Head Lice

    WHAT IT IS: Infestation of head lice is a common communicable childhood condition that can happen to anyone; it has nothing to do with cleanliness. This is an easily treated condition that is generally not associated with any serious medical complications. It is important to treat the infestation quickly and thoroughly to prevent its spread to others. This web page will acquaint you with the nature of this infestation and what should be done to get rid of it.

    HOW YOU GET IT/PREVENTION: Head lice are usually transmitted through sharing combs, brushes and other grooming aids, through sharing hats, caps, wigs, or coats, or through co-mingling of these items at the homes of friends, at school, at church, or other public places. Many people have the impression that only persons who are unclean become infested with lice. In the case of head lice, this is NOT true. Frequent bathing will neither prevent head lice not eliminate an infestation once it has become established.

    WHAT TO LOOK FOR: Head lice are elongated insects about this (-) long and grayish-white with dark margins. Newly hatched lice are about the size of a period (.). Lice do not have wings and, therefore, cannot fly. Although they do NOT jump, they do move very quickly; this quick movement makes them difficult to find in a child’s hair.

    Since crawling forms can be difficult to find, head louse infestation is frequently diagnosed by finding nits. A nit is a louse egg. Nits are teardrop-shaped, about the size of a period and vary from yellowish-brown to white. Head lice attach each nit to the side of a hair shaft with a waterproof, cement-like substance. Thus, nits cannot be washed out or brushed out of the hair like dandruff or other debris that may look like nits to the naked eye. Clusters of nits may be found in any section of the hair, but in light infestations, a careful examination of the entire scalp may be necessary to detect them.

    TREATMENT: It is necessary to treat the infested individual and his/her personal articles such as caps, combs, brushes, towels, and bedding. The U.S. Public Health Services do not recommend fumigating or using insecticides in the home, school, and school buses.

    INDIVIDUAL TREATMENT: Apply head louse shampoo according to your physician’s instructions or the label instructions provided by the drug manufacturer. Several products are available without a prescription. A cool water rinse over a sink or the side of the bathtub is recommended to minimize absorption of the medication through the scalp. Have your child put on clean clothing after treatment. All nits must be removed from the hair to prevent reinfestation. Repeat the treatment in 7-10 days to kill any newly hatched lice. The 7-10 day interval corresponds to the incubation period of a louse’s egg. All household members and close friends of your child should be examined. Anyone found to have lice or nits should be treated as well.

    DECONTAMINATION OF PERSONAL ARTICLES AND ENVIRONMENT: Since heat kills lice and their eggs, many personal articles can be disinfected by machine washing in HOT water and/or drying using the HOT cycle of the dryer. Eggs are killed in 5 minutes at 125 degrees F and adult lice die in slightly lower temperatures. Home hot water heaters keep water at about 140 degrees F when the heat selector is set on medium or high. However, some water heaters do not sustain the 140 degree F water temperature when several loads of laundry are washed one after the other or when demands for hot water (e.g., bathing) are made simultaneously. To maintain the water temperature, allow time between loads for the water heater to regain its maximum water temperature. If you depend on the clothes dryer for disinfection, dry articles for at least 20 minutes at the high heat setting. Some non-washable articles may be disinfected in the dryer if the heat will not harm them.

    Machine wash all washable clothing and bed linens that have been in contact with your child. Personal articles of clothing or bedding that cannot be washed or dried may be dry cleaned or simply placed in a plastic bag and sealed for 10 days. Combs, brushes, and similar items can be disinfected by soaking them in a pan of water heated on the stove to about 150 degrees for a minimum of 20 minutes (caution: heat may damage some combs and brushes). Because lice can live only a short time if they fall off the head, the U.S. Public Health Service recommends that you limit the cleaning of carpets, upholstered furniture, etc., to simple vacuuming. Using insecticides or fumigants on upholstered furniture, carpets, bedding, etc., is not necessary.

    NOTIFICATION OF OTHER PARENTS: Parents of your child’s closest friends should be notified that their child might also be infested. This is particularly important if the children have slept together or participated in activities involving frequent close body contact.

    RETURNING TO SCHOOL: An adult must accompany your child to school after he/she has been treated for head lice and all nits have been removed. Report to the school nurse who will examine your child’s head prior to readmission to school to determine if the treatment was effective and all the nits were removed. Continue to check your child’s hair periodically to monitor for any recurrent symptoms.

    Your child’s school nurse is happy to assist you in your efforts to quickly address this inconvenient condition and limit the interruption to your child’s education.