Recommended Guidelines For the Control of Head Lice for Schools and Caregivers of Children

Reprinted with permission from © Baby Blues Partnership. King Features Syndicate http://www.babyblues.com/Testing/index.php?formname=getstrip&GoToDay=09/1/06

Managing Head Lice (Pediculosis) in School Settings and at Home

• Recommended Guidelines for Professionals
• Help for Families and other Caregivers of Children

The Department of State Health Services (DSHS) School Health Program strives to provide current and accurate information to school staff, parents and the general public on the diagnosis, treatment and prevention of head lice so that they are better informed and equipped to address head lice infestations using safe and effective methods. For this reason the DSHS School Health Program has provided the Recommended Guidelines for the Management of Pediculosis (Head Lice) in School Settings for school personnel and a new pamphlet for families and other caregivers called “Everything you need to know about HEAD LICE/Todo lo que debe saber sobre los PIOJOS DE LA CABEZA”. The Guidelines will be useful to school staff, parents, physicians, local health authorities, and other agencies and/or individuals that work with and/or care for children and/or encounter head lice infestations. The new pamphlet is for schools, daycare centers and other organizations to provide to parents struggling with children that have contracted head lice.

General Information

Head lice are tiny insects (about 1/10 to 1/8 of an inch long) that live in human hair and feed on human blood. They multiply rapidly, laying little silvery-colored oval-shaped eggs (called nits) that they glue to the base of the hair close to the scalp. Although it is hard to see head lice, a person can see the nits if they look closely. Nits are most often found in the hair behind the ears and at the back of the head and neck. Nits should not be confused with dandruff. Dandruff can easily be flicked off the hair; nits cannot because they are firmly attached to individual hairs. One telltale sign of head lice is a persistent itching of the scalp, which is caused by the bite of the louse, and that is sometimes accompanied by infected scratch marks or what appears to be a rash. A secondary
bacterial infection can occur, causing oozing or crusting. Swollen neck glands may also develop.

Anyone can get head lice. They are not a sign of being dirty and should not be considered a sign of an unclean house or bad parenting. Head lice are easily spread from person to person by direct contact and are most often found in school settings. Head lice do not spread disease.

Head lice need human blood to survive. They are transmitted through direct contact with an infested person or with shared items, such as combs, brushes, towels, pillowcases, hats, headphones, other headgear, and clothing.

“No-Nit” Policies

The Department of State Health Services is republishing is original 2001 recommendation on “No-Nit” Policies in Schools. The Recommendation is below. Additional information on “no-nit” policies for schools can be found through the American Academy of Pediatrics at www.aap.org/advocacy/archives/septlice.htm and the National Association of School Nurses at www.nasn.org/Default.aspx?tabid=237

(Microsoft Word document, 130kb)
(Adobe PDF, 40kb)

Treatment

The Texas Department of State Health Services recommends the following treatment for head lice and nits:

1. Use an FDA-approved pediculicide shampoo/treatment. Follow the directions on the packaging exactly. Consult w/ a pharmacist or doctor regarding proper and safe use, possible side effects, etc.
2. Remove as many nits as possible with a nit comb (available at pharmacies or provided with the pediculicide).
3. Household treatment should be done simultaneously and should include:
   • Soaking combs and brushes in pediculicide for 1 hour, or in 130 degree water for 5-10 minutes.
   • Washing bedding in 130 degree water.
   • Drycleaning non-washable items; or, sealing items in a plastic bag for 1 week.
   • Vacuum furniture, carpets, and mattresses thoroughly.
4. Treatment of hair should be repeated in 7 days (follow the manufacturer of the pediculicide’s instructions) to ensure that if any nits have hatched, the lice are killed before they lay eggs.
5. There is no need to cut hair. The same treatment must be used for any length of hair for effective lice removal.

Prevention Guidelines:

• Develop a policy, in consultation with the local health department, for responding to cases of infestation outbreaks.
• Learn to recognize nits, and regularly check students’ heads and hair when there is a case of head lice diagnosed in the classroom.
• Teach parents to recognize nits and to check family’s hair periodically. Because outbreaks of head lice occur periodically in almost all schools and because parental concern may exceed the threat of head lice to health, this is a prime area for preventive education and information. A well-organized and prompt response to the first few cases can prevent a widespread problem and avoid the spread of misinformation.
• If a case is identified, follow recommended treatment procedures closely. If a parent finds nits, it should be reported to the school nurse, who can check close contacts.
• Remind students not to share combs, brushes, hair accessories, headphones, hats, helmets, towels, clothing, bedding, and so forth.

Everything you need to know about HEAD LICE -Todo lo que debe saber sobre los piojos de la cabeza View/Download brochure in Color (1.3MB PDF) View/Download brochure in Black and White (1.2MB PDF) This updated and transcreated head lice pamphlet, targets all care givers of children who want to know about the treatment and prevention of head lice in children. Enhancements to the new, upbeat and colorful pamphlet include the latest science of care, family sensitive information and cultural appropriateness for any audience. This reader-friendly pamphlet is now bilingual, English/Spanish and is designed for schools to educate parents as well as specific school challenges. Click on the links on this page where you can download the pamphlet in color or black and white. Feel free to reproduce this pamphlet in any quantity at no charge. For more information or questions, contact Ellen Kelsey, Information Specialist, School Health Program or phone 512-458-7111, Ext. 2140.

Other Useful Links to Head Lice Information:

Harvard School of Public Health
Center for Disease Control
DSHS Infectious Disease Control Unit
DSHS Surveillance, Reporting and Investigations
American Academy of Pediatrics

If you have any further questions about head lice and/or the resources provided on this page, please contact the DSHS School Health Program at (512) 458-7279 or, .

Written and Published by the:

School Health Program
Child Health and Safety Group
Health Promotion Unit
Department of State Health Services
1100 West 49th Street
Austin, Texas 78756-3199
(512) 458-7279

Last Updated September 25, 2007