Lice outbreaks

Have you ever had the experience where your child pulls out a notice from their school nurse, informing you that there’s been a lice outbreak in their class or school? If it left you feeling worried, grossed out, or even a little itchy, you’re not alone. Many parents have similar reactions.

Learning how to recognize and treat head lice is your best defense against an outbreak at home. Most cases of head lice can be treated using over-the-counter or prescription medications.

Lice are a type of tiny insect that feeds on blood. Three main types of lice feed on human blood: head lice, body lice, and pubic lice. These different types of lice are named for the parts of your body they’re most likely to infect. Another name for pubic lice is “crabs.”

Only body lice are known to spread diseases. In contrast, you can’t get diseases from head lice, which are the most common type to infect children. In most cases, head lice only cause mild symptoms and pose little health risk.

A head lice infection is technically called “pediculosis.” Contrary to popular belief, it doesn’t indicate that your child is dirty or has poor hygiene. The cleanest person in the world can get head lice if they come into close contact with someone who has lice or share personal items with them. For example, your child can get head lice if they:

  • put their head or hair close to someone who has head lice
  • put on a hat or scarf that’s been worn by someone with head lice
  • use a comb or a brush that’s been used by someone with head lice
  • shares other personal items, such as barrettes, hair ties, pillows, blankets, washcloths, or towels with someone who has head lice

Head lice have no wings and can’t fly or hop. They can only crawl. Their eggs or “nits” aren’t very mobile either, since lice glue them onto hair shafts. As a result, some form of close contact is needed for lice to be transferred from one person’s head to another. Since they only drink human blood, there’s no risk of contracting head lice from pets or other animals.

It’s a common myth that lice can’t live in short hair. In fact, they don’t care much about hairstyles or length. They attach themselves about 1/4 inch from your scalp. That means they can survive on most people’s heads, even people with relatively short hair.

Your child might have head lice if they have:

  • an itchy scalp
  • a sensation of something crawling on their scalp
  • tiny spots of blood on their scalp, which can become infected

The risk of infection is higher if your child scratches their scalp a lot.

If you suspect that your child may have lice, use a magnifying glass to check their scalp and hair. It may also help to shine a bright light on their head. Lice tend to avoid bright light, which can make them easier to spot as they try to move away.

Lice and nits are most likely to be found around and behind your child’s ears, along their hairline, and at their neck. You can use a lice comb on your child’s hair to check for nits and lice. You should also check their eyelashes and eyebrows, although you’re less likely to find nits or lice there.

If you’re not sure if your child has lice, ask their school nurse, doctor, or local health department official to double check.

If your child has head lice or nits, it’s important to treat it quickly to avoid spreading it to other members of your home. You should also check other household members for signs of lice and nits. Treat everyone who has lice or nits at the same time, to lower the risk of one person spreading them back to another.

Most cases of head lice can be treated with over-the-counter or prescription medications, known as pediculicides. After you apply the medication, thoroughly check your child’s head and comb their hair with a lice comb to remove remaining nits and lice every two to three days. You may need to apply another dose of medication about a week after the first round. Follow the package directions and consult your doctor if you have questions.

It’s also important to clean items that might carry head lice. For example, if your child has head lice or nits, remember to wash their:

  • hats
  • scarves
  • hair accessories
  • clothing worn in the days before treatment
  • pillow cases and bedding used in the days before treatment
  • brushes and combs
  • towels

Lice and nits are killed by extended exposure to hot temperatures. Machine-wash in hot water items that might be infested, and dry them with hot air. If you can’t launder an item, soak it in hot water for five to 10 minutes, dry-clean it, or seal it in a plastic bag for two weeks to kill the lice and nits it might carry.

Other family members in the household should be checked as well, just in case the lice have already spread. Only those found to have lice need to be treated with pediculicides.

To be extra safe, vacuum mattresses, furniture, and floors to remove any hairs that may have fallen from your child’s head while they were infected with lice or nits.

Different schools and school districts have different policies on head lice. Some have “no nit” polices, which require students to stay away from school until they’re completely free of lice and nits. Both the American Academy of Pediatrics and National Association of School Nurses have advised against such policies. Instead, they recommend that students be allowed to return to school once they’ve begun treatment for lice. A set of international guidelines for managing head lice infestations, published in the Journal of Drugs in Dermatology, also suggests that no-nit policies are “not justified” and do “more harm than good.”

Dealing with an infestation of head lice can be unpleasant. It’s important to recognize that head lice aren’t a sign of uncleanliness or poor hygiene. Anyone who comes into close contact with someone who has head lice, or their personal belongings, can potentially get it.

If your child or another family member gets head lice, take steps to treat it quickly. Over-the-counter or prescription medications are strong enough to kill most cases of lice and nits. It’s also important to clean personal items that may be carrying lice and nits. By following these simple steps, you can help defeat and prevent lice outbreaks.