Managing Head Lice in School Settings and at Home

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School Health LogoThe Department of State Health Services School Health Program has been charged by the legislature to provide current and accurate information to school staff, parents and the general public on how to recognize, treat and prevent head lice in a safe and effective way.

For this reason the School Health Program has developed and provides the following information for schools, families and others that work with and care for children such as teachers, physicians, health clinic staff and day care attendants.

Materials
Downloadable fact sheets about prevention and treatment of head lice for families and schools.

Guidelines
A brief description about head lice, how to recognize and treat it and how to keep it from happening again.

Head Lice laws, rules and policy
Describes why there is no law in Texas that excludes children with head lice from school.
States the DSHS policy that suggests children who are found with lice eggs should stay in school.

Setting School Policy
Offers guidelines for schools interested in setting district policies relating to head lice.

Resources
Offers additional websites to visit for more information on head lice.

 

MATERIALS:

The following Fact Sheets provided in English and Spanish are copyright free and can be downloaded and printed off in black and white or color to be distributed to parents, caregivers and school staff to help educate and inform.

Lice Fact Sheets - English

  • What Are Lice? (Publication # E05-12864) (Color | B&W) (PDF)
  • How Do I Know if My Child Has Lice and How Did They Get It?  (Publication # E05-12865) (Color | B&W) (PDF)
  • What Should I Do If My Child Has Lice?  (Publication # E05-12866) (Color | B&W) (PDF)
  • How Do I Keep Lice From Coming Back?  (Publication # E05-12867) (Color | B&W) (PDF)
  • Misconceptions and Truths about Lice Treatment  (Publication # E05-12868) (Color | B&W) (PDF)
  • Lice Resources  (Publication # E05-12869) (Color | BW) (PDF)

Hoja informativa sobre los piojos de la cabeza - En Español

  • ¿Qué son los piojos?  (Publication # E05-12864) (Color | B&W) (PDF)
  • ¿Cómo sé si mi hijo tiene piojos en la cabeza? Y, de ser así, ¿cómo se le pegaron?  (Publication # E05-12865) (Color | B&W) (PDF)
  • ¿Qué debo hacer si creo que mi hijo tiene piojos en la cabeza?  (Publication # E05-12866) (Color | B&W) (PDF)
  • ¿Cómo evito que vuelvan los piojos?  (Publication # E05-12867) (Color | B&W) (PDF)
  • Mitos, ideas erróneas y verdades sobre el tratamiento de los piojos de la cabeza  (Publication # E05-12868 (Color | B&W) (PDF)
  • Recursos sobre los piojos de la cabeza  (Publication # E05-12869) (Color | B/W) (PDF)

GUIDELINES:

What are Head Lice?

  • Head lice are tiny gray to brown insects about the size of a sesame seed that live in human hair and must feed on human blood to live.
  • They lay tiny white oval-shaped eggs about the size of a knot in a thread.  Lice glue thier eggs to each strand of hair close to the scalp. A nit is an empty egg casing after the louse has hatched or died.  Although it is hard to see head lice, a person can see the eggs if they look closely.
  • Lice eggs and live lice are most often found in the hair behind the ears and at the back of the head and neck. The first sign of lice is itching of the head which is caused by the bite of the head lice.

How do You Get Head Lice?

  • Head lice happens mostly with elementary school-aged children.
  • Children get lice from other children through head to head contact during play or sports or nap time and most often in school settings.
  • Sometimes sharing combs, hats or school lockers with a louse infested child can spread head lice.
  • You can’t spread the eggs…only live lice.
  • Head lice do not spread disease - they are not a public health threat and therefore lice cases are not tracked by the Department of State Health Services. 
  • Any child can get head lice. It doesn’t matter where they live or go to school, boy or girl, black, white or brown. It doesn’t mean the child is sick or unclean. It certainly doesn’t mean they have bad parents.
  • Children get head lice almost as much as the common cold. Millions get it at least once a year.

How Do You Get Rid of Head Lice?
The Texas Department of State Health Services recommends the following treatment for head lice and their eggs:

  1. Use an over-the-counter FDA-approved shampoo treatment that you find at the drug or grocery store. Follow the directions on the packaging exactly.
  2. Remove as many eggs as possible with a special comb that comes with the head lice treatment.
  3. Treat your home at the same time you treat your child. Do the following:
    • Soak combs and brushes for 5-10 minutes in some of the lice shampoo for 1 hour or in very, very hot water.
    • Wash sheets, blankets and other bedding in the hottest setting of water in the washing machine.  Dry in a hot dryer.
    • Dry-clean non-washable items or seal these items in a plastic bag for 1 week or tumble them in a very hot dryer. 
    • Vacuum furniture, carpets and mattresses thoroughly.
  4. Treat hair a second time 7 to 10 days after the first treatment (or follow the instructions of the manufacturer of the lice treatment) to make sure that you kill any lice that may have hatched from eggs that might have been missed during the combing.
  5. There is no need to cut hair. Lice like to crawl on short hair just as much as long hair and they need the same treatment.

How Do You Keep Lice From Coming Back?

  • Teach family members to recognize eggs and how lice is spread and check everyone’s hair periodically.
  • If you find lice, follow the recommended treatment closely. It should be reported to the school nurse, who may want to check close contacts.
  • Remind children not to share combs, brushes, hair accessories, headphones, hats, clothing, bedding, coats and so forth.
  • Ask the teacher at your child’s school if there is a space to keep jackets, hats and other personal items separate for each child. Ask what you can do to help.

THE LAW AND POLICIES ADDRESSING HEAD LICE:

Laws and Rules
There is no statute in Texas that addresses excluding children with head lice from school . Lice are not a public health threat, they do not carry disease.  Therefore, the Department of State Health Services does not monitor or track cases of head lice. It is up to each school district to create head lice policies if they so choose.…and some do. Talk to the school nurse or someone else in charge to find out what the school policy is in your district.  Refer to the topic "Setting Policies for Schools" that appears on this page for policy suggestions .

“No-Nit” Policies
A “no nit” policy is one that excludes students from school based on the presence of lice eggs whether or not live lice are present. The Department of State Health Services (DSHS) does not recommend a “no nit” policy. We do recognize, however, that school districts may adopt one as a local option.

DSHS does not have authority to impose a set policy regarding head lice on districts. DSHS does, however, urge school districts to ensure that its policy does not cause children to miss class unnecessarily or encourage the embarrassment and isolation of students who suffer from repeated head lice infestations.

Head lice infestation is a social issue not a health threat. “No nit” policies place a disproportionate amount of emphasis on head lice management than on real health concerns which should be a higher priority. This over-emphasis can lead to unproductive use of time by school staff and parents, missed classes, unnecessary absences, and parents missing work.

The complete DSHS “no-nit” policy is attached here.
(Microsoft Word document, 130kb)
(Adobe PDF, 40kb)

Additional information on “no-nit” policies for schools can be found through the American Academy of Pediatrics and the National Association of School Nurses.

 

SETTING POLICIES FOR SCHOOLS (for school personnel):

When developing district policy about head lice control here are some issues and topics you may want to consider:

There is no law that addresses headlice; the school or district can create there own guidelines by developing written policies that:

  • Facilitate efficient and consistent implementation by all campuses
  • Protect school nurses, teachers and other school staff
  • Create peace of mind for administrators and parents
  • Ensure all children are treated in a fair and equitable manner

Policy should be a joint effort with your School Health Advisory Council, local health care providers, district administrators, school nurses, parents and other stakeholders.

When developing policy, consider the following:

  1. Screening procedures – staying away from unwarranted mass screenings that disrupt student and teacher class time and take away from the nurses’ ability to address the needs of the more physically or mentally disabled student
  2. Parent/Guardian Notification – including a lice information fact sheet or brochure with the student handbook at the beginning of the year and notification when there is an infestation confined to a specific classroom
  3. Exclusion Protocol – including what happens if the parent is not home
  4. Readmission criteria – consider stating they should use an FDA-approved, medicated treatment
  5. Definition of and district response to excessive absences – may help address issue of parents who can’t keep their children free of lice. Texas Education Agency has criteria for excessive absences.

You may also want to address the following:

  1. How the school/district may want to address those families that cannot afford to pay for the treatment to rid their child of lice.
  2. Care in the classroom to prevent the spread of head lice.
  3. Inservice training for school staff.

RESOURCES/LINKS:

 

Contact:  Ellen Smith (512) 776-2140 or ellen.smith@dshs.state.tx.us.

Last updated August 21, 2014