Head Lice Guidelines

Purpose

The goal of the HCS Head Lice Guidelines is to manage head lice infestation in students with minimal learning disruption and to promote effective treatment solutions and prevent reinfestation:

Minimize Absences: Reduce the number of school days missed due to headlice, which can negatively impact student learning
Promote Effective Treatment: Educate parents and students about effective treatment methods, including OTC products, nit removal, and/or professional lice removal services
Reduce Reinfestations: Prevention of head lice spread in the classroom setting by avoiding head-to-head contact and sharing of personal items
Maintain Student Privacy: Confidentiality regarding head lice infestation is crucial to avoid stigma and provides a supportive environment.
Provide Accurate Information: Dispel myths surrounding head lice, emphasizing that head lice infestation is not related to cleanliness and hygiene.

Head Lice

Head Lice, Pediculus humanus capitis, are small parasitic insects that live on human scalp/hair and feed on human blood. They can also be found in eyebrows and eyelashes. Head lice bite your skin and attach their eggs (nits) close to your scalp causing itchiness. Nits are very small oval or tear-dropped shaped eggs. Nits can be white, yellow, tan or brown making them very difficult to see on a human hair. Head lice are most commonly found in young children and their caregivers. Head lice have 3 life stages: nit (eggs), nymph, and adult. Nits are “glued” on a hair shaft near the scalp by a female louse. Nits hatch within 7-12 days becoming nymphs. The immature nymphs resemble an adult louse but are smaller and go through a series of molts before becoming an adult louse. Nymphs feed on human blood. Adult lice are approximately 2-3mm long, the size of a sesame seed, are tan to gray-white in color, and have a life span of approximately 30 days. Adult lice feed on human blood several times a day. Adult female lice are slightly larger than males and can lay 8-10 nits per day. A louse’s complete life cycle lasts a maximum of 35 days. Lice can only survive for a maximum of 2 days off of a human host.

Symptoms of Head Lice

People with head lice may not immediately have symptoms of an infestation. Itching (puritis) is the most common symptom of a head lice infestation and is due to an allergic reaction to louse saliva. It may take several weeks after infestation before itching appears. Additionally, intense itching can cause redness and sores leading to a potential bacterial infection. Some people can feel lice crawling in their hair, especially at night as the lice are more active. Difficulty sleeping leading to irritability is also a risk.

Head lice do not transmit disease and are not considered a health hazard but considered a nuisance.

How Does Head Lice Spread

Head lice spread mainly by direct head to head contact. Lice move by crawling, they cannot jump or fly from person to person. Head lice can also be spread by sharing clothing, brushes, towels, or laying on a bed/couch that has had recent contact with an infested person. School-aged children are most often affected by head lice due to close head to head contact during playtime. Animals do not get or spread head lice.

Treatment

Over-the-counter or prescription shampoos, lotion or cream effectively kill adult lice when used per manufacturer’s guidelines. Treatment of the hair must be repeated per instructions. To remove lice from clothing, bedding, and personal items you must wash and dry items in high heat. Anything unable to be washed should be stored in an air-tight sealed bag for a minimum of 2 weeks. Wash combs and brushes in very hot water and coat them with an otc or prescription shampoo, lotion or cream for 15 minutes, then rinse thoroughly. Vacuum all areas of home/school that could have come in contact with lice. Professional lice removal is available in some areas. See your healthcare provider if otc treatments are not working, or if you/your child have developed a fever, sores that won't heal,or if excessive pain, tenderness, redness, or swelling is noted on the scalp.

Evidence-Based Guidance

The National Association of School Nurses (NASN), the American Academy of Pediatrics (AAP) and the Centers for Disease Control (CDC) advocate for discontinuing the following practices:

Whole classroom screening
Exclusion for nits or live lice
Notification to others (non-parent/non-guardian)

HCS head lice guidelines will follow the most current evidence-based information and minimize school absences due to head lice given the low contagion of head lice in the classroom. Students with active head lice should be sent home at the end of the school day and can return to school once appropriate treatment begins.

HCS Nurse Management of Head Lice

Notify parent/guardian if student has confirmed care of head lice
Send student home with HCS Lice Letter
Student will remain in school and can be transported home by bus
Encourage student to avoid activities with potential head to head contact
Student must be screened by the school nurse upon returning to school (treatment must have begun and student must be free of live lice)
Student will be nurse excused one day for lice treatment
Nurse will notify custodian for enhanced cleaning of classroom
Maintain strict confidentiality