Head Lice Info

Procedure – Head Lice

Head lice are a common community problem, with an estimated 6-12 million lice cases occurring each year in the United States.  Lice most commonly afflict children ages 3-11 years old. While lice can be bothersome and make many people anxious, they are not dangerous and do not spread disease.  With that said, they do spread easily by head to head contact.

In the school setting, especially in younger children, head itching is commonly seen by teachers and the student is referred to the school nurse.  In the past the nurse would send the child home to initiate treatment immediately. The nurse would check classrooms of children and send notifications home.  Many of our past practices have proven to be outdated and ineffective. Below is a description of our current procedure in the school setting. The onus of responsibility to “cure” head lice is not that of the district, but the parents.  School nurses advocate for their students and are knowledgeable about head lice. They serve as a resource to the parent, offering information and resources to assist in the eradication of head lice from the home.

Our district policy is guided by current information and research conducted and published by the American Academy of Pediatrics and the National Association of School Nurses.  Through their guidance we have developed the following head lice procedure in the school setting:

If a child is sent to the nurse by a teacher or parent with common symptoms of head lice:

Tickling feeling on the scalp or in the hair

Itching (caused by the bites of the louse)

Irritability and or difficulty sleeping (lice are more active in the dark)

Sores on the head caused by scratching

The nurse will assess the student for the possibility that there is a head lice infestation.  If, through assessment, it is determined that the child has an active case of lice, the child’s parent will be notified to initiate treatment.  Immediate exclusion from school is not necessary. The child most likely has had lice for several weeks and excluding them from school impacts their learning.  If the parent so chooses to pick up their child to initiate treatment upon notification, that is their choice.

If the student has no live lice but nits (lice eggs) are found, the school nurse will notify the parent for the parent to monitor closely for any lice infestation over the course of the next 2 weeks.  Exclusion from school is not necessary. A child should only be treated if live lice are found.

Teachers are asked to monitor their students for any of the listed signs and symptoms of lice and send any student to the nurse who displays constant and frequent head itching.  Mass head lice checks have not proven to be effective in decreasing the incidence of lice cases.

Classroom notification letters will be discontinued.  Communication between school personnel and parents/caregivers highlighting cases of head lice (e.g.”head lice outbreak letters”) has been shown to increase community anxiety, increase social stigma causing embarrassment of affected students and their families, and puts students’ confidentiality rights at risk.

The role of the school nurse is assessment and education of students, parents and teachers about the most current and effective treatments for head lice.  Parents will be given information about treatment in writing and verbally to assist in eliminating head lice from their household.

Please refer to the following documents if you have any further questions about head lice and their treatment.

Head Lice Management in the School Setting (Revised 2016)

Position Statement  By: NASN – National Association of School Nurses 3/3/17

Head Lice

An abstract published by the American Academy of Pediatrics Clinical Report and published in Pediatrics

May 2015, Volume 135/ issue 5