Lice do not pose any immediate health risk and do not indicate a lack of cleanliness. In addition, when managed correctly it can be eliminated completely in a timely manner.
Lice can be identified as having 6 legs, tan to grayish white in color, and are about the size of sesame seed. The ones I’ve seen are darker in color than I originally imagined they would be. Lice need a blood source to survive so you will find them near the scalp. The usual places are near the ears or nape of the neck. They have been found elsewhere too so check your child’s entire head. Nits (lice eggs) will not flake off. You will literally need to pull it off the hair shaft. They are usually a brownish, grayish nodule. They will vary in color – the ones I have seen are gray with a pearl iridescent shine. I cannot emphasis enough how small these nits are – it’s tough to see them if you check too quickly. They usually latch on to the hair follicle at the tip – it looks like a tear drop hanging from the follicle. Lice cannot jump or fly. However, I have seen a live louse in action and they latch onto a hair follicle very quickly. They know where their ‘food’ comes from! Itching may also be seen, however this is a later symptom.
The following is the recommendation from the American Academy of Pediatrics (updated treatments for head lice April 2015 – aap.org). Unless resistance has been seen in the community, pediatricians and parents should consider using over-the-counter medications containing 1 percent permethrin or pyrethrins such as Nix®, as a first choice of treatment for active lice infestations. The best way to interrupt a chronic lice problem is with regular checks by parents and early treatment with a safe, affordable, over-the-counter pediculicide. After applying the product according to the manufacturer’s instructions, parents should follow with nit removal and wet combing. The treatment should be reapplied at day 9, and if needed, at day 18.
In areas with known resistance to an over-the-counter pediculicide, or when parents’ efforts on their own do not work, parents should involve their pediatrician for treatment with a prescription medication such as spinosad or topical ivermectin. These are new medications that were introduced since the last time the AAP published recommendations on head lice in 2010.
Instructions on proper use of products should be carefully relayed. Safety and efficacy should be taken into account when recommending any product for treatment of head lice infestation. It is important to note that this product does not prevent lice, so do not use products on anyone who does not have active head lice. Thorough cleaning of your home and vehicles is also recommended.
While new studies now state it is not necessary to remove every single nit from your child’s head, those who have dealt with head lice state that nitpicking is the key to getting rid of the problem. It is a very slow process and needs to be repeated daily until the nits are gone. Find a good light source, wet your child’s head down with water (easier to see the nits on a wet head), and slowly comb his or her hair in sections with a metal lice comb. Remember the nits will not flake off – you need to physically remove each and every one you find.
In order to reduce the number of children affected it is recommended that you encourage your child not to share personal items such as combs, hats, or other clothing with other children. It is also proven by the American Academy of Pediatrics that careful parental inspections of a child’s head is more effective than mass school screenings. I would advise you to check your children on a weekly basis. Take time to carefully check your children’s scalp.
If untreated nits or live lice are detected on a student, the parent will be notified. The student will be sent home for treatment.
Three websites with more information are health.state.mn.us, Identify.us.com, and mnlicelady.com. If you have any more questions pertaining to head lice, please contact me at the school, 392-5621.
Jill Steiner, RN, PHN Hancock School Nurse