What should I know about head lice now that the kids are back in school?

Child scratching head

Head lice. Ugh. Been there, done that. Twice.

The first time: The school sent home instructions to check our kids for lice because they were going around. Sure enough, after searching and searching my husband found one. One is enough to start the purge.

The second time happened the following summer when I noticed that a young houseguest was scratching her head quite a bit. Upon investigating, her mother and I found considerably more than one tiny creature scurrying along her scalp. She freaked out. I wasn’t happy, but I knew the drill and I knew that freaking out solved nothing. Trust me, the first time, I freaked out, too — more on that later.

Head lice nits

Source: Pond5

Ten things you should know about head lice

1) They are a nuisance, but not a medical problem.

2) Personal hygiene and cleanliness have nothing to do with getting head lice.

3) You’re at the greatest risk if you have direct contact with the hair of someone who is infested.

4) Head lice don’t hop or jump, they crawl.

5) Lice are usually easier to spot than their eggs or nits. They crawl along the scalp and are most likely to be found around and behind the ears or near the neckline at the back of the head.

6) The nits are yellowish-white and about the size of a sesame seed. They stick to the hair shaft — like in the picture above.

7) Lice are after human blood, but you might also find them and their eggs on clothing, bedding, towels, and other items. Without a human host, they’ll die within two days. That said, you should wash questionable items in hot soapy water or put them in a hot dryer for 30 minutes. Also vacuum furniture, floors, and carpets.

8) There are several ways to treat active head lice, but the American Academy of Pediatrics has this warning:

Not all products and techniques have been evaluated for safety and effectiveness. One percent permethrin lotion is recommended as initial treatment for most head lice infestations with a second application 7‑10 days after the first. Parents and caregivers should make sure that any treatment chosen is safe; preferred treatments would be those [that] are easy to use, reasonably priced, and proven to be non‑toxic. All products must be used exactly according to manufacturer’s instructions. Your pediatrician can help with diagnosis, treatment choices and management of difficult cases.

The CDC website has additional information about over-the-counter and prescription medications.

9) An important part of treatment is getting rid of nits. You’ll need a special comb because they stick to the hair shaft.

10) To help prevent another infestation, all family members who have head lice should be treated on the same day.

Unfortunately, head lice are a common occurrence where children gather, such as in day care or at school. It doesn’t mean you or your kids aren’t clean, and it doesn’t mean you’re a failure as a parent. It is what it is, and the important thing is to get rid of them.

Dr. Lisa Ryan, Chief of Pediatrics at Mercy Hospital’s Harry E. Davis Pediatric Center, adds this important information:

The recommendations for household contacts is for them to be checked and treated only if they have evidence of lice or nits. Kids don’t need to be sent home from school but school nurses typically are quite upset about kids with lice being in school. The most important thing is to remind kids not to share brushes, hats, bandanas, pony tail holders with other kids at school!

My head lice freak out moment

And now, my confession. I freaked out the first time we had to deal with head lice and ended up feeling like a bad mother and a bit of a hypocrite. I had calmly explained to my daughter, who was about eight at the time, that it wasn’t a big deal. Anyone could get head lice I said, but she’d have to stay home from school until we were sure they were gone.

I was really proud of the way I handled the situation — until I walked into her bedroom and listened in horror as she shouted out the window to all the kids waiting for the school bus. “I can’t go to school today,” she yelled, “because I have head lice!” ƒ

I yanked her away from the window and quickly closed it. “But, Mommy,” she asked, “why are you upset? You told me it wasn’t a big deal.”

“I know,” I replied rather sheepishly, “but I didn’t expect you to shout it from the rooftops!”

Diane Atwood

About Diane Atwood

For more than 20 years, Diane was the health reporter on WCSH 6. Before that, a radiation therapist at Maine Medical Center and after, Manager of Marketing/PR at Mercy Hospital. She now hosts and produces the Catching Health podcast and writes the award-winning blog Catching Health with Diane Atwood.