• Lice
    Head lice are tiny wingless, silvery, gray or brown insects (1/10 to 1/8 of an inch long) that live in human hair and feed on human blood. They multiply rapidly, laying little silvery-colored oval-shaped eggs (nits) that they glue to the base of the hair close to the scalp. Although it is hard to see head lice, a person can see the nits if they look closely. They prefer dark, damp areas near the nap of the neck or around the ears or under bangs. Nits should not be confused with dandruff. Dandruff can easily be flicked off the hair; nits cannot because they are firmly attached to individual hairs. One significant sign of head lice is a persistent itching of the scalp, which is caused by the bite of the louse. Head lice survive less than one or two days if they fall off the scalp and cannot feed. Head lice eggs (nits) cannot hatch and usually die within a week if they do not remain under ideal conditions of heat and humidity similar to those found close to the human scalp. Therefore, because a nit must incubate under conditions equivalent to those found near the human scalp, it is very unlikely to hatch away from the head. In addition, if the egg were to hatch, the newly emerged nymph would die within several hours if it did not feed on human blood.
    Anyone can get head lice. They are not a sign of being dirty and should not be considered a sign of an unclean house. Head lice are easily spread from person to person by direct contact and are often found in school settings. Head lice do not spread disease.
    Head lice need blood to survive. They are transmitted through direct contacts with an infested person or with shared items such as combs, brushes, towels, pillowcases,and clothing.
    Students identified with head lice may complete the school day and information addressing lice management and treatment is sent home for the student and parent or legal guardian.The state does urge school districts not to cause children to miss class unnecessarily or encourage the embarrassment and isolation of students who suffer from repeated head lice. Mass screenings for head lice are not done in school. They impede the educational process are not necessary. No disease is associated with head lice, and in-school transmission is considered to be low. When transmission occurs, it is generally found among young children with increased head-to-head contact.. Head lice occurs world wide and among all socioeconomic groups.
    Children found or suspected of having head lice should remain in class, but be discouraged from close direct head contact with others.
    Children with suspected head lice are sent to the nurse for screenings and nursing assessments in the privacy of the clinic. The nursing assessment includes observation and inspection for signs or symptoms  
    Treatment recommendations for pediculosis should be based on evidence based literature from public health, medical and nursing content experts rather than anecdotal reports or commercial advertisements. A negative social stigma frequently accompanies the identification of pediculosis as well as the frustration involved with the cost, time and effort needed for treatment and environmental control
    • Remove as many nits as possible with a nit comb. One of the best combs available is the “Lice Meister” comb. Treat the child’s hair with recommended Pediculocide. Parents or legal guardian may choose to consult with their doctor or local pharmacist in choosing what product to use.  
    • After treatment has been administered, soak combs and brushes in the pediculocide for 1 hour or in 120 degree water for 5-10 minutes.
    • Bedding should be washed in 120 degree water.
    • Non-washable items may be dry cleaned or sealed in a plastic bag and stored for 2 weeks to kill any lice that are present or may hatch from nits present on the items.
    • Furniture, carpets and mattresses should be vacuumed thoroughly and dispose of vacuum cleaner bag.
    • Hair treatment should be repeated in 7 days or according to manufacturer’s recommendation to ensure nits hatching later are killed before they lay eggs.
    • No need for haircuts.


    • Treatment for head lice is recommended for persons diagnosed with an active infestation.
    • Misdiagnosis of head lice infestation is common. The diagnosis of head lice infestation is best made by finding a live nymph or adult louse on the scalp or hair of a person.
    • Because adult and nymph lice are very small, move quickly, and avoid light, they may be difficult to find. Use of a fine-toothed louse comb may facilitate identification of live lice.
    • If crawling lice are not seen, finding nits attached firmly within ¼ inch of the base of hair shafts suggests, but does not confirm, the person is infested. Nits frequently are seen on hair behind the ears and near the back of the neck. Nits that are attached more than ¼ inch from the base of the hair shaft are almost always non-viable (hatched or dead). Head lice and nits can be visible with the naked eye, although use of a magnifying lens may be necessary to find crawling lice or to identify a developing nymph inside a viable nit. Nits are often confused with other particles found in hair such as dandruff, hair spray droplets, and dirt particles.
    • If no nymphs or adults are seen, and the only nits found are more than ¼ inch from the scalp, then the infestation is probably old and no longer active — and does not need to be treated
    • In addition, Do not use a combination shampoo/conditioner, or conditioner before using lice medicine. Do not re-wash the hair for 1-2 days after the lice medicine is removed. These measures may reduce the effectiveness of the lice medications.
    • Children's heads should be checked consistently as part of their daily hygiene at home.