Schoolhouse Head Lice Protocol
Updated October 2017
For families and teachers of school-age children, head lice can be a real nuisance. The purpose of this document is to outline the roles, responsibilities and expectations of the Schoolhouse community in assisting with the treatment and control of head lice in a consistent and coordinated manner. While parents have the primary responsibility for the detection and treatment of head lice, our school community will work in a cooperative and collaborative manner to assist all families to manage head lice effectively.
Goals of head lice education at the Schoolhouse
- Reduce the frustration and misinformation associated with head lice.
- Decrease the concerns regarding head lice within the school community.
- Promote regular home-based screening.
It is expected that families attending the Schoolhouse will:
- Check their child’s head for lice on a weekly basis, at home.
- Notify the Head of School if their child is found to have live lice and let her know when treatment began (your child may not attend school with untreated head lice).
- Tie a child’s long hair back if being treated for lice.
- Use safe, recommended practices to treat head lice.
- Notify the parents of your child’s friends so they have an early opportunity to detect and treat their children, if they have been in contact with each other (ex: sleepovers).
- Maintain a sympathetic attitude and avoid stigmatizing/blaming families who are experiencing difficulty with control measures.
- Act responsibly and respectfully when dealing with any/all members of the school around issues of head lice.
Guidelines for parents to control head lice
Head lice aren’t dangerous and they don’t spread disease. But they are contagious, and they can be downright annoying. Their bites may cause your child’s scalp to become itchy and inflamed, and persistent scratching may lead to skin irritation and even infection. Having head lice is not a sign of uncleanliness or poor hygiene. These pesky little bugs can be a problem no matter how often a person clean their hair or bathes. Head lice move by crawling, they cannot hop or fly. Head-to-head contact with an already infested person is the most common way to get head lice.
Inspect your child’s head for lice and nits
- The only way to know if your child has lice is to look through their hair. Inspect all family members’ hair thoroughly, especially in areas close to the scalp at the neckline and behind the ears for lice and nits (head lice eggs). Wetting the hair before combing has been shown to be a helpful method in finding lice. Use of a magnifying lense and a fine-toothed comb or nit comb may also be helpful. Nits are firmly attached to hair shafts and are usually yellow to white. The adult louse is about the size of a sesame seed and is greyish-white to tan.
- Correct identification of actual nits is critical. Anything that slides along the hair shaft is not a nit.
- Crawling lice are difficult to see, but finding nits within a ¼” of the scalp confirms the presence of live lice and the need for treatment.
- If you are not sure if your child has head lice, the diagnosis should be made by a person trained to identify live head lice.
Treatment of head lice
- The most important components of head lice control are a single treatment, then reapplication if live lice are found 7-10 days later. Daily nit combing should also be performed.
- Treatment of lice is controversial. Please talk to your pediatrician for advice. Here are a few websites that will help you weigh the advantages of different options.
- Daily removal of lice and their nits from a child’s hair with a nit or flea comb with long metal teeth is the most effective lice control measure. Complete nit combing of the entire head has to be performed every day (dampen hair for easier combing) until no more lice or nits are found. Any nits that cannot be combed must be removed either by picking them out with the fingernails, or snipping the hair above where the eggs are attached. A useful method for nit combing is to part the hair into small sections. After each section is combed, secure each section to keep track of what has been combed. You may also seek professional services to assist with the process of manual remove and environmental control.
- Most over-the-counter products are only effective for live lice and do not kill or remove nits or eggs. Follow the label directions carefully. It is important to apply one treatment per infested person - do not divide treatments among infested people. Do not treat a second time until at least 7-10 days following the first treatment. Repeat treatments may be dangerous and are unnecessary.
- This document has more detailed information about how to check for lice.
Lice biology and washing recommendations
- Lice will die within two days without a blood meal (off a person).
- Bed linens should be washed in hot water then dried on a hot cycle for at least 20 minutes.
- Wash items in close or prolonged contact with the head (hats, combs, brushes, hair bands, barrettes).
- Items that are not washable may be put in a sealed plastic bag for two weeks to kill hatching lice (nits take 6-9 days to hatch and are unlikely to hatch away from the scalp).
- Carpets and furniture should be vacuumed. Do not use household lice sprays or pesticides.
What is the Schoolhouse’s lice policy?
We follow the CDPH guidelines on lice prevention and control in schools and have a no-lice policy. Children at the Schoolhouse may not come to school with live lice. But once treated, they may return.
If you find head lice on your child:
- Email the Head of School to let her know. This information will be treated confidentially, and the Head of School will determine whether classroom or school-wide notification is necessary. Names of students will not be shared to protect privacy.
- Treat your child for head lice. This may be an at-home treatment or a professional treatment. Follow the treatment as prescribed by the professional or the over-the-counter instructions.
- Let the Head of School know which treatment you have performed prior to your child’s return to school.
- Your child may return to school once treatment has begun.
- A trained person designated by the Head of School may check your child for lice before they return to class.
Where did the Schoolhouse lice policy come from? What are best practices for schools?
Head lice, while a significant nuisance problem, do not transmit disease to humans. Traditionally, head lice policies in schools emphasized that a child infested with head lice could not return to school until no nits were found in their hair (“no-nit” policy). There is no evidence that a no-nit policy prevents or shortens lengths of outbreaks. The American Academy of Pediatrics, the National Association of School Nurses, and the Centers for Disease Control and Prevention (CDPH) are all opponents of no-nit policies. “No-nit” policies that require a child to be free of nits before they can return to schools should be discontinued for the following reasons:
- Many nits are more than ¼” from the scalp. Such nits are usually not viable and are very unlikely to hatch to become crawling lice, or may in fact be empty shells, also known as “casings.”
- Nits are cemented to hair shafts and are very unlikely to be transferred successfully to other people.
- The burden of unnecessary absenteeism to the students, families and communities far outweighs the risks associated with head lice.
- Misdiagnoses of nits is very common during nit checks conducted by nonmedical personnel.
CDPH recommends a no-lice policy. The essential components of a no-lice policy are as follows.
- Early detection of head lice infestations through routine screening by parents and/or caregivers.
- Treatment of children found to have live lice.
- Distribution of educational material to school staff and parents on head lice, nit combing, and treatment.
Students diagnosed with live head lice do not need to be sent home early from school; they can go home at the end of the day, be treated, and return to class after appropriate treatment has begun. Nits may persist after treatment, but successful treatment should kill crawling lice.
In addition, “there is a lack of evidence showing that routine class or school-wide screening reduces lice infestation rates. Parents should check their children for lice regularly. If lice are seen on a child at school, the parents should be called to pick up their child at the end of the school day... At home, all members of the family must be checked for head lice. This policy allows the parent to treat the child overnight. The day following treatment, the child should be re-examined and return to school. If the child is still infested, then the parent should be re-contacted. While classroom or school-wide notification is not recommended after head lice have been detected in a student, this policy is at the discretion of the school.”