SPN: Head Lice: A Lingering Pest

As October comes to end and the weather changes over from warm to cold, kids will start carrying more garments. Cooler weather is prime time for head lice outbreaks. Contrary to popular belief, head lice are not a sign of poor hygiene; in fact, lice are perfectly comfortable on a clean head. According to the Centers for Disease Control (CDC), there is no reliable data on how many people get head lice each year in the United States; however, an estimated 6 million to 12 million infestations occur each year in the United States among children 3 to 11 years of age.

head lice nits Mike Merchant

Nits adhere to the hair and can become dislodged when kids share items like headphones, hair brushes, helmets and other items.

Lice eggs, known as “nits,” are firmly adhered onto hair shafts, making it especially difficult to remove them. Each louse can live up to one month and produce one hundred offspring with regular meals of human blood. Head lice can be transferred by head-to-head contact, sharing hats, combs and pillows.

Screening for head lice in schools is a very useful role for the school health professional. Active infestations need to be addressed individually. Parents of all children using the room with any child with confirmed head lice should be notified and provided with basic information including description, signs and symptoms; strategies to eliminate head lice. The information should include where to go for additional help.

School districts vary in adoption and enforcement of the controversial “No Nits” policy, which states that any student with head lice, even a single nit, should be forced to stay home from school. The American Academy of Pediatrics and the National Association of School Nurses advocate that “No Nit” policies should be discontinued. Since lice do not spread disease or have any harmful effect other than an itchy scalp, requiring students to miss school is unnecessary and detrimental to their performance. The presence of nits alone is not a good predictor of infestations; only about 18% of children with nits alone will become infested with adult lice. Supporters of the zero tolerance policy, including the National Pediculosis Association, state that the only way to control and stop the cycle of lice infestation is to keep kids out of school until all nits are removed.

How to Spot Head Lice

Lice have three pairs of legs and are grayish-white in color. Nits are oval white cylinders that are about a sixteenth of an inch long. Lice prefer to lay their eggs near the ears and the back of the head.

Prevention and Treatment

Children should be encouraged not to share combs, hats or other personal belongings. Once an infestation is detected, non-chemical treatment options include washing clothing, pillow cases, sheets, blankets and other bedding material in hot soapy water and drying on a high heat cycle to kill all lice and their eggs. Use of lice sprays on furniture and toys is not effective. Non-washable items can be sealed in plastic bags for seven to ten days.

Manual removal of nits close to the head is always recommended. Fine-toothed “nit combs” are helpful. Combing and brushing wet hair damages lice and eggs significantly. Additionally, use of a hair dryer further injures adults, nymphs and nits. Botanical-based lice removal aids such as Lice-B-Gone® and De-Licer® may ease removal.  See our IPM Action Plan for more tips.

To remove lice and nits,

1. Comb and divide hair into sections, use a metal fine toothed louse comb to remove nits and lice. After combing each section dip the comb in a container of hot soapy water to remove lice and nits.
2. Repeat if nits are still attached within 1 cm of the scalp.
3. Repeat until all the sections of hair have been systematically combed.
4. Clean nit removal comb, clips, brushes, headphones, hats, etc. with hot soapy water.

For more information about head lice, download the Human Lice factsheet or visit the Texas Department of State Health Services website Managing Head Lice in School Settings and at Home
Head Lice (Pediculosis) Fact Sheets


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