Those Pesky Critters……….



School is  back in session.  The children gather and lots of little heads are  in one place. With that comes all they bring with them.  Time for reading , writing and head lice.  Yes, lice.  They are in your school, and in your classrooms. You can use this PowerPoint for yourself or to teach others the basics.

When my youngest was in kindergarten, she had blonde hair down to her backside. And imagine my surprise when I found a headful of those lovely creatures one afternoon. It was a good lesson for me in empathy for  families.  It took us quite some time (and a haircut) to be rid of them, despite hours of nit picking, hair combing, an electric lice shocking device, olive oil, and over the counter products. I even had a microscope at home to try to figure it all out.  When I saw her with her baby doll between her knees one day, pretending to pick nits- I knew my approach needed to change.  Many weeks had passed… it was time. One treatment with a prescription product and we were done!  (There are lice that are resistant to some of the over-the-counter products and that’s what we had)!

You discover one or more children in your school or room with head lice.  What are you to do?  The first thing is to keep calm! Lice are a nuisance and a pain but are NOT a health risk. They are not known to carry disease in the United States.   Secondly, if you haven’t already- you should educate yourself on how they are passed from one person to the next.  Despite what you may have been told- they do NOT jump or fly.  Head lice are passed by direct head to head transmission. Meaning, one head needs to touch another.  There are theories that they can live in carpets and various inanimate objects but the evidence says this is just a theory.  And the lice in your school aren’t setting out to look for other places to live. They are perfectly content where they are as long as a human head is involved.  If they get passed along, it’s due to happenstance- they aren’t mounting expeditions looking for a new home!!

When kids get head lice there is a course of action that should be taken, and the ultimate fix often isn’t with just one treatment.  Children should only be treated when live lice are present, nits do not confirm an active  case.  When a child is diagnosed with head lice a pediculicide (medicine which kills lice) should be used. The American Academy of Pediatrics recommends starting with 1% permethrin lotion (Nix) initially.  This product is not 100% ovicidal (meaning it doesn’t kill all the eggs) so a second treatment is needed in 7 to 10 days. What does this mean for folks in school?  That it’s normal to see live lice again after treatment in about a week and not that kids have gotten them again.  There are lots of “natural” products available but medical studies have not supported their effectiveness.  There are several websites supporting things like “no- nit” policies and exclusion of children from school.  Organizations such as the Centers for Disease Control and Prevention and the American Academy of Pediatrics say these policies are counter productive and should not be adopted.  For more information on head lice treatment go to:

Often I see the same children repeatedly dealing with head lice.  This becomes frustrating for schools.  In these situations families need additional support. Hopefully you have a school nurse who can be involved (if you don’t- your school needs one!)  As mentioned earlier, lice can be resistant to over the counter treatment so a health care provider may need to be involved.  In my own situation I know I was doing the “right” things yet it was still difficult to get rid of.  The prescription medicine made the difference.  Sometimes we have to help families understand or get additional help.

You may be thinking that we need to just go straight to prescription medication.  That is not recommended because lice will soon become resistant to those treatments if over used.

In my years of school nursing, head lice has been what has gotten me yelled at the most, by parents and by school staff, and any of you who work in schools can likely say the same. It’s a very emotional issue, and no one wants to have head lice.  The more you educate yourself the better.  Not only to help decrease the spread in your school and classroom, but also when it comes to knowing what to do to help.  When you discover lice in a student, I recommend the following:

1.  Make sure it’s really lice.  That sounds crazy but there have been studies showing that many times kids are diagnosed with “lice” in school when they don’t really have it.

2. Check your school/district policies.  Most kids have had lice for a month or more before it’s discovered. The American Academy of Pediatrics and the Centers for Disease Control and Prevention do not recommend they be sent home that day.  You need to know what your policy says but know that it hurts them academically when they are excluded.

3. Make sure the school nurse is involved (I do so hope you have one). She/he is a great support and help for you and families.

4. Let the parent/guardian know.  Hopefully you have a nurse or resource who can help guide them through the best options for treatment.

5.  Know that its normal to see live lice  in 7 to 10 days.  This doesn’t mean they got it “again”.

6.Check your practices or (if you aren’t a teacher) the classroom where the student(s) are- do the kids lay in a spot (such as a special reading place) with their heads all together?  Are their coats/jackets all piled up in one place?  These could be ways to transmit at school!

7.  Know some good referral sources (this is for school nurses as well!)  I teach parents that they should do an over the counter permethrin or pyrethrin (if no allergies), and then to repeat in 7 to 10 days.  If they see live lice in their child’s hair  7 to 10 days after that second treatment I usually refer to their health care provider, or assist the families in getting a prescription medication.

The problem can be a challenge but we are smarter than the critters! Don’t let it be a barrier to your success in school!



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