It’s one of the great humiliations of a child’s school experience: getting sent home because the teacher or school nurse believes he is infested with head lice. It’s also mortifying for parents, who may feel their housekeeping or grooming practices are under the microscope along with locks of their child’s hair.
No one needs to be embarrassed about lice, says Richard Pollack, a research associate at the Harvard School of Public Health who has extensively studied lice infestations around the world. “Head lice have nothing to do with hygiene or housekeeping,” Pollack says. “Nor are head lice as prevalent or as contagious as we’ve been led to believe.”
Symptoms of Lice
Children with active lice infestations may have the following symptoms:
- Scratching their scalp due to intense itching
- Reporting a ticklish feeling near the scalp
- Having sores on the scalp caused by scratching
- Having swollen lymph nodes in the front and back of the neck
- Not all children with active infestations have these symptoms, however.
“No Nits” Policies
Schools commonly have policies that require students with lice or their eggs, tiny specks known as nits, to stay home until they are lice- and nit-free. Proponents of no-nit policies say strict enforcement is necessary to stop the spread of head lice. Pollack believes such policies are misguided. He cites the Centers for Disease Control and Prevention, which advises that children should not be kept out of school because of suspected head lice and children with confirmed infestations should be allowed to return as soon as treatment begins.
If your child shows symptoms of lice, or if other cases have been reported in the school, he may be inspected for lice at school; however, Pollack says, many parent volunteers, teachers, and even school nurses don’t know exactly what to look for and tend to misdiagnose. Many samples of supposed lice and nits that Pollack has reviewed over the years have turned out to contain other bugs, dirt, and sand.
Schools sometimes send kids with suspected lice home in the middle the school day. There’s no need to send kids home, Pollack says. “If the child has a live infestation, she has probably had it for a month, so a few more hours at school won’t hurt.” He recommends that school officials keep kids in class, then talk with parents about the situation at the end of the school day.
If You Think Your Child Has Lice
If it’s suspected that your child has lice, first reassure her that she has done nothing wrong. Then look for live bugs in your child’s hair. If you find a bug or what looks like an egg, compare it with photos on the Internet to determine whether it is a louse. If you aren’t sure, seek advice from a pediatrician or nurse. You can even send the bug or egg, taped to an index card, to Pollack and he’ll tell you what it is, though he notes that he doesn’t always have time to reply promptly.
If you see live bugs, try to remove them with a fine-tooth comb. If this crosses your personal parental gross-out line, remind yourself and your child that lice are generally harmless and no big deal. Pollack recommends focusing your efforts on live bugs, not objects that might be eggs. Removal of such specks can be time-consuming and unnecessary, he says. “Sit behind the child and use a suitably bright light to inspect and comb through the hair one section at a time,” Pollack says. “Repeat until no live lice are observed.”
If this proves ineffective, consider using an over-the-counter insecticide containing permethrin or pyrethrins and specifically labeled for use on people. Read the label and follow instructions carefully. Insecticides should be considered a serious step only for children with live infestations, Pollack says.
Check your child’s head the next morning and see whether you can spot any more live bugs. Even if the treatment appears successful, you will probably need to treat again in 10 days to kill any bugs that hatch from surviving eggs.
Some lice are resistant to over-the-counter treatments. If you still see live bugs on your child’s head after using a treatment, seek help from your pediatrician. Your child’s doctor might prescribe a prescription remedy. Use with extreme caution and follow directions carefully.
Avoid essential oils, which some parents claim suffocates the bugs. In concentrated doses, these oils may not be safe. Home remedies such as olive oil, shortening, mayonnaise, and butter are probably harmless, but there are no conclusive studies on the effectiveness of these methods, Pollack says.
Do not, under any circumstances, use gasoline or kerosene on your child’s head. Such products are flammable and could cause a serious accident.
Other home remedies to avoid: bleach, hair dye, and intense heat, such as a hair dryer on a high setting.
Do not feel compelled to clean your whole house and wash everything in hot water. Head lice cannot survive for long without a host. Instead, focus on cleaning your child’s bedding, night clothes, and towels as well as your car seat covers.
Don’t get obsessed with finding out who gave your child head lice. Kids get head lice from other kids, which is why more social children seem to be more vulnerable. Sharing helmets, hairbrushes, and other items poses very little risk, Pollack says.
Throughout the process of dealing with a head lice infestation, give your child extra hugs. After 4th grade, infestations are rare, so consider it a parenting challenge that will pass in time. Most children are unbothered by head lice, Pollack says; it’s the embarrassment of being singled out at school that hurts.
If your child’s teacher or school nurse insists that your child stay home because of nits, refer her to Pollack’s webpage on head lice information and frequently asked questions as well as the CDC page on head lice in schools.