Preventing (or Dealing With) Head Lice in the Classroom

I am phobic, phobic about head lice! I have been since I was a child. Turns out, I probably work in the worst profession for someone with this phobia — right? I have to laugh at the irony. Over the years, my OCD around the topic has helped me to develop some survival techniques for dealing with this enemy. By no means am I even remotely close to having the expertise of a nurse or dermatologist, but through talking to school nurses, reaching out to the teacher blogging world, and digging into some general online research, I have found a few good tips and resources for lice prevention. Read on to see what my head lice plan of attack is for this school year!

GENERAL PRECAUTIONS:

As recommended by the American Association of Dermatology (AAD): "Teach your child to stop sharing things that touch the head. Brushes, combs, hair accessories, hats, helmets, scarves, towels, and even earbuds offer head lice a good place to hang out until they can crawl onto a human. When someone has head lice, tell your child not to touch couches, chairs, pillows, rugs, and beds that a person who has head lice uses."

HERBAL PREVENTION?

The jury is out on a final verdict, but I’ve talked to many a mother, even some who are nurses, and certainly found all over Pinterest, the wonders of using tea tree and lavender oils mixed with shampoo or water solutions as a preventative measure (and possibly treatment) against these pests. Certainly, do your own research, but I personally mix this solution into my son’s shampoo and styling spray bottle. It smells great, his hair looks great, and it gives me some hope that it might be helping prevent any creepy crawlers from coming home as stowaways. 

BAG IT UP:

I’ve used heavy-duty garbage bags to store everyone’s personal belongings when we’ve had a lice outbreak in class. Two years ago I had what I think was a genius moment when I realized I should just do this same prevention all year. We don’t have separated cubbies, so student coats, backpacks, hats, etc. are constantly right next to each other, which is not optimal when trying to prevent the spread of head lice. My first attempt at daily bagging led me to the dollar store laundry bags below. These worked great for organization of our entryway, and must have at least somewhat helped with lice spread prevention.

The laundry bag method is certainly worth a try (if for no other reason than for organization of a hook area in the classroom), but it has two drawbacks: 1) The bags eventually wear out, usually before the end of the year; and 2) The bags are not totally sealed, nor made of 100 percent impermeable material.

So, I scoured the Internet for other potential ideas and found the king of lice prevention bags: SUPER JUMBO zipper seal bags with handles. These were originally designed for basement storage, but are perfectly sized for backpacks, coats, and other home items. They seal, they hang, and they are made of plastic so they are impermeable!

WHEN LICE STRIKES:

According to the AAD, if lice become an issue in your classroom (or at home), there are a few things you can do to catch the problem early and hopefully remedy the situation. As for my own tip, I would certainly suggest instantly bagging up belongings of ALL STUDENTS into at least garbage bags or any of my other suggestions above. On the AAD website, they suggest you:

• Check your child’s hair

• Inspect household items that can get infested with lice and nits: towels, rugs, and bedding.

• Look carefully at the clothes your child has worn during the past two days for lice and their eggs.

• Reinforce the message to stop sharing anything that touches the head.

• Tell your child to stop head-to-head contact with other kids until the school is free of lice.

LET’S TALK ABOUT LICE

Lice happens. We want kids to learn about it, know about how to prevent lice from spreading, and we also want to be very sensitive to the feelings of anyone who might have lice in the classroom. We would never want someone to feel isolated, bullied, nor made fun of because they have or had head lice. I find that having open discussions about lice, pointing out that head lice is a common part of elementary school life, and that lice can happen to anyone prevents insensitivity from ever being an issue. 

How To Get Rid of Lice Naturally (Advice From a Professional Nitpicker)

Have you ever noticed how motherhood has a way of making you feel guilty about random things, like going to the bathroom by yourself? Well, here’s one thing you shouldn’t add to your list: lice.

If your little one gets it, it’s not because they were dirty . . . though it’s probably a good thing if they are sometimes. Lice thrive in clean hair, dirty hair, blue hair and even weird beard hair.

If you’re like me, you remember being doused with a foul, tar-like shampoo after a wave of lice hit your local elementary school. For even the natural mamas among us, it’s easy to think that this might be the time to bring out the big guns. Who wants to fight this stuff for weeks, right?

Before you lather up, though, here’s what you need to know:

Conventional Lice Treatments Are Worse Than We Thought

Over-the-counter options like Nix, Rid, A-200 and Pronto and prescription varieties like Ovide or Kwell contain neurotoxins that kill lice by attacking the central nervous system.

Permethrin and pyrethrum, which are found in over-the-counter options, are neurotoxins that have been linked to “side effects such as headache, ringing of the ears, nausea, tingling of fingers and toes, breathing problems, and other nervous system problems.” The Asthma Society of Canada adds that “Children are particularly vulnerable to the effects of pesticides, especially those with a history of allergies or asthma.”

Prescriptions options use stronger pesticides. For example lindane, which is found in Kwell, is linked to seizures, slurred speech, mental confusion and tremors. In fact, the “pharmaceutical use of lindane is already banned in at least 52 countries across the globe. The American Academy of Pediatrics recommends against the use of lindane, citing toxicity to the central nervous system and cases of seizures in children, as well as low efficacy.” 

“Increasingly pesticides like lindane, even in very small amounts, are linked to a wide range of adverse impacts on children’s health,” said Mark Miller, MD, MPH, director of the UCSF Pediatric Environmental Health Specialty Unit. “The options for lice and scabies control shouldn’t include this neurotoxic pesticide.” 

Plus, They Don’t Even Work

You see, lice are super these days. And by super I don’t mean awesome, I mean resistant to pesticide-based products. According to a study published in the Journal of Medical Entomology, 99.6% of the lice found in the U.S. at the time of the study were “super lice.” Just like bacterial superbugs, they’re unaffected by conventional treatment methods.

If you’re scratching your head about what to do instead, I have a few suggestions.

How To Get Rid of Lice Naturally

Last week I discovered that one of my boys had lice. Since it spreads easily between family members I decided to treat everyone, including myself. My hair is long and thick, so separating it into sections to go through with a nit comb (more on those in a sec) is not an easy task.

Nit Comb

Professional “nitpickers” most often use the Nit Free Terminator  to remove lice and eggs.

After comparing the metal comb I was able to find at our local store with the Terminator comb, I ordered the Terminator. Missing just one or two eggs can lead to a recurrence, so I wanted to have it on hand in case the comb I’d used didn’t fully do the job. It’s also good to have on hand for future issues, although I hope we don’t have any.

In the video below, a professional “nitpicker” walks you through effective combing techniques for removing lice and nits.

Home Remedies For Lice (Application Guide & Recipes)

If you’re wondering how much essential oil to use during the suffocation treatment and what other options should be considered, this section is for you. Below are some natural ingredient combinations that I’ve used personally and/or friends have recommended.

APPLE CIDER VINEGAR

Some people believe that applying vinegar to the scalp/hair before blowdrying helps loosen the “glue” that holds lice eggs in place. I used a glass spray bottle to apply the vinegar to my daughters hair, then allowed it to dry naturally before drying the scalp with a hair dryer.

COCONUT OR OLIVE OIL + ESSENTIAL OILS

As mentioned above, in this study, a lotion that included 10% tea tree and 1% lavender oil was 97.6% effective in eliminating lice, while insecticides like pyrethrins and piperonyl butoxide were only 25% effective.

When I applied coconut oil to my kids, I used 9 drops essential oil per tablespoon of coconut/olive oil.

How To Prevent Lice From Coming Back

Lice don’t do well in the environment if separated from us, so preventing reinfestation is relatively easy with a little know-how.

• Place brushes, combs, rubber bands, and other hair related items in a sealed bag/container and place in the freezer for 24 hours

• Wash and dry bedding and towels in hot water, then place in dryer. At the end of the drying cycle I turned my dryer setting to “high heat” and let it run for 20 minutes before taking everything out.

• Wipe down car headrests and seats if possible

Or just avoid all the trouble and book an appointment with us at Larger Than Lice, we will be more than happy to help you and your family be lice free and stress free in no time!

A Mom’s Take on the Stigma of Lice, and Why It Puts Children at Risk

Strolling a main street in my neighborhood, chatting on the phone with my slow-speaking, aging dad, I muttered, embarrassed, “We have… lice.”

“You have lies?” Dad asked in his Texas drawl.

“LICE,” I shouted. “We have LICE!”

A longish-haired hipster passed me, looked back in horror, and touched his hair anxiously as if simply hearing the word might spread the parasite.

It took me back to the late ‘90s, when a gay male friend who had contracted crabs felt obliged to call and inform one of his sexual partners. Unlike when people get STDs, though, when you get head lice, your doctor does not implore you to contact everyone with whom you have come into head-to-head contact to help alleviate the spread. But they should.

Our first cootie encounter

Like losing my virginity and qualifying for my first mortgage, I remember clearly the first time my family got head lice. One of my daughter’s classmates contracted it, and our class parent suggested everyone check their kids. I bought the over-the-counter head lice treatment, Rid, intending to prophylactically treat everyone in the family. And in that process I found a bug. Still moving, fighting for its life. Houston, I thought, we have lice. And then my own scalp started itching.

Imagining that the best way to reduce the spread of head lice was to fess up that you have it, and then avoid contact with others’ heads, I emailed our class list serve. I named names. “We have lice! We are actively treating it. Check your kids tonight!” I emailed the principal, the teachers, the school guidance counselor, anyone we had rustled on the playground with, and playdates within the last 36 hours. More than 100 people had now been informed.

Tackling head lice phobia head on

I’ve gotten pretty comfortable talking about things that make others squeamish. I came out as a lesbian in the ‘90s. I marched in the streets shouting, “We’re here, we’re queer, get used to it!” I traveled to Washington to rally for reproductive rights, holding placards that proclaimed: “DYKES FOR CHOICE.”

For this new cause, I needed only to update my mantra to: “We have lice, we’re treating it, check your own kids!” Fundamental to my previous activism had been my belief that disclosing information, provoking discussion, and removing shame and stigma is key to treating societal problems like sexism and homophobia. And now head lice phobia. 

My children are embarrassed by my compulsive need to talk openly about topics others don’t want to broach, but I hope I’m teaching them by example about why it’s important to speak out, even when it doesn't feel comfortable or convenient.

Alone with my kids and my nit comb

“That was quite an email you sent,” remarked one mom, avoiding a hug, the morning after my first disclosure. Would she rather I have stayed silent and let the critters spread? While no one wants to get lice, and treatment is painfully time-consuming, lice are not actually physiologically harmful — just psychologically and socially.

Playdates were canceled. Weekend family dinners disbanded. I was alone with my kids and my nit comb, a social pariah, as people slowly backed away. And yet lice continued to spread at our school and in our classrooms. But no one seemed to want to discuss it, and there didn’t seem to be one gold standard of treatment.

Head lice had become, for me, the herpes of the modern parenting set. According to the Centers for Disease Control and Prevention (CDC), an estimated 6 to 12 million children in the United States get head lice each year. Still, the CDC says data are “unreliable,” probably in part because of low self-reporting numbers. Many of those millions of families won’t admit when they've contracted it, so it spreads among us, an unwelcome guest in already cramped urban quarters.

I heard from one mom at the YMCA that another had complained about all the families spreading lice in our school: “Lice are totally preventable! Why are these kids coming to school with them?” I stepped off the treadmill and started grandstanding, comparing what she had said to the ‘80s, when people like Senator Jesse Helms wanted to quarantine people with AIDS on an island. A hyperbolic stretch, I know, but the secrecy and victim shaming were familiar.

And so I kept talking about lice. It seemed ridiculous, and ineffective, to stay silent and isolated about something so silly — something that could, in fact, be prevented, but only if more people would let go of some of the shame surrounding it, and disclose it more willingly upon first contraction.

My Norma Rae moment

Perhaps because of inadequate treatments, or resistant mutant super strains, or maybe because the same stubborn buggers kept cycling through our social circle, we got lice again.

And again. And again.

It was traumatic and exhausting, but also continued to give me a mouthpiece for advocacy. I once again informed our school community, neighbors, the clerk at the local Rite Aid transacting my purchases of large bottles of Pantene, and my favorite barista. I stood up at a PTA meeting and came out to 100 peers: “Our family has been battling lice for months…” as I proposed a formal lice check program be funded and implemented. A random mom met us on the subway and remembered, with a chuckle: “You’re the lice mom!”

That PTA meeting became my Norma Rae moment, where Sally Field stands up at the factory holding the “UNION” sign. If people can see my face and associate me with lice (and prevention and education), maybe they’ll feel a little less alone when their child comes home with nits, and feel OK emailing me about treatment options and support.

And it seems to have worked. In the weeks and months after our initial lice outbreaks, I fielded many texts and emails: “OMG, I think Sam has lice. What do I do?”

I’m proud to be the local lice mom

I now have a whole “lice treatment” folder on my laptop. I have the numbers for two professional lice eliminators in my phone, one of whom I hired to do our formal lice checks at school several times a year, and with whom I have a regular text relationship.

I disseminate information, and an offer of a glass of wine, to anyone who asks. Recently my daughter’s teacher approached me. “One of my kid’s parent’s was told her kid has lice, and the parent doesn’t know what to do. Can I have her email you?” Of course, I said.

I’m OK being the go-to lice mom at our school, if it helps us all get to a better place, one nit at a time.

A School's Guide to the 'Nitty-Gritty' about Head Lice

Head Lice 101: The Basics

• NEVER apply pesticides to any classroom, bus, furniture, clothing or student in an attempt to control head lice. These applications do not help control lice populations. The children/staff are exposed to needless pesticide risk, and the school faces unnecessary LIABILITY. The University of Georgia, National Pest Control Association, National Pediculosis Association and Georgia Pest Control Association all support this "no pesticide" policy.

• Head lice are primarily transmitted by direct head-to-head contact and sharing of personal grooming items. Lice cannot jump, hop or fly, but they can crawl rapidly.

• Discourage children from sharing combs, brushes, hair accessories, scarves, hats or headphones to diminish the spread of lice. If headphones are used as part of a class, wipe them with a damp cloth before allowing another student to use them. Store each student's hat/coat separately. Articles can be isolated in bags if space is a problem.

• If you are concerned about head lice on carpets or furniture, vacuum them or wipe smooth surfaces with a damp cloth. Notify bus drivers of a head lice outbreak so they can wipe school bus seats with a damp cloth.

• Teach all school personnel to look for signs of head lice and establish a written school head lice policy (see further information in this brochure). Early detection of head lice is critical to control outbreaks.

The Facts

• More than 12 million people, mostly children and school personnel, get head lice every year. Several research groups have identified populations of head lice in the United States that could not be killed with commonly used insecticidal shampoos.

• Lice cannot live longer than 24-48 hours off their host. They cannot reproduce on or in carpets, pets, furniture, trash cans, etc.

• Do not panic! Head lice are not an emergency and, in most cases, do not pose a heath risk -- they are simply an inconvenience that should be dealt with compassionately and calmly.

• The best treatment for head lice is manual removal. Encourage parents and school nurses to follow thorough manual removal techniques as a first step. See "10 Tips for Manual Removal" in this brochure.

Head lice are small, wingless parasitic insects.

They are typically 1/6 to 1/8 inch long, brownish in color with darker margins. The claws on the end of each of their six legs are well adapted to grasping a hair strand.

A child cannot "catch nits." Nits (lice eggs) can only be laid by live lice.

Female head lice glue their grayish-white to brown eggs (nits) securely to hair shafts. The eggs are resistant to pesticides, and they are difficult to remove without a special 'nit-comb.' The nits are generally near the scalp, but they may be found anywhere on the hair shaft.

How to Avoid a 'Hair-Raising' Experience With Effective School Policy

Head lice can spread rapidly through the school population, and your school should establish a written policy to deal with these outbreaks. Many schools have adopted a no-nit policy. School administrators, however, should carefully consider both advantages and disadvantages before establishing a no-nit policy.

What are the advantages of a "No-Nit" policy?

Under a no-nit policy, children may not return to school until the school confirms complete removal of all lice and nits. In this way, infested children will not transmit head lice to others.

What are the disadvantages of a "No-Nit" policy?

Children are often excluded from school even when they are not at risk to transmit head lice. In a Harvard University study, dandruff, fibers, dirt, scabs, skin cells, knotted hair or other insects are misdiagnosed as head lice 40 percent of the time! Another study found that most children with nits alone did not become infested with adult lice. These reports indicate that many children are unnecessarily excluded from school under a strict no-nit policy.

What are the components of an effective head lice policy?

• Designate a person (such as a school nurse or principal) to check all students when an outbreak occurs. This person must also check infested children daily for 10 days after treatment (manual removal, shampoo, etc.) and re-admission to school. A repeat treatment of the child may be necessary in 7-10 days.

• The designated monitor must be trained to identify head lice and nits. Do not exclude children from school based on the diagnosis of an untrained or inexperienced person. Talk to your local health department about training opportunities.

• Educate parents and students about head lice and how to avoid infestation. Emphasize prevention! Distribute the "Parent's Guide to the 'Nitty-Gritty' about Head Lice" to concerned parents.

• Be sensitive when dealing with children (and parents of children) that have head lice. Although not dangerous, head lice can be traumatic.

• Base your policy on the presence of live, adult head lice. Policies based only on nits will be inconsistent and may unnecessarily exclude children from school.

10 Tips for Manual Removal

1. Work in a well lighted area or use a flashlight and hand lens.

2. Use a grooming comb or hairbrush to remove tangles. A hair detangler spray or other hair conditioner may aid in this process.

3. Divide the hair into sections and fasten off the hair that is not being worked on.

4. Use a lice comb to detect and remove lice and nits. 

5. Go through hair sections from the scalp to the end of the hair. Nits are usually found close to the scalp.

6. Dip the comb in a cup of hot, soapy water or use tape to remove lice, nits or debris from the comb.

7. Sift through the same section of hair and look for attached nits and live lice.

8. Move on to the next section until the entire scalp and all hair has been checked.

9. Screen the infested person every day for 10 days and regularly thereafter.

10. If additional nits (at least 3-5 per day) are discovered, another manual search is recommended.

Head lice cause more stress than harm

Here are two words that strike fear in the heart of every parent: head lice.

The very thought that tiny blood-sucking, parasitic bugs are living on your child’s head and could spread among other family members before you kill them is enough to send even the toughest parents running for cover at the nearest pediatrician’s office.

“Head lice cause no medical harm, but lice cause an enormous amount of anxiety among parents and teachers at schools,” said Dr. Michael Cater, an Orange County pediatrician with an office in Tustin.

Adding to this anxiety is a new study revealing that some lice in California and 24 other states have become resistant to over-the-counter medication. Prescription medication may now be required to eradicate lice; however, natural alternatives can sometimes produce good results. 

Head lice are mostly spread from head-to-head contact, and lice infestations are common at many schools worldwide. In the United States, head lice infestations are most common among preschool- and elementary school-age children and their household members and caretakers, according to the Centers for Disease Control and Prevention.

t’s a myth that only poor or unclean children get head lice; lice infestations are common in all communities. In fact, it’s estimated that 6 million to 12 million lice infestations occur each year in the United States among children ages 3-11, said the CDC.

Head lice move by crawling; they cannot hop or fly. They are spread by direct contact with the hair of an infested person. Anyone who comes in head-to-head contact with someone who already has head lice faces the greatest risk, according to the CDC. Dogs, cats and other pets do not spread head lice, said the CDC.

If your child has an itchy scalp and the itching doesn’t stop, or you notice sores on the child’s scalp from scratching, the first step in dealing with a suspected head lice infestation is to call your pediatrician, said Cater. The pediatrician will examine the scalp and look for a living louse or nits (eggs) on the hair shaft, he said.

Keeping the child’s environment clean and free from lice and nits is equally important to prevent a re-infestation. Parents should also wash the child’s bed linens twice in hot water and wash all combs and brushes. The goal is to rid the child of the infestation and prevent the lice from returning. However, if you have taken all these steps and your child’s head is still itching, she might have lice again. 

Your child’s pediatrician can tell if the lice have returned or the medication didn’t work for some reason, whether it was ineffective or applied incorrectly, said Cater. He said a different medication can be tried if necessary for a re-infestation.

Finally, a word about schools: The policy of the American Academy of Pediatrics is that a child should not be restricted from attending school for head lice, said Cater. Every school district handles the issue differently. Parents can ask their child’s school for its head lice policy, if there is one.

More districts allowing kids with lice to stay in classroom

f you’re a parent, you’ve probably gotten the dreaded call from the school nurse, letting you know that your child has lice. It happened to our older daughter in kindergarten, and then again two years later when our youngest was in the same grade. Each head lice infestation was a mini nightmare: a work and school day lost to early pickup, chemical shampoos, vacuuming and endless combing for nits (eggs). The days after, spent worrying that a stray louse might mean another call from the nurse and another day out of school. And that call always came: Your daughter has lice again. She’ll be waiting for you in the office. Last year, we spent a couple hundred dollars on a professional lice remover, just because we could no longer face the hours every night we needed to spend nit-picking.

Our experience was not uncommon. At many schools, any discovery of live lice in a child’s hair warrants a phone call and the immediate removal of the child from school. At some schools, the child may return the next day if the parents have treated the child’s hair — that is, shampooed it to kill live lice. But in schools with “no-nit” policies, a child can’t return unless every last tiny louse egg has been combed from her hair — and schools may check returning students and send them home if any nits are found.

But then, this fall, everything changed. The schools have adopted what you might call a live-and-let-lice policy. No child will be sent home for lice or for nits. If a child has lice in her hair, the nurse will contact parents but send the child back to the classroom for the rest of the day. Parents are expected to treat the lice, but no one is checking in to enforce this expectation. No classes or groups will be screened for bugs. “No healthy child,” the policy reads, “should be excluded from or miss school because of head lice.”

When I told friends in other school districts about the shift in our school’s lice plan, their jaws dropped. “That’s amazing,” they said. “Finally,” they said. And, “How can I persuade my school to do the same thing?” But my friends are gross, so you may, understandably, have a different reaction to this news. Like, “Ew, a school is letting a bunch of bug-covered, itchy kids rub heads in the classroom?”

Sorry, your response is wrong. Arlington’s new stance on lice is being adopted by schools all over the country, encouraged by the American Academy of Pediatrics and the National Association of School Nurses. And it’s the right one. Lice are not particularly contagious, they hurt basically no one, and they’re not a public health risk. Lice don’t actually matter. It’s high time that squeamish parents and school administrators stop acting like they do.

Let’s start with many schools’ long-standing no-nits policies — policies that say kids can’t return to school unless every last tiny louse egg has been combed from their hair. “No-nit policies don’t make any medical or scientific sense,” said Dr. Barbara Frankowski, professor of pediatrics at the University of Vermont. Frankowski, the lead author of the American Academy of Pediatrics’ study recommending changes in school lice policies, told me that, as any parent who has tried to remove nits knows, the eggs are firmly cemented to a child’s individual strands of hair. “They’re not going anywhere,” she said, “and pose no risk to other children.”

But even parents who understand the logic of not checking endlessly for nits get nervous about sending a child upon whom the nurse has just discovered live lice back to the classroom for the rest of the day. Shouldn’t those children go home so they won’t spread the lice to other kids? “If you find live lice during the school day, it’s likely that child has had lice for weeks,” said Carolyn Duff, the president of the National Association of School Nurses and the nurse at an elementary school in Columbia, S.C. “Allowing that child to remain in the classroom for a few more hours is not putting children at risk.”

After all, despite what you may think, “It’s not that easy to get lice!” Duff exclaimed. “They don’t fly. They don’t jump. They can barely crawl through your scalp. They can only spread through head- to-head contact, and children in schools don’t usually have head-to-head contact.” Even transmission through hats or hairbrushes is difficult — it can happen in families where such sharing is commonplace, but much less frequently in schools. (According to the experts I talked to, children are much more likely to spread lice during sleepovers or playdates, or at sleepaway camp.)

And even if they were highly contagious: The point that both the AAP and the NASN want to make is that it’s far more important to keep kids in school than it is to send them home in the hope of stopping the spread of lice. Because, again, lice don’t hurt anyone. “We’ve heard stories of kids missing weeks of school because of lice, even being held back a grade,” said Frankowski. “It’s unfair to kids. It’s unfair to parents who work or who have other difficulties that don’t allow them to go through hours of delousing.”

If your school still sends kids home for lice or for nits, what can you do? Find out who makes the decisions on those policies. Sometimes it’s a school-by-school choice, which means you can collect all the relevant scientific information and talk to your principal.

Altschuler’s claim that lice transmit disease — that they are, themselves, a disease — is not supported by most scientists. In general, experts say, parents stress out way too much about head lice. “Head lice are a fact of life. It happens. It’s not a health issue, really,” said Marian Harmon, the school health bureau chief for Arlington County’s public health division who signed off on our schools’ new policy. “It’s not a sign of poor hygiene. It’s not an infection. It’s not a communicable disease. We treat it for the comfort of the child and the family. It shouldn’t be escalated to such a high priority.”

Lice: Overview

Lice

Few phrases can make a parent recoil faster than “head lice.” Nobody wants their child anywhere near someone who has been diagnosed with them or—heaven forbid—have to treat a case crawling on her kiddo's scalp.  But guess what? Head lice are actually no big deal. Yes, they are tiny, wingless parasites that like to live in hair and off the blood in our scalps (seriously gross). But, head lice are not an actual health threat, and public health experts around the country want us all to calm down, breathe, and not overreact when our child comes home with that dreaded note from the daycare center or school nurse declaring: "there has been a case of head lice in your child's classroom."  

“If your child gets head lice, stay calm,” says Barbara Frankowski, M.D., a pediatrician in Burlington, VT and former chair of the American Academy of Pediatrics (AAP) Council on School Health. Coming home with a case of them is as inevitable as scraped knees or the common cold, says Dr. Frankowski. “It’s a normal risk of being a healthy, active social child.”

In July 2010, a clinical report for the AAP, co-authored by Dr. Frankowski, issued new guidelines for schools, stating that since lice don’t spread disease, and since by the time a case of lice has been discovered it’s already been present for at least a month, no child should miss school because of them and recommended that no-nit policies be abandoned. (Typically a child is sent home as soon as head lice are discovered and cannot return to the classroom until he has been treated and the nurse has checked his head for nits, the small dandruff-like egg casings that stick to the hair.) This has proven controversial, with some parents and teachers saying that a child with lice disrupts the classroom- despite attempts at confidentiality -- and that an infected child should be shielded from teasing by being kept home. It’s yet to be seen how many schools will adopt the AAP’s guidelines.

The upshot is this: if your child gets lice, don’t panic. Instead read our guide to spotting and stopping the buggers – without bugging out.

Lice: Symptoms

A very itchy scalp. An allergic reaction to the saliva of lice causes itching, but only after an initial exposure period. A child who has never had lice won’t start itching until several weeks into the infestation. But when he starts to scratch his head with vigor, or reports a tickly feeling, it’s time for a lice check.

Nits. The tiny un-hatched lice eggs are about the size of a pinhead and are tan-colored if they are alive or darker if not (if hatched, their discarded shells are white and more visible). Unhatched, they are usually attached to the hair close to the scalp and are difficult to remove  (hence the term nit-picking -- more on that later!). Nits, which don’t move, are usually easier than actual lice for a parent to detect.

Adult lice in the hair.  Look for tan-colored or brown bugs about the size of a sesame seed. They frequently hang out in the hair behind the ears, and on the hair above the nape of the neck and will crawl quickly away from light. If your child doesn’t have a lot of them, they might be hard to spot.

Because it is easy to mistake dandruff or other debris in the hair for lice, experts recommend getting a diagnosis from your pediatrician or the school nurse before starting treatment. 

Lice: Causes

Lice have been around since prehistoric times; they’ve even been spotted on Egyptian mummies. They are not as contagious as most people think; they’re spread by direct contact between individuals (such as when your child is huddled over her desk working on a group art project, or snuggled close to her buddy during story time). They can also be spread by sharing personal items such as combs, brushes, or hats. Contrary to popular belief, they cannot jump or fly from one person to another, and contracting lice has nothing to do with hygiene or how often you wash your hair, says Joseph A. Bocchini Jr., M.D., chairman of the department of pediatrics at Louisiana State University Health Sciences Center in Shreveport and the other author of the AAP’s clinical report. 

Lice: Diagnosis

Your pediatrician or school nurse will part your child’s hair to get a good view of the scalp, where she’ll be on the lookout for adult lice or nits. She may use a special light in a darkened room to help her see the little buggers better, or may catch them on a piece of tape, and examine them under a microscope. 

Lice: Prevention

There’s not much you can do to keep lice from finding its way onto your child’s head other than asking him not to share combs, brushes, hats or earphones. But since lice much easier to treat if caught early, why not make a good comb-through a weekly ritual? Done well (with a little detangler beforehand), it can even be a pleasurable experience for your child and help them cooperate if (or more likely when) they do bring lice home. 

Lice: Age-by-Age Guide

Baby to Toddler

Although lice is most common in preschool and school-age kids, smaller children can get it too, often from daycare or infected older siblings. When infestation does occur, it can be hard to treat since this age group isn't known for their ability to sit still, and some treatments are not appropriate for children under 3. If you suspect your baby or toddler has lice, talk to you doctor about the most age-appropriate way to deal with it.

Preschool to Grade School

Lice often first strikes during the school years – think of it as a big kid rite of passage.  Since you’re likely to still be washing and combing your young child’s hair anyway, it’s a good idea to always be on the lookout for nits or lice in the hair behind the ears and at the nape of the neck. “If parents do that once a week, they are more likely to pick up an infestation early when it would be easier to deal with,” says Dr. Frankowski. 

The Lice Diaries

It had been fairly stressful at work that day, and I could feel my blood pressure surge as I checked my email and read the ominous subject line, all in caps: “HEAD LICE/NITS HAS BEEN IDENTIFIED IN YOUR CHILD’S CLASS.”

I put my head in my hands. “Here we go again,” I hissed.

You see, just a few months ago, in late June, I was walking my five-year-old daughter Chloe to the park to play when I suddenly noticed her vigorously scratching her head. I stopped her to take a look, and with the advantage of natural light, was able to immediately spot the large louse moving quickly through her hair.

“Here we go again,” I muttered under my breath.
You see, a few years ago, I’d gone through a seemingly endless cycle of lice infestation with my middle child, who was around 9 when it first began, as it normally does, at school.

When I found them on her, my first thought was to try the drugstore treatments. I’d had lice one time as a child, in Grade 4, and my mother quickly eliminated it using them, so they must work, right?

Wrong.

I thought something was odd when, after applying the treatment and following the instructions, during the comb-through, I was still pulling out live lice (a sight that is truly disgusting to behold), wiggling and squirming, evidently fighting for life.

But I wasn’t sure. So I followed up with a second treatment within 10 days, as instructed, only to find a few weeks later, several bugs in her hair again. And I repeated the process, to end up with the same result.

Her father and I, who have been separated for years, didn’t have the full facts about the drugstore chemical solutions – their safety is questionable and they don’t, in fact, work. They’re simply ineffective.

Lice have built an immunity to these products, and what we eventually learned when we turned to a professional company for help in finally eliminating this problem, which had spread to me and all members of the family, is that key to permanently getting rid of the buggers is careful combing and removal of all remaining nits. This is no small task.

Beyond the inconvenience of extra laundry, it requires a considerable amount of time and patience spent combing through hair, sometimes for several days, to ensure all bugs and nits are gone. But it took me, and her father, a bit of time to absorb that message completely.

It was a couple of years before we finally figured it out, and my third child had just been born. Now, that child is in prime lice-attracting mode, being in Grade 1 and attending daycare, where I notice the kids enjoying hugging and being physically close as they play. And I cringe.

Back to last summer, and my odd relapse into the old “maybe I’ll just buy the treatment and get rid of it quickly” mindset. Yeah, that wasn’t happening.

Treatments for her – and me, as I quickly discovered I had it too – were again ineffective, and I once again turned to professionals for help. This time, we went through several sessions and I received a thorough explanation of what to do – and how to try and prevent this scourge, the bane of my existence.

I spent hundreds of dollars to clear our whole family, once again, of lice. And now, I vow I will never end up in that situation again.

The night I received that email from the school, I brought Chloe immediately home, saturated her hair with conditioner, and combed through her hair until I could finally be confident that she doesn’t have any lice or nits –YET.

And now, that little girl goes off to school every day with her hair pulled back in a tight braid, her hair, jacket collar and hat sprayed with tea tree oil, which smells ungodly.

No matter. I’m going to do everything I can to keep our home lice-free – and my sanity intact – for as long as possible.