1. Head Lice: What You Should Know
Virginia O’Malley

2. Head Lice/Pediculosis
Are tiny parasitic insects about the size of a sesame seed.
Have six claws that are used to “cling” to hair shaft.
Are tan, brown or grey in color.
Can only live on a human head and feed on human blood
Can move very fast and are hard to see.
Are wingless and do not jump or fly – they crawl.
Are not a health hazard, do not cause diseases
Are not a sign of poor hygiene.
(Frankowski, 2010)
(CDC, 2013)

3. Lice Facts Who gets lice? How does a person get lice?
In the U.S. it is estimated 6-12 million infestations of head lice occur each year in children ages 3-11yrs.
Almost anyone can get head lice.
Preschool or elementary school aged children, and persons who live with them, are the most commonly affected.
How does a person get lice?
Spread by direct head-to-head contact with an already infested person.
They do not live off the head for long, so it is uncommon to spread head lice by contact with clothing or other personal items.
Your pets cannot get or transmit lice.
(CDC, 2013)

4. Stages of Head Lice *You may see all stages present at the same time
Nits
Lice eggs laid by adult female
Teardrop/oval shaped
Attached to the hair shaft, with a glue like substance
Yellowish or white
Often confused with dandruff
Cannot be brushed off
Nymph
Are baby/immature louse
Grows to adult size in 9-12 days
Found on the scalp or in the hair
Adult louse
Size of a sesame seed
Lives about 30 days on a persons head
Lay about 6 eggs a day.
Commonly behind the ears and near the neckline
*You may see all stages present at the same time
(CDC, 2013)

5. Life Cycle

6. Symptoms of Possible Head Lice
Tickling feeling on the scalp or hair, like something is moving
Itching (allergic response from the louse’s bite) may start after 4 to 6 weeks after initial infestation
Since lice are more active in the dark, may experience irritability and difficulty sleeping
Sores on the head from scratching
Seeing a live nymph or louse is the best way to confirm having head lice!
(CDC, 2013)
(Frankowski, 2010)

7. What Do You See?

8. Treatment Considerations
Only treat persons with evidence of live infestation.
Everyone in the household should be regularly checked for live lice.
Consult your physician for pediculicide recommendation and follow instructions per label or box.
Do make sure to consult your physician for retreatment if needed.
Continue to check the hair every 2-3 days for 2-3 weeks
Do not over-treat. Resistance to some over-the-counter medications has been reported.
(CDC, 2013)
(Frankowski, 2010)

9. Environmental Care
Full grown/adult head lice survive less than 1-2 days, and nits usually die within a week once they fall off a person and cannot feed
Do not use insecticide fumigants or fogs; they are not necessary and may be toxic if inhaled or absorbed through the skin
Machine wash in hot water any bed linens and recently used clothes, hats and towels. Disinfect combs, brushes and hair clips in very hot water or sealed in a plastic bag for two weeks
(CDC, 2013)

10. Challenges and Issues with Head Lice
Misdiagnosis results in unnecessary treatments
“No Nit” policies keep children out of
classroom
Improper use of treatment, whether overuse or underuse, can lead to resistance
Indirect cost – childcare expense, lost wages
Direct cost – pediculicides, office visits, laundry
Caregiver strain
(Sciscione, 2007)

11. School Procedure Moved away from No-Nit Policy
Students with live lice will be dismissed. Parent/guardian will be notified via telephone and a note sent home with student.
Treatment is required before returning to school
Upon returning to school, student must be escorted by an adult and the school nurse will check for continued presence of live lice.
Classrooms are not routinely screened
Notices are not routinely sent home
Confidentiality must be and will be maintained
(Sciscione, 2007)

12. Head Lice are Here to Stay
But can be managed

13. References
Centers for Disease Control and Prevention. (2013). Biology. Retrieved from Centers for Disease Control and Prevention. (2013). Epidemiology & risk factors. Retrieved from Centers for Disease Control and Prevention. (2013). Head lice information for schools. Retrieved from Centers for Disease Control and Prevention. (2013). Prevention & control. Retrieved from Centers for Disease Control and Prevention. (2013). Treatment. Retrieved from Frankowski, B., & Bocchini, J.r. (2010). Head lice. Pediatric, 126(2), doi: /peds Sciscione, P., & Krause-Parello, C.A. (2007). No-Nit policies in schools: Time for change. The Journal of School Nursing, 23(1), doi: /