Head Lice Information
Parents should assume that lice are present in the school all year. Parents will be asked to monitor their children regularly and keep the school informed on the progress of treatment.
If head lice are found on a child while at school, the parent will be notified and requested that the child be treated before returning to school. During the course of treatment, children may be monitored but will be allowed to stay in school. Exclusion from school can stigmatize a child and interfere with education. However, non treatment may result in exclusion from school until treatment has begun. The described approach reduces exposure of children to pediculocide chemicals (treatment shampoos), provides a measure of daily progress toward successful treatment, reduces "treatment failure", eliminates lice while the child is attending classes, switches the focus from the environment to the infested individual, reduces the overall cost of management, and is much more child-friendly.
Important facts about head lice
- Lice are insects about the size of a sesame seed; they do not jump or fly.
- Lice live for about a month. The adult females lay up to 10 eggs (nits) per day. The nits hatch in 7-10 days, and the newborn lice (nymphs) are almost invisible. In about a week, the nymphs have matured and start laying their own eggs.
- The eggs are yellowish white, oval shaped and appear glued to the hair shaft. The egg is actually wrapped around the shaft.
- Symptoms are itching, red bite marks on scalp, and occasionally swollen head or neck glands.
- They are highly communicable (catching) and are usually transmitted by head to head contact, or by contact with clothing, combs, or brushes, hats, helmets, costumes, earphones, pillows and stuffed animals.
- There are thought to be more than 10 million cases in the U.S. every year.
- Lice can infest anyone. In fact lice are known to prefer clean, healthy heads.
- Lice are most common in 5-12 year olds because their play habits can lead to head to head contact, and sharing of clothing, combs and scrunchies.
Chemical Removal
Live lice are killed by the chemical shampoo or cream rinse that can be bought in the drugstore. You only need one application to kill the live lice, but manual removal of the eggs (nits) is also an important step. Pesticide shampoos/rinses are not recommended for prevention. Use these products only as directed. Children under the age of two years and people with asthma, allergies, seizures, pregnant and breast feeding women should consult their physician before applying the lice pesticides.
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Manual Removal Live lice move quickly on dry hair. They are typically light brown. They can be caught using a lice comb, tweezers, or fingernails, or by "sticking them" with double-sided tape wrapped around your fingers. The NPA (National Pediculosis Association) believes that mechanical removal with a comb is the safest and most effective alternative. Combing removes both the lice and the nits. |
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Nit Removal
Nits are tiny yellowish or grayish-white oval eggs attached to the hair shaft at an angle. They are the size of poppyseeds. They are most often found at the nape of the neck and behind the ears very close to the scalp, but can be found anywhere. They do not wash off or blow away. Nits may be confused with dandruff, hair casts, or dried gel, but these brush off. Although it can take time, you must remove all the nits to ensure effective treatment. Nits can be removed with a special comb. Combing is best accomplished on damp hair, and using conditioner can make it easier.
Recommended treatment consists of two parts. The first part involves the use of therapeutic shampoos, which should be used according to label instructions or from recommendations made by a physician or pharmacist. The second part should be seen as a two-week process of daily use of an ordinary shampoo followed by a cream rinse conditioner, along with combing the wet hair with a fine-tooth comb and frequently cleaning the comb on a paper towel between strokes to remove scalp debris and lice.
For instance, therapeutic (medicated) shampoos should be utilized on days 1 and 7; and ordinary shampoos followed by cream rinse conditioner and wet combing on all days (2-6 and 8-14). Efforts at fine tooth combing of wet hair daily are very important.
Procedure for wet combing the hair to remove the nits (Days 1-14)
- The use of white vinegar as a rinse or a commercial product to help loosed lice eggs saves combing time.
- Divide the hair into 1" sections.
- Hold each section at hair's end and comb as close to scalp as possible.
- Comb repeatedly until all nits are gone.
- Pin back sections as you go.
- When all hair is combed, soak comb in very hot water (130 degrees) for 15 minutes.
Helpful Hints
- Nit removal, done properly, will take time. It may help to allow your child to watch TV or read a book.
- Work under good light on wet hair (use conditioner or warm vinegar). Visibility is key. Even if eyesight is not a problem, you may want to use "drugstore" reading glasses or a magnifying glass.
- Use a regular brush or comb to remove tangles, then divide the hair in sections and fasten off the hair that is not being worked on.
- Use a good lice comb or fingernails, go through each section of hair FROM THE SCALP to the end of the hair. Rinse the comb by dipping in a bowl of warm water of holding under running water and dry with a paper towel to remove any lice, nits or debris between combings. Dispose of lice/nits carefully (i.e. in the trash or toilet).
- Look through each section of hair for live lice or attached nits. Go on to the next section until the entire scalp has been completed.
- Rinse out the conditioner and then repeat the combing process for the whole head again until no more lice or nits are found.
Clean the Environment
Environmental attention includes the laundry of pillowcases, bed linen and clothing worn by the child worn the day of diagnosis. Environmental lice sprays are not recommended due to potential health threats. Although an essential step in treatment, it is not necessary to turn your house upside down in an effort to get ride of lice. Lice depend on human blood to survive and typically die within 24 hours without a host (nits also die off humans). Some cleaning is necessary to remove a possible source of re-infestation.
- Machine wash all recently used (last 3 days) clothing, towels, and bedding in hot water and dry in a hot dryer. Items that cannot be washed (i.e. scrunchies, ribbons) can be put into sealed plastic bags for 2 weeks or put in hot dryer for 20 minutes or some items can be dry-cleaned. The NPA feels that bagging may not be necessary. Don’t forget hats and coats.
- Check all family members for live lice and nits as well.
Taken in part from the Iowa Disease Bulletin by the Iowa Department of Public Health.