Head Lice in Schools

- Head lice and school-age kids -

Summary: Head lice are common in school-age children and outbreaks occur frequently. When outbreaks occur schools should not respond with "no-nit" policies. Instead head lice can be managed at home with medicated shampoos or lotions and proper nit combing.

Jack DeAngelis, PhD
OSU Ext. Entomologist (ret.)

Head lice ("lice bugs") identification

This series of articles will help you identify and get rid of head lice. There are three types of lice (singular: louse) that can affect humans. Other animals, like birds and mammals, have their own species of lice but humans are host to the following three species: Head lice (Pediculus humanus capitis), body lice (Pediculus humanus humanus) and pubic lice (Pthirus pubis).

Head lice are small (2-3mm ~1/8") elongated, wingless insects that feed on the blood of humans and a few other primates (see photo right). They spend their entire lives in close contact with their hosts. Both head lice and pubic lice attach their eggs, the so called nits, to the head and body hairs of their host whereas body lice lay their nits in clothing. So, the location of nits, on clothing versus hair, is a pretty reliable way to tell head lice from body lice. Public lice look very different but also attach their eggs to hairs.

human body or head louse
human louse about 2 mm (1/16") long

Common misspellings and misnomers for head lice: headlice, cooties, lice bugs

Lice infestations

Head lice are ectoparasites (external, blood-feeding) and are especially common in school-age children. They bite to obtain blood much like mosquitoes and bites cause itchy wounds but they do not transmit diseases.

Head lice are most common in kids where they can be found in any group regardless of socioeconomic level. Head lice are generally transmitted by person to person contact and sharing of personal items which is why they tend to be more common in kids. However, anyone in the family can become infested.

Unfortunately, head lice cause much over-reaction and over-treatment by well-meaning adults. They can be effectively managed despite growing problems with insecticide resistance to pyrethrum and permethrin, the medications in popular OTC lice treatments.

I have argued for a long time that head lice are no reason to keep kids out of school. It now (2015) seems that the American Academy of Pediatrics agrees.

In a recent article the AAP now recommends that:

  • so called "no-nit" policies should be abandoned
  • head lice not be treated as a serious medical issue but instead a simple nuisance
  • head lice not be considered an indication of unsanitary conditions
  • head lice should be diagnosed by a pediatrician, not by nit-screening at school
  • excessive cleaning at home is not needed

Lice treatments

Head lice treatment is passionately debated by parents, teachers and everyone concerned about kid's health. The bottom line, however, is that head lice are treatable, they are not a serious medical concern, and they should not be a reason for missed school days. Nit (louse egg) removal, or "nit-picking", is the most important step and hair can be treated with oils and conditioners to aid combing to remove nits. Next, medicated shampoos or creme rinses can be used to kill immature and adult lice (see How To Safely Control Head Lice for the detailed steps to follow for safe and effective lice control).

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