Head Lice (Pediculosis)

From time to time head lice make their unwelcome appearance at school. If you find head lice on your child, please notify the school nurse. Bear Creek does not routinely screen for head lice in classrooms or at the all-school level, as the CDC and the American Academy of Pediatrics indicates that such screening does not reduce the incidence of head lice. However, if the school nurse identifies live head lice, parents will be notified, and we ask that you follow the treatment recommendations. A child who has begun treatment for head lice may attend school or preschool.

What are lice?

A head louse is a tiny gray bug that can cause scalp irritation. An adult louse is about the size of a sesame seed. Head lice live on the scalp of humans. Head lice exist as adults, nymphs (newly hatched), or eggs (also called nits). If a louse falls off a person it dies in one to two days.

How are lice transmitted?

Head lice are transmitted through close contact with the hair of an infested person, such as during play; sitting close during class; riding in vehicles; or at sports activities, camps, or slumber parties. Lice can also be transmitted through infested items. Hairbrushes or combs, clothing (hats, hair ribbons, and scarves), towels, furniture, carpet, and stuffed animals have served as contact sources. Lice do not jump or fly. Lice do not spread from animals to humans. Children from 3 – 10 yrs of age are most at risk for lice, but it can happen to anyone, anywhere in the world regardless of social status or personal hygiene habits.

How are lice detected?

The nits may be mistaken for dandruff, as they are tiny, but nits are the easiest to detect because they are attached to the base of the hair shaft. Nits are gray-white and oval-shaped. There may be so few nymphs and adult lice that they may be difficult to find. Your child may not have any symptoms, or may complain of an itchy, crawly scalp. The back of the neck and around the ears are common areas.

How should lice be treated?

Head lice can be treated at home. By following the treatment guidelines all lice and nits can be killed. There are no lasting problems from having head lice. They do not carry diseases and will not make your child feel sick.

  • Eliminate the lice and eggs. Wash your child's hair with an over-the-counter or prescribed pediculocide (shampoo with medicine that kills lice and most of the eggs). Follow directions on the medication bottle for the length of time to wait before rinsing the scalp with water. Do not use a regular shampoo, conditioner, or rinse before or during application of the pediculocide as these may reduce the effectiveness of the medication. Do not re-wash the hair for one to two days after pediculocide application. 7 – 9 days after the first application you will need to re-apply the pediculocide to destroy the lice that hatch from eggs that were not killed from the first application, before they lay eggs. Follow re-application directions on the medication bottle. Reapplication may need to happen again on day 18 if not all lice and nits are eliminated.
  • Comb the dead lice and nits out of the hair with a fine-toothed comb after application and every 2 – 3 days thereafter. This is key to ensuring the nits are removed and the infestation cycle is broken.

The following persons should avoid using pediculocides and seek advice for treatment from a health care provider: women who are pregnant or breast-feeding; persons with allergies, asthma, or other medical conditions. Cetaphil cleanser may be used as a substitute treatment (check with provider first). Cetaphil is a soapless skin product that can be bought over-the-counter. It works as a lice treatment by coating the lice and suffocating them. It has a 97% success rate but as with all treatments regular combing is important for the removal of all nits.

Assess household members and close contacts for head lice. Treat those who show signs of active infestation (live, moving lice) at the same time you treat the child. It is a matter of preference as to whether to treat all household members and close contacts. Recheck all treated persons 2-3 weeks after the initial application to make sure all lice and nits are gone. Rid the household of lice and eggs.

  • Launder in hot water the washable items (clothing, linens) that the affected persons came into contact with at least two days prior to finding the lice. Dry the items for 20 minutes on the hot cycle.
  • Dry clean items that are not washable.
  • If preferred, seal items in a plastic bag and store for 2 weeks.
  • To clean combs and brushes, soak for 1 hr in rubbing alcohol or Lysol, or anti-lice shampoo.
  • Vacuum the floor and furniture. Do not use lice spray as it can be toxic if inhaled.

Please contact school nurse Lea Hysom at lea.hysom@tbcs.org or 425-898-1720 ext. 399 to report a case of head lice.

More information about lice is available on the CDC website.