Head Lice

  • Head lice are a common problem in school-age children. It can take up to two weeks for head lice infestation to become apparent. This information may help decrease the risk of your child becoming infested or give you the information you need to treat head lice in your child.

    What are lice?

    Head lice are small, light to dark brown insects no larger than the size of sesame seeds. The female head louse lays eggs, called nits, on the hair shaft close to the scalp. These nits, which look like tiny whitish ovals, are firmly glued to the hair shaft and usually hatch within two weeks. Nits are most often found in the hair behind the ears and at the back of the head and neck. Nits should not be confused with dandruff. Dandruff can be easily flicked off the hair; nits cannot because they are firmly attached to individual hairs.

    Anyone can get head lice. They are not a sign of being dirty and should not be considered a sign of an unclean house. Although head lice do not jump, they can spread from one person to another. School-age children and their families are likely candidates for head lice because it spreads through close contact. Tell your child that he/she should not share personal items such as hats, combs, brushes, pillows or bike helmets, because these items can transmit lice. Head lice do not cause any diseases to humans.

    If you suspect head lice, check your child's head closely. Head lice may be hard to locate because they move to avoid light. Nits may be easier to find. If left untreated, head lice will quickly increase in number, so you have to be sure to treat it as soon as it is detected.

    What can I do?

    At home, the best thing to do is to check your entire family for lice and nits regularly, especially after sleep-overs. It's also important to be alert for the signs and symptoms which include intense head scratching. If you find lice or nits in your child's hair, comb out as many of the nits as possible using a fine toothed comb or tweezers and then use a special medicated shampoo that contains either pyrethrin or permethrin. These products can be purchased without a prescription at any pharmacy and at most grocery stores. The medication should be used exactly as directed in the package instructions. Do not shampoo your child's hair with regular shampoo or excessively comb for several days after the application of the medicated shampoo. This will allow the medication to work and continue to kill the lice and nits. Use the medicated shampoo again in one week, if needed. None of the treatments are 100% effective and it is very common for it to take a few weeks to completely resolve a head lice infestation. Remember to check all family members and treat those with any signs of head lice. For persistent cases that do not respond to 2 or 3 consecutive weekly treatments of the over-the-counter shampoo, prescription medications are available. Contact your health care provider for more information.

    It is also important to wash bedding, towels, clothes and coats in hot soapy water. Drying these items in a hot dryer is recommended. Items which cannot be washed can be sealed in a plastic bag for two weeks. Carpets, upholstery and car seats should be vacuumed. Head lice do not live off of their hosts for more than a day or two, so excessive cleaning is not needed.

    ACPS Protocol

    When a child is identified with an active head lice infestation at school, parents are notified of the suspected infestation and provided with information about treatment. Students will be sent home at the end of the day and may return to school after they have received appropriate treatment at home. Students with nits only are not excluded from school.

    Please know that we share your concern about head lice. If you detect head lice in your child, please let the school nurse know. ACPS school nurses will alert parents and guardians when there is an unusual clustering of head lice cases, while still seeking to protect the privacy of individual students. By working together, we can successfully eliminate head lice. Please feel free to contact your school nurse if you have any questions.

    Resources for More Information


    Virginia School Health Guidelines (2nd Edition), Virginia Department of Health, May 1999. Available at http://www.doe.virginia.gov/support/health_medical/

    Frankowski, B. L., and Weiner, L.B. (2002). American Academy of Pediatrics, Committee on School Health; and the Committee on Infectious Disease. Head Lice. Pediatrics, 110, 638-643.