Head Lice
M.S.A.D. 35 - Head Lice Protocol
Definition: The head louse is a parasitic insect that can be found on the head, eyebrows and eyelashes of people.
Forms of Head Lice
Egg/Nit: Nits are the lice eggs, laid at the base of the hair shaft, nearest thescalp. Nits are firmly attached to the hair shaft, are very small and hard to see.
Nymph: An immature louse that hatches from the nit. It looks like a small version of the adult louse.
Nymphs mature in 9-12 days and require blood meals to survive.
Adult: The fully grown adult is about the size of a sesame seed, has six legs,and is tan to grayish-white. The adult can live about 30 days on a person’s head, but will die within a day or two if it falls off a person. An adult female can lay about 6 eggs a day.
How are Head Lice spread?
Head lice are spread by direct contact with the hair of an affected person. Spread by contact with combs, brushes or hats is uncommon, but can happen. Head lice CANNOT hop, jump or fly, they move solely by crawling.
What are the signs and symptoms of Head Lice?
Tickling feeling of something moving in the hair.
Itching, caused by an allergic reaction to the bites of the head louse.
Irritability and difficulty sleeping; head lice are most active in the dark.
Sores on the head caused by scratching. These sores can sometimes become infected with bacteria found on the person’s skin.
What do we know about the lives of head lice?
Head lice have been in existence for thousands of years.
Head lice are not a source of infection or disease; they are simply a nuisance.
Head lice do not cause disease.
Head lice do not fly or jump. They live only on human heads.
Pets do not get or transmit head lice.
Head lice reproduction requires a male and female louse. Nits (eggs) are laid very close to the scalp and cemented onto the hair. The egg hatches in 7-10 days.
A louse matures in 7-10 days from hatching and then starts laying eggs.
Head Lice begin to lose water as soon as they are off the scalp and die within 24 hours; they are probably incapacitated before that.
Only LIVE lice can spread to another person. Nits (eggs) cannot spread to another person. Some nits that are empty egg sacs, may remain on the hair for months after an infestation.
How do we handle lice at school?
Based on recommendations from the National Association of School Nurses, the American Academy of Pediatrics and the Maine Center for Disease control, MSAD 35 nurses do not support a ‘no nit’ policy. An evidence based approach to head lice will significantly reduce unnecessary school absences, limit embarrassment of students, decrease unnecessary exposure to potentially toxic chemicals and calm anxiety on the part of parents and school staff.
In the case of several infestations in one classroom, the school nurse will develop a plan and advise the teacher on how it will be handled. The literature does not find whole class head checks to be useful in controlling head lice infestations. What research has demonstrated is, that when these “alert letters” are sent home to classrooms where a child is found to have lice, that children are treated unnecessarily with chemicals, adding to the risk of desensitization of lice to the chemicals.
An emphasis on identifying individuals with active infestations & referring them for treatment is a more effective strategy.
Discussion: Head Lice Can Happen To Anyone!
Hats & coats touching in school are not sources of lice and there is no need to separate or bag them. A louse on a hat or coat is a dying louse which is not be capable of reproducing. Healthy ones stay close to the scalp. They can not survive without blood, that is why they bite. Contrary to popular belief, schools are not the most common place where head lice are spread. Sleepovers among friends and relatives are thought to be the common way they are passed home to home.
Each student who is found to have head lice is handled in a discreet and private manner to minimize anxiety and embarrassment.
Treatment:
DO NOT APPLY ANY INSECTICIDE OR OTHER CHEMICAL not specifically labeled for treating head lice on people. Well intentioned parents treating their children with toxic or flammable substances have caused poisonings and death.
There are many possible over the counter treatments for head lice. No one brand works better than others and store brands can save a family money. These are chemical based and work to kill the live lice that are laying eggs, immature nymphs that have hatched and may or may not kill what may be in the egg sacs. (nits) Follow the instructions that come with the product.
Use of creme rinse (if you are looking for a non chemical treatment)
These all work by suffocating the lice and nymphs. They must be heavily applied and left on 2-3 hours. Rinse hair thoroughly. This method may help more with combing through the hair.
Once the products (chemical or natural) are rinsed from the hair the hair should be towel dried for the next step of the treatment. This next part is the MOST TIME CONSUMING PORTION of the treatment and can NOT be taken lightly or skipped. Make sure you sit under a bright light or near a sunny window.
Section your child’s hair into multiple small sections. Using a LICEMEISTER or similar LICE COMB, take a very small piece from the first section and comb through it. After each swipe through, wipe the comb of with a tissue and throw the tissue out.
This removes the egg sacs or remaining lice out of the comb. You must go through each section of hair combing and at times, manually pulling the small nits off the hair.
As time consuming as this may be, it is vital this is done initially and then every day for the next 4-6 weeks. If you do not remove the nits (egg sacs) some of them will continue to hatch and start the cycle all over again!
It is recommended that the chemical treatment or other treatment you use be repeated 8-10 days from the first treatment. This is to kill any new live lice that may have hatched since the last treatment and not yet been found. You will also be combing out any nymphs (baby lice) when you are combing. Repeating the treatment sooner, several days in a row, or on a ‘regular basis’ as a prevention, can cause lice to develop a resistance to the chemical treatments. The non chemical treatments can be repeated more often if you feel the need to, but it is the daily combing to remove the lingering nits and immature nymphs that can hatch, that will eventually break the cycle and get rid of the lice!
Cleaning the house and car:
Lice off the head usually die within a day and the eggs are not viable away from the scalp.
Vacuuming the house and car is recommended, but a major cleaning effort will do little to eliminate head lice.
Using insecticide treatments for home, in vehicles or on carpets and furniture are not needed, not recommended and unnecessarily expose family members to insecticides.
You will need to change the infested person’s bedding, and wash the blankets.
If your child has many stuffed animals, these can be bagged and put outside in the freezing temperatures overnight and this will kill the lice. Otherwise place stuffed animals in the dryer on “high” heat for 30 minutes and this will kill the lice. Wash hats and coats as well and place in dryer on high for at least 20 minutes.
Brushes and combs used by the infested person, should be washed in hot, soapy water or replaced. Each person should use a separate brush/comb so to not cross contaminate others.
Followup:
Head lice is not the public health risk people believe it to be. Using appropriate, thoughtful and evidence based treatments it can be handled discreetly and effectively. The new guidelines point us in a direction that will deal with head lice in a more reasonable way while minimizing class time lost and decreasing social stigma and stress for children & their families.
References:
Maine Centers for Disease Control
American Academy of Pediatrics
National Association of School Nurses
IdentifyUS- A company founded by Richard Pollack, Ph.D. Entomologist at Harvard School of Public Health
WEEKLY HEAD LICE CHECKS OF YOUR CHILD'S HEAD IS THE BEST FORM OF PREVENTION.
For more information about Head Lice:
https://www.nlm.nih.gov/medlineplus/headlice.htm
https://www.webmd.com/parenting/features/what-do-when-your-child-has-head-lice