Preventing & Treating Head Lice
What to look for
- Adult lice are small (about the size of a sesame seed).
- Eggs (nits) are usually found firmly attached to the base of the hair shaft.
- Lice stay near the scalp, often behind the ears, near the neckline, and back of the head.
- Head lice hold tightly to the hair. They move by crawling. They cannot hop or fly (they do not have wings), but do move quickly making it difficult to find in a child’s hair.
- Signs of a head lice infestation include: itchy scalp, tickling sensation in a person’s hair. Head lice are most active in the dark.
If your child is found to have head lice, it is important to treat your child before he/she returns to school. Please begin treatment as soon as possible. Exclude your child from attendance at school until one day after their first treatment with a medicated head lice product (either over-the-counter or prescription). Your prompt action is requested so that your child can get back to school as soon as possible.
How to Perform a Head Lice Check
- Watch this video clip below that thoroughly explains how to complete a head lice check.
Tips for combing out head lice and nits
- Use a fine-toothed louse or nit comb. These combs may be included within packages of medicated head lice treatment or you may buy one from most drug stores or pet supply stores. Combs with metal teeth spaced close together seem to work best.
- Sit behind your child, and use a bright light (and magnification if needed), to inspect and comb through the hair, one small section at a time.
- Repeat combing until no more active lice are observed.
- Comb daily until no live lice are discovered for two weeks. It may take several hours each night for several nights to tackle the problem. An entertaining video may help keep the child occupied during this time.
- Adult female lice cement eggs to the base of a hair shaft near the skin. As the hair grows, eggs are moved away from the scalp. Eggs more than ¼” from the scalp are nearly always hatched and do not mean live lice are present.
- Combs, brushes, hats and other hair accessories in contact with an infested person should be washed in hot water each day to dislodge any lice or nits.
- Combing is sometimes painful to the child or it may be impractical for other reasons. In these cases, consider using anti-louse products. Speak with the school nurse or your child’s doctor for advice.
Tips for prescription or over-the-counter head lice treatment
- Whether using an over-the-counter head lice product or a prescribed treatment, it is very important that you read and follow all directions on the product’s label.
- Do not treat someone who does not have live lice (or nits close to the head). Do not use these products as a prevention method to avoid lice.
- Do not use a cream rinse, combination shampoo/conditioner, or conditioner on the hair before using the lice medicine.
- It is recommended that both the person getting treated and the person administering the treatment put on clean clothing after the treatment is completed.
- Be cautious not to use more than one head lice medication at time.
- Eight to 12 hours after treatment, examine your child’s head again. If you see a few lice still around, but they are moving more slowly than before, do not re-treat. Comb the dead lice and any remaining live lice out of the hair using a fine-toothed nit/lice comb.
- To comb through the hair, sit in a well lighted area. Part the hair into small sections and comb through one section at a time. Be patient and thorough, it can take a lot of time.
- Eight to12 hours after treatment, if no dead lice are found and lice appear to be as active as before, the medicine may not be working. Do not re-treat until speaking with your healthcare provider. Your healthcare provider may recommend using a different lice treatment.
- Re-treatment is generally recommended for most lice medicines after 9-10 days. This should kill any newly hatched lice before they produce new eggs. Be sure to follow the instructions for the product you are using.
- It is important to check the hair and comb through it with a nit comb every 2-3 days. This will help to remove nits and lice and can decrease the chance of self re-infestation. Do this for 2-3 weeks to be sure all lice and nits are gone.
- Wash combs, brushes, hats and other hair accessories of the affected person in hot water.
Treatment of clothes and other items
- A clothes dryer set at high heat or a hot pressing iron will kill lice or their eggs on pillowcases, sheets, nightclothes, towels and similar items your child has been in contact with during the previous two days. (Lice and their eggs do not live more than one to two days off the head.)
- Lice and their eggs on objects (such as toys) may be killed by freezing temperatures. Objects that cannot be put in a clothes dryer can be placed in a freezer (or outdoors if sufficiently cold) for several days. This treatment is rarely required.
Cleaning the house and car
- Once lice fall off of the head, they usually die within a day and eggs generally cannot live much longer. Thoroughly vacuuming the house and furniture is all that is really necessary for cleaning the home. A major cleaning effort will do little to further eliminate head lice.
- Insecticide treatments for the home, vehicles, or carpets and furniture are not needed and unnecessarily expose family members to the insecticides.
Please contact the District School Nurse if you have additional questions at Nurse@apamail.org