Head Lice – A Lousy Problem Developed by: Updated 9/15.

Head Lice – A Lousy Problem

Developed by:

Updated 9/15


The facts about head lice How to detect head lice Treatment and management Recommendations for child

care and schools Resources

What are Head Lice?

Head lice are small insects (about the size of a sesame seed) that live on the human head and feed on human blood.

Head lice are specific to humans; they do not and cannot live on animals.

Head lice are flat and wingless and can not fly, hop or jump.

What are Head Lice?

Head lice vary in color depending on their surroundings.

Head lice have six legs, a diamond shaped head and an elongated body.

The mouth is shaped like a stylet; this allows the louse to pierce the skin to feed (blood meal). Actual louse on a hair shaft

(highly magnified)

Life Cycle

Eggs

Nymphs

Adults

Transmission

Person-to-person transmission (direct contact)

Transmission

Vector Transmission (indirect contact)

Once away from the human host, the adult louse can usually survive no longer than 24-36 hours.

Transmission

Head lice may be brought into the home by a person’s contact with an infested person, but the most rapid spread of head lice occurs in the home because of the close proximity of family members.

Transmission

Head lice can infest all people, regardless of age, race, social-economic status or hygiene practices.

It is a myththat headlice infest

dirty hair overclean hair.

Detecting Head Lice

Signs and Symptoms:• Itching• Sores in the head caused by scratching• Tickling feeling of something moving in the

head• Sleeplessness• Or there may be no symptoms

Detecting Head Lice

The most obvious sign that someone is infested is the presence of nits or lice.

Treatment and Management

Careful inspection and screening of the hair and scalp

Use of a head lice treatment product Manual removal of nits Cleaning of personal items and the environment Daily checks of the

hair and scalp

Inspection of the hair and scalp to identify lice and/or nits correctly

Supplies needed:• Time• Good light source• Magnifying glass

(optional)• Disposable tools

(optional)• Vinyl or latex gloves

(optional)


Examine the entire head; pay special attention to the areas behind the ears, near the crown and at the back of the neck.


Nits vs. hair debris: Improper identification of nits is a common problem which can lead to unnecessary treatment, absence from child care, school or activities and stress.

Use of a Head Lice Treatment Product or Alternative Therapy

Pediculicidal products (those products that contain permethrin or pyrethrin, such as Nix or Rid)

Alternative shampoos and/or therapies

Prescription only


Head lice treatment products/shampoos are to be used for the treatment of head lice only. They should not be used as a regular shampoo.

Head lice treatments products will not prevent someone from getting head lice. They should only be used on those people that are infested.


As with any product, it is very important that you follow the label directions EXACTLY. – Many will instruct to retreat the hair in 7-10 days.

All safety precautions and contraindications for use listed on the product label should be observed.

Despite product claims, no product is 100 percent effective in getting rid of all the lice and eggs.

Pediculicidal Products

Products that contain permethrin or pyrethrin, such as Nix or Rid

Treatment failures may occur due to: Misdiagnosis Noncompliance Repeat infestation Resistance


Do not use a pediculicidal product if: The person has a known

sensitivity to any component in the product.

The child is younger than age 2.

The person has an infestation of the eyebrows or eyelashes.


The following groups of people should consultant their health care provider before treating themselves or others: Those with neurological

conditions Pregnant women or nursing

mothers Those with skin conditions

such as psoriasis or open sores


The following groups of people should consult their health care provider before treating themselves or others: Those with cancer Those with asthma or

allergies Those with an allergy or

sensitivity to ragweed or chrysanthemums and roses


Products containing Lindane, such as in the prescription product Kwell, should be used with extreme caution. Neurotoxic reactions have been reported as a result of the normal use of Lindane shampoos.

No longer recommended bythe American Academy of

Pediatrics

Alternative Therapies

Remember, “natural” doesn’t always mean safe.

FDA approval recommended Products should provide toll-free numbers and

a list of product ingredients.

Home Remedies

Examples include: Olive oil Mineral oil Vaseline Mayonnaise Vinegar Listerine Cetaphil

Home Remedies

Oil-based products appear to work by clogging up the breathing pores of the lice.

These products are hard to remove from the hair.

Few scientific studies have been conducted that show these treatments to be effective.


Despite product claims, no product is 100 percent effective in getting rid of all lice and eggs!

Daily head inspections and the manual removal of lice and nits is necessary following the use of any treatment product.

Never Use:

Toxic and/or flammable household products such as gasoline, paint thinner, pesticides intended for use on insects and/or bugs other than head lice, pesticides intended for animals, bleach or any other household cleaners.

What About Head Shaving or Cutting Hair?

Cutting or shaving a child’s head to get rid of head lice will work, but it may be at a high emotional cost to the child and is not necessary.

Manual Removal of Nits

A good lice comb is important!

Metal combs are sturdier and stand up better to cleaning.

Light colored combs allow for better visualization.


Comb hair one section at a time, removing all the lice and nits.


Removing nits is a very time-consuming but important process!

Cleaning of Personal Items and the Environment

Even though cleaning the environment is important, excessive cleaning such as scrubbing down walls is not necessary.

Concentrate on heads, where head lice live and feed.

Daily head inspections and nit removal will go much farther in the management of head lice.


Soak all family combs and brushes in hot water (130 degrees F) for at least 10 minutes or boil for five minutes.


Wash all recently worn (within two days) clothes and/or bedding in hot soapy water (130 degrees F) and dry using high heat for at least 20 minutes.


Vacuum rugs, carpets, upholstered furniture, pillows, mattresses, car interiors and car seats.

A sticky lint remover can also be used on upholstered

surfaces.


The use of lice sprays is NOT recommended and is strongly discouraged, as they may be harmful to family members and pets.

LiceSpray

Daily Checks of the Hair and Scalp

For those treated, hair should be inspected and nits removed once daily for seven to 10 days.

Inspect all household

members daily for seven to ten days.

– Treat anyone who was not treated previously, but is found to be infested through daily inspections.

Recommendations for Schools and Child Care

There is no state law that governs the management of head lice control in school or child care.


Develop a head lice control policy that addresses: Screening procedures Parent/guardian

notification Exclusion protocol Readmission criteria Definition of and district

response to excessive absences

The “No-Nit” Standard/Policy

Controversy exists in the medical literature regarding the “no-nit” standard.

The “No-Nit” Standard/Policy

The American Academy of Pediatrics, Center for Disease Control and Prevention and the National Association of School Nurses no longer support the “no-nit” standard.

Disadvantages of a “No-Nit” Policy:

“No-Nit” policies can be carried out too rigidly. Children are often excluded due to misidentification of

nits or the presence of nonviable nits. Exclusion may hinder academic performance and

increase social stigma. No other minor medical condition excludes children,

including upper respiratory infections, which are often more contagious.

Proactive Community Education

Provide the community with a baseline understanding of head lice, modes of transmission and the importance of safe and effective treatment and control measures – before outbreaks occur.

Routine Screening and Early Detection

Scheduled and announced group screenings encourages parental compliance and promotes community cooperation and individual accountability.

Opponents of “no-nit” policies do not advocate for group screenings. Rationale: Mass screenings may be disruptive and have not been proven to have significant effects on reducing the incidence of head lice in schools.

For Against

Inform All Parents of a Case of Head Lice

When a case of head lice has been identified in a classroom, a written notification should go out to all parents.

– Allows for precautionary head lice checks to be done in the home environment.

Opponents of “no-nit” policies do not advocate for classroom or school-wide notifications. Rationale: Such notifications may increase public alarm, disrupt school productivity, strain school resources and bring undue attention to those children with head lice infestations.

For Against


No child should be excluded from school or child care for long periods of time because of head lice!

If the child is sent home more than twice, the information being supplied to the family may not be adequate.


Frequent infestations and excessive absences may be signs of other problems.

Get the family some support by involving your local public health unit or social services.


The use of insecticides, lice sprays or environmental fumigants of any kind to fog the school or child care room, or to treat walls, floors, desks and carpets are of no value in the control of head lice.


Remember to keep things in perspective. Although head lice are a nuisance, they do not carry disease.


Be sensitive when communicating with children and families who have head lice. Although not dangerous, head lice can be emotionally traumatic and cause a lot of frustration.

Resources

Fact sheets:– Head Lice: A Lousy Problem booklet– Head Lice (Pediculosis)– Quick Guide for Removing Head Lice

Available from:The North Dakota Department of HealthDivision of Family Health1.800.472.2286701.328.2493

http://www.ndhealth.gov/head-lice/

Resources

National Pediculosis AssociationP. O. Box 610189Newton, MA 02461781.449.NITS (6487)www.headlice.org

American Academy of Pediatrics141 Northwest Point BoulevardElks Grove, IL 60007-1098847.434.4000www.aap.org

Resources

Centers for Disease Control and Prevention 1600 Clifton Road

Atlanta, GA 30333404.639.3311www.cdc.gov

National Association of School Nurses1100 Wayne Ave, #295Silver Spring, MD 20910240.821.1130www.nasn.org

Head Lice – A Lousy Problem Developed by: Updated 9/15.

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