Head lice are a common problem for children in child care settings and schools. Anyone can get head lice— they are not a sign of being dirty. Head lice are very small, tan-colored insects approximately the size of a sesame seed) that live on human heads. They lay their eggs (nits) on the hair. The eggs are tiny (about the size of the eye of a small needle) and gray or white in color. 

Symptoms

Itching of the scalp or neck. Look for: 

1. Crawling lice in the hair, usually few in number 

2. Eggs (nits) glued to the hair, often found behind the ears and at the base of the neck 

3. Scratch marks on the scalp or back of the neck at hairline

Exclusion
Child Care and School: None, but treatment is recommended before returning to school. “No nit” policies and exclusion from school or childcare of students with active head lice infestations is not recommended. A child with an active infestation has likely already had an infestation for over one month. The risk of further transmission is low. Children with active head lice infestations should be encouraged to avoid head-to-head contact with other children. Until the first treatment is completed and there are no live lice. Follow center’s/school’s nit policy. 

Prevention/Control

1. Avoid sharing hair care items, towels, bedding, clothing, hats, and headgear, such as headsets and sports helmets.

2. Hang clothing in individual lockers or on assigned coat hooks and spaced so they do not touch.

3. Hats should be tucked into sleeves. 

4. All contaminated combs, brushes, and similar items must be sanitized by one of the following:

a. Soaking in the medicated shampoo for 10 minutes 

b. Soaking in a 2 percent Lysol* solution for one hour 

c. Soaking in hot water for 10 minutes 

5. Clean floors, furniture, mattresses, and carpeting by thorough vacuuming. Be sure to dispose of vacuum contents after cleaning, sealing the waste bag off, and removing it from the setting. The use of insecticide spray is not recommended. 

6. Machine wash and dry clothing, bed linens, and other items that an infested person wore or used during the two days before treatment using the hot water (130°F) laundry cycle and the high heat drying cycle. Clothing and items that are not washable can be dry-cleaned or sealed in a plastic bag and stored for two or more days. 

7. Check your child’s head frequently throughout the year. If one person in a family, child care, school, etc., has head lice, others should be checked, too. Only those who have head lice should be treated. Pretreatment will not prevent a child from getting lice.

Treatment

1. Use a lice-killing shampoo, lotion, or cream rinse obtained either over the counter at the drugstore or by prescription from your healthcare provider. 

2. Follow the product’s approved directions only as some treatments are toxic. Directions will vary, depending on the product used. If additional treatments are necessary, after following product directions, contact your healthcare provider. Do not exceed recommended product directions. 

3. The nits are glued onto the hair shafts as they are laid, and they are difficult to remove. Although it can take time and sometimes be difficult, remove all nits to ensure complete treatment. 

Consult your pharmacist or health care provider before applying or using lice treatment pesticides when the person involved is pregnant, nursing, has allergies, asthma, epilepsy, pre-existing medical conditions, or has lice or nits in the eyebrows or eyelashes. Never use a pesticide near the eyes. 

Prior to treating a child 2 years or younger, consult a healthcare provider. 

* Lysol is a brand name. The Northern Kentucky Health Department does not endorse specific brand names. 

Is it Reportable?

Parents/guardians: Inform your school/child care provider if your child has this illness.