From the Nurse: About Head Lice

Posted on January 18, 2012 by oakhillpto in From Newton Public Schools

In the last week, two different case of head lice, in two different grades, have been discovered at Oak Hill. Since the problem can be spread can be spread from one child to another, please examine your child’s head daily for the next few weeks for any signs of lice. Please read on about how one gets lice, what to look for, treatment, notification, and when to return to school.

HOW YOU GET IT:
A head lice infestation is a mild health condition without serious health consequences for a child. Head lice are usually transmitted through close personal contact with another infested individual, through sharing combs, brushes, and other grooming aids; through sharing hats, caps, scarves or coats; or through mingling of these items at home, in the school or other public places. Once lice have been found, prompt treatment is the key to effective control. Many parents/guardians have the impression that lice become established on people who are unclean. In the case of head lice, this is NOT TRUE! Frequent bathing will neither prevent head lice nor eliminate an infestation once it has been established.

WHAT TO LOOK FOR:
LIVE LICE: Small insects about the size of a sesame seed

  • Usually light brown but can vary in color
  • Move very quickly and shy-away from light, making them difficult to see

NITS (EGGS): Small teardrop (oval) shaped specks

  • Vary in color from yellow to brown to white
  • Firmly attached to hair shaft (unlike dandruff) with a waterproof cement-like covering
  • May be found anywhere but most commonly found behind the ears, around the nape of the neck, and on the crown of the head
  • Most often found within one inch of scalp

SCRATCHING OF THE HEAD

RED BLOTCHING ON THE SCALP

INDIVIDUAL TREATMENT

  • Chemical treatment with the use of a medicated shampoo is an option. This decision should be made after consulting with your health care provider. Manual removal is necessary with both the chemical and non-chemical options:
  • Chemical Treatment:
  • Apply head lice shampoo (containing Lindane, Permethrin, Piperonyl Butoxide, Isporopyl Myristate or other pediculocide). Follow package insert directions carefully.
  • Apply shampoo while child is standing over the sink to minimize the exposure of the chemical to the rest of the body. Confine product to scalp and neck. Avoid contact with the eyes.
  • Do not use the products on babies or pregnant women.
  • Do not treat individuals who do not have evidence of head lice.
  • Apply clean clothing after treatment.
  • The shampoo usually kills the nits, but the only sure way to remove them from the hair is combing. See manual nit removal.
  • Continue daily head checks for 7 to 10 days (incubation period) after initial application of shampoo. If nits or lice are found, additional treatment may be necessary.

ALL NITS MUST BE REMOVED TO INSURE COMPLETE TREATMENT
Manual Treatment:

  • Sit in a comfortable chair with a good source of light (natural sunlight is preferred).
  • Thoroughly clean and comb-out the hair, removing all tangles and debris.
    Obtain a metal fine-tooth comb and comb out all of the nits.
  • Work on one section of the hair at a time. Comb each section away from the scalp, using a fine-tooth metal comb.
  • Clean off the comb after each stroke to remove any caught lice or eggs.
    Repeat this technique throughout the head, carefully inspecting the hair.
  • Those nits left after thorough combing must be picked out individually. Remove nits with fingernails or safety scissors.
  • Continue daily head checks for 7 to 10 days. If nits or lice are found, additional treatment may be necessary.

In-between chemical treatments:

  • Do not use the pesticidal shampoo more often than directed (usually not more than once in a week).
  • Apply olive-, coconut-, lippa- other oil to the head, soaking the scalp and hair.
  • Cover with a shower cap, and leave the oil on the hair for several hours or overnight before washing it out with your regular shampoo.
  • You should be able to remove the nits more easily after the oil treatment. Follow the manual treatment (above).
  • Thoroughly blow-dry the hair in sections under the hot setting for 30-minutes.

TREATMENT OF PERSONAL ARTICLES AND ENVIRONMENT
Heat is lethal to lice and their eggs, therefore, many personal articles can be disinfected by machine washing in HOT water (>140°) and/or machine drying, using the hot cycle (>155°) of the dryer. Non-washable items may be disinfected in the dryer, provided that heat will not harm them. If total reliance is placed on the clothes dryer for disinfection, dry articles for at least 20 minutes at the high heat setting.

  • Machine wash all washable clothing and bed linens that have been in contact with the infested individual within the previous three days.
  • Non-washable items can be vacuumed, dry cleaned, or placed in a plastic bag and sealed for 14 days.
  • Combs, brushes, and similar items can be disinfected by soaking them in one of the pesticidal shampoos for one hour or by soaking them in a pan of water heated on the stove to about 150 degrees for 5-10 minutes (caution: heat may damage some combs and brushes).
  • Because lice can live only a short time once they fall off the head, environmental clean-up is limited to simple vacuuming of carpets, upholstered furniture, etc.
  • Use of insecticides or fumigants on upholstered furniture, carpets, bedding, etc. is not recommended.

NOTIFICATION (SCHOOL AND OTHER PARENTS/GUARDIANS):
It is imperative to report your child’s case to the school nurse and to the parents/guardians of playmates.  If you suspect that your child may have head lice, please notify the school nurse. Lice are a common problem of school-aged children (and not a sign of poor hygiene). It is essential that all cases be reported in order to prevent the spread of this condition. Additional information is available regarding treatment of your child at home.

RETURN TO SCHOOL:
Your child may return to school after he/she has been treated with the medicated shampoo. He/she must stop at the nurse’s office prior to returning to class. If your child has not been treated with the medicated shampoo and nits are still present, your child will not be allowed to remain in school and will not be allowed back until all the nits are removed.

If you have any questions or comments, please call the Oak Hill School Nurse, Sue Riley, RN,BSN,NCSN at 617-559-9205 or email at Susan_Riley@Newton.k12.ma.us, or call the Newton Health Department at 617-796-1420.