School Nurse

Head Lice Information

Send Head Lice Packing . . .
Know the Facts

Louse: Up Close & Personal

Life Cycle of a Louse

Enlarged image of head louse. Actual size 2 to 4 mm. Head lice have been around for many thousands of years. Anyone can get head lice and given the chance head lice move from head to head without discrimination.

Head lice are small, wingless, blood sucking insects.
Their colour varies from whitish-brown to reddish-brown.
People get head lice from direct hair to hair contact with another person who has head lice.
Head lice do not have wings or jumping legs; they cannot fly or jump from head to head. They only crawl.

Lice can crawl and hide. . .
Easiest & Most Effective Way to Detect:

Step 1
Comb any type of hair conditioner on to dry, brushed (detangled) hair. This stuns the lice and makes it difficult for them to grip the hair or crawl around.

Step 2
Now comb sections of the hair with a fine tooth, head lice comb.

Step 3
Wipe the conditioner from the comb onto a paper towel/tissue.

Step 4
Look on the tissue and on the comb for lice and eggs.

Step 5
Repeat the combing for every part of the head at least 4 /5 times

diagram of egg on hair If lice or eggs are found, the child's hair should be treated.

Head lice eggs are small (the size of a pinhead) and oval. A live egg will 'pop' when squashed between fingernails.

Life Cycle of Head Lice

Egg is laid on hair shaft. Egg is called a 'nit'.
Louse emerges after 6-7 days.
First moult 2 days after hatching.
Second moult 5 days after hatching.
Third moult 10 days after hatching.
Emerging from their third moult as adult lice, the female and slightly similar male begin to reproduce.
Female lays first egg 1 or 2 days after mating.
Female can lay approximately 3 to 8 eggs per day for the next 16 days.
Having lived 32 to 35 days the louse dies.

Treatment Choices

Chemical
Treat and comb to remove the head lice and eggs; repeat in 7 days
Non-Chemical
Use conditioner and comb to remove head lice and eggs; repeat every 2 days until no live lice have been found for 10 days.

Head lice: Scratching for Answers (322kb, pdf)

Treating Head Lice

Concentrate on the head - there is no evidence to suggest that you need to clean the house or classroom.
No treatment kills all of the eggsso treatment must involve two applications seven days apart.
If you are using lotions, apply the product to dry hair.
There is no need to treat the whole family, unless they also have head lice.
Only the pillowcase requires specific laundering; either wash it in hot water (at least 60 degrees centigrade) or dry it using a clothes dryer on the hot or warm setting.
There is no product available that prevents head lice. Using the conditioner and comb method once a week will help you detect any head lice early and minimise the problem. Tying back long hair can help prevent the spread of head lice.
Combs with long, rounded stainless steel teeth positioned very close together have been shown to be the most effective, however, any head lice comb can be use.

Frequently Asked Questions about Head Lice

Do head lice fly or jump?
Head lice do not have wings so they cannot fly. They can't jump because they do not have ‘knees’.

Where do head lice come from?
Head lice have been around for thousands of years. As with any insects, they learn to adapt to their environment in order to survive. We are never going to be completely rid of them, but we can make managing them easier.

So how do head lice move around?
Head lice CRAWL very fast and require head to head contact for transmission. It is possible that because of the way young children play, head lice are seen more widely amongst primary school children than adolescents or adults.

Can head lice spread disease?
No. A head lice infection is not a life threatening health condition – like similar health conditions such scabies, and ringworm, it is a parent or guardian’s responsibility to treat and care for their child.

Do head lice live in carpets, clothes, hats or sheets?
No. Head lice very rarely fall from the head. They require blood to survive. Head lice feed 3-4 times a day and without blood, will dehydrate in 6 hours in a dry climate and 24 hours in a humid climate. An egg requires warmth to hatch and is the reason why they are laid close to the scalp. The further away from the scalp, the less likely they are to survive.

Is it true that head lice only like clean hair?
No. Head lice are not selective. They don't care if hair is long, short, blonde, brown, washed this morning or last week. As long as they are warm, and have blood to drink, then they are content.

What treatment kills 100% of head lice or eggs?
There is no single treatment that kills 100% of head lice or eggs. Whichever treatment you choose it can take time and persistence to get rid of head lice. Use a method that will not risk the health of your child.

Is there a way to prevent head lice?
No, not that we know of. It's important to check your child's head regularly with conditioner even when you don’t think your child has head lice. There is no research to prove that chemical or herbal therapies can prevent head lice.

How does the conditioner and comb method work?
It’s a very cheap and effective way of finding head lice. Hair conditioner does not kill lice, but it does stun them for about 20 minutes, meaning they do not move around, and it is difficult for them to hang on. This gives you time to comb through the hair with a lice comb.

How does a chemical treatment work?
Only use products that are licensed or registered for head lice. There are four different active chemicals that target head lice, each works differently and aim to kill lice and/or eggs.

Frequently Asked Questions about Treatment

Do some products work better than others?
Over time, head lice may develop resistance to some chemicals. It is important to check if a treatment you used has worked, and if not, treat again with another product that has a different chemical.

Why do you have to treat again in seven days' time?
Head lice eggs take 6-7 days to hatch. And when you treat, it’s easy to miss an egg or two. By treating again in seven days, you are aiming to kill and comb out any lice that have since hatched from eggs, which were missed.

Should I treat everyone in the family?
It is important to check each family member, using conditioner and comb, for head lice but only treat those with live lice.

What should I wash or treat at home?
As head lice only live for a short time off the head, the only extra cleaning needed is to wash the pillowslip on the hot cycle or place in clothes dryer. Head lice combs can be cleaned in water hotter than 60 degrees.

Why does my child keep getting re-infected?
Re-infection is the least likely reason for head lice returning in a week's time. If eggs do not die, or were not removed during the original treatment they may hatch and the lifecycle occurs all over again. To break this lifecycle you must re-treat (regardless of treatment method) seven days after the first treatment and continue with weekly checking.

Does my child have to miss school?
According to the Health (Infectious Diseases) Regulations 2001, children with head lice may be readmitted to school after head lice treatment has commenced. A certificate from a doctor or council is not required before your child goes back to school. Children do not catch head lice from school, they catch it from other children when they gather together at schools. Head lice are not the fault of schools.

Helpful Hints

Using the conditioner and comb method every week is the best way to detect head lice early and minimise the problem.
Tying back hair can also help prevent the spread of head lice.
Many parents will complain that they are doing the right thing but other parents aren’t. Placing the blame will not achieve anything. Instead of pointing the finger, help each other.
A school with a head lice education program and policy in line with Scratching for Answers? is a proactive school attempting to help families address a common health concern.
The DHS head lice management strategy is supported by the Department of Education and Training.

Information from Pawnee Hand Book

According to the Illinois Department of Public Health, head lice do not transmit communicable disease. Persons from all socioeconomic levels without regard to age, race, sex, or standard of personal hygiene, can become infested with head lice. The psychological, social problem far outweighs its significance as a health concern in most situations. It becomes a social concern because of the emotional reaction to its presence. Due to the continued concern and frustration in dealing with head lice in the school, the latest national recommendations for school guidelines have been reviewed and Pawnee School District will seek to achieve a consistent approach to head lice management within the school. The following information was obtained from the American Academy of Pediatrics, Center for Disease Control, Center for Health and Health Care in Schools, and the National Association of School Nurses.

Head lice is not a serious medical condition, but rather a nuisance.
Adult lice are 1-2 cm in length. Head lice crawl; they do not jump or fly and they are dependent on their host for nourishment (human blood). Lice that fall off a head or either injured or dying and incapable of causing an infestation on another person. Lice are very fragile and cannot live off of their human host for more that 24 hours. Transmission occurs by direct head to head contact. Indirect spread through contact with personal belongings (combs, hats, coats) is very unlikely due to the biology of the louse.
Nits (eggs) are tiny white/yellowish oval shaped eggs that are attached to the hair shaft at an angle. Nits found more that 1 cm from the scalp along the hair shaft are considered non-viable. These are empty egg cases from the current infestation or a past infestation.
Routine head checks of healthy students are not recommended. Entire classrooms should only be checked when head lice is present in 2 or more students.
Head checks should be done on symptomatic students(i.e.: itching of the scalp)
Exclusion from school with head lice disrupts the educational process and should not be viewed as a strategy in managing head lice. Exclusion policies are unjustified and discriminatory. Active infestation poses no risk to others and students should remain in class There is little reason to immediately send the student home or isolate him/her from the rest of the school population. transmission is much more likely to occur before the infestation is identified.
Parents have the primary responsibility for the detection and treatment of head lice and schools should work in a cooperative and collaborative manner to assist all families.

Expectations of parents/caregivers are:

Child's hair will be checked for head lice on a weekly basis at home.
Upon detecting head lice at home or school, parents will use a safe and recommended treatment for head lice and inform the school of finding head lice at home and/or treatment of such.
Encourage children with long hair to attend school with hair tied back.
Notify parents of your child's friends so they have an early opportunity to detect and treat their children if indicated.
Maintain a sympathetic attitude and avoid stigmatism/blaming families who are experiencing difficulty with control measures.
Act responsibly and respectfully when dealing with members of the school and community around head lice issues. Parents are asked to respect privacy issues and not call the school with reports of names of children other than their own who have or were known to have head lice. These reports will not be accepted by school personnel, nor will those children be checked by the school nurse for head lice under those circumstances.

Expectations of School:

Distribute current and up-to-date information on the control of head lice to parents and staff at the beginning of the school year. Include updates throughout the year as needed.
Inform parents when there are 2 or more cases of head lice in the child's classroom.
Inspect the heads of children in a classroom that has 2 or more identified cases of head lice.
Once a child has been identified as having an active infestation of head lice at school, the parent will be notified and given information regarding standard treatment and follow-up procedures and encouraged to contact their physician/pharmacist for further questions or information. Ideally, the parent should pick the child up from school to allow the school nurse to show the parent the evidence of infestation, and at the same time, provide assurance and guidance. If the parent chooses, the child may return to the classroom for the remainder of the day and receive treatment after school.
Followj-up the day after treatment by checking the child's head to assure that proper practices were used for treatment of head lice. If it is determined that the child still has an active infestation, the parent will be contacted and asked to come to the school to pick up the child. Additional instruction will be given to the parent on standard head lice management, treatment, and follow-up. Continued follow-up and assurance will be given to the family.
Provide privacy and confidentiality when dealing with head lice issues.

Information is courtesy of Assoc Professor Rick Speare and team of researchers at School of Public Health, James Cook University, Queensland.This information was provided by Communicable Disease Control, Public Health Branch, Rural & Regional Health & Aged
Care Services Division of the Victorian State Government, Department of Human Services, Australia