  Now what?

If you find live lice or you see nits within ¼” of the scalp, prompt treatment should be initiated.  Not all members of the household need to be treated unless lice are found on others or the infested individual has shared a bed with another person. 

·        The infested person must be treated adequately, using 4 oz. of chemical per 6” of hair (meaning long hair may require 2 bottles!), applied exactly according to the manufacturer’s instructions.  Over-the-counter treatments can be used (such as permethrin 1% cream rinse (Nix®) or pyrethrin (Rid®) shampoo).  Another option available is Lice Clinics of America (https://www.lcaconnecticut.com), or you may contact your child’s pediatrician for prescription treatment if indicated.

·        Avoid using hair products such as conditioners, detanglers, or conditioning shampoo for 2 weeks following treatment so as not to deactivate the therapeutic chemicals.

·        Wet comb hair with a fine-toothed or delousing comb daily to remove any nits

·        Remove/kill any remaining lice in your home/car by vacuuming all carpets and upholstered surfaces that may have come in contact with the infested person’s head in the 2 days before treatment.  Personal items such as combs, brushes, barrettes, etc. can be soaked for 1 hour in Lysol or rubbing alcohol or washed with hot soapy water (130 degrees).  Hot wash and dry (at least 20 minutes) all exposed clothing and linens (not forgetting car seat covers, backpacks and jackets).  Stuffed animals may be placed in a hot dryer for at least 20 minutes.  Non-washable items may be dry cleaned or placed in a tightly sealed plastic bag for 14 days.  Keep in mind that it is very unlikely that remaining nits would be able to incubate and hatch away from the human head.

·        If an over-the-counter treatment has been used, retreatment needs to be done between days 7-10, ideally at day 9.  A persistent case may require a third treatment (check with your physician).

·        Continue to thoroughly recheck your child’s head to detect re-infestation

·        Please notify the school nurse and any daycare facility that your child may attend.  We understand that this is a sensitive issue, but it is important for the school nurse to know so that we may help with accurate diagnosis, treatment assistance, and screening for re-infestation.  The nurse will examine the affected child’s scalp upon return to school after treatment and then once a week for three weeks (as discretely as possible).

·        It is NOT recommended to use insecticides or fumigation at home or in schools.  These chemicals can be toxic if inhaled or absorbed through the skin.

 

 

To help control head lice outbreaks, children can be taught to avoid activities that may spread head lice.  Teach children to:

·       Avoid head-to-head contact (this may be difficult for young children, as close play is common)

·       Do not to share personal items such as combs, brushes, hair ornaments, pillows, hats, scarves, other personal headgear, etc.  (Head lice being spread by inanimate objects and personal belongings may occur, but is very uncommon)

·       Hang coats separately, placing hats and scarves inside coat sleeves or backpack

 

 

 

 

 

LICE 101  
   Everything you really didn’t want to know about lice!


Definitions
Lice= more than one louse Nit=eggs, dead or alive, of a louse

Louse=small insect that lives on the scalp (singular of lice)

Parasite=lives off another, in this case the blood of humans

Pediculosis=having an infestation of lice

Infestation=having an insect present, in this case, on your head
Myths Truths
Lice are easy to get Lice are spread only by head to head contact.  They are much harder to get than a cold, flu, ear infection, pink eye, strep throat, food poisoning, or impetigo.

You can get lice from your dog, guinea pig or other animal

Lice are species specific.  You can only get human lice from another human.  You cannot get another animal’s lice

Lice are often passed via hats and helmet

Rare, but possible.  Hairbrushes, pillows and sheets are much more common modes of transmission

School is a common place for lice transmission

School is a VERY RARE source of transmission. Much more common are family members, overnight guests and playmates  who spent a large amount of time together

Poor hygiene contributes to lice

Hygiene makes absolutely no difference.  Lice actually like clean hair more than dirty.  You get lice by close personal contact with someone else who has lice, not by being dirty

Lice can jump or fly from one person to another

Lice can only crawl.  They can neither fly nor jump.  They must crawl from one person to another

Any nits left in the hair can cause lice to come back

Any nits farther away than ¼ to ½ on the hair
shaft are ALREADY HATCHED and pose no risk to others

Eggs or nits can fall out of the hair, hatch and cause lice in another person

Nits are cemented to the hair and very hard to remove.  They cannot fall off.  Newly hatched larvae must find a head quickly or will die.

Lice can live a long time

Lice live only 1-2 days off the head

All members of a family should be treated if one person has lice

Only the person with lice should be treated.  Lice shampoos are INSECTICIDES and can be dangerous if used incorrectly or too frequently.  Household members and close contacts should be checked, but only treat those who actually have lice.  The house should NOT be sprayed with insecticide, nor used on clothing or other items.

Checking a classroom when one student has lice can prevent lice from spreading

Classroom transmission is EXCEEDINGLY RARE and a waste of valuable teaching time.  Checking family members and close playmates is much more appropriate

Avoiding lice is important as they spread disease

Lice do not spread any known disease.  They are annoying and icky, but cause no disease.

Source: Pershing County School District (http://www.pershing.k12.nv.us/Parents/health_issues/lice101.html)

References:

 

American Academy of Pediatrics (2010).  Clinical Report: Head Lice.  http://aappolicy.aappublications.org/cgi/content/full/pediatrics;126/2/392

 

Centers for Disease Control and Prevention (2010).  Head Lice FAQ’s.  http://www.cdc.gov/parasites/lice/head/gen_info/faqs.html

 

Connecticut Department of Public Health (2008).  Head Lice- Fact Sheet.  http://www.ct.gov/dph/cwp/view.asp?a=3136&q=388318&pp=12&n=1

 

Devore, Cynthia Dilaura, MD. (2010).  Ask SSN.  School Nurse News.  November 2010 issue. p 5-7.

 

National Association of School Nurses (2011).  Head Lice: A Real Head Scratcher-Fact Sheet for Parents. http://www.nasn.org/portals/0/resources/scratch_fact_parent_2010.pdf

 

 

Pontius, Deborah J., MSN, RN. (2011)  Hats off to Success: Changing Head Lice Policy.  National Association of School Nurses Publication; Volume 26; Number 6. November 2011. p 357-362.