Head lice are a school nurse’s worst nightmare. They are usually more common in the elementary grades when children love to share everything including lice. I know when a teacher would call me and say so in so is itching their head like crazy I would think maybe a sick day is in order. Despite this sudden urge to flee, I instead, as most school nurses would do, hurried to the room with all my lice checking equipment. I would explain to the children that I was going to do a head check. So with my trusty lice checking sticks (look like long Q-tips with out the cotton swab on the end) I would begin the tedious chore of checking all the children’s heads. Inevitably I would find nits in a couple of the student’s hair and most likely one or two live lice which I would try to catch latter in my office so as to add to my collection. I would keep track of the students that I wanted to follow up on and try to discreetly call them to my office for further investigation. I would call the parents to see if they were aware or had been treated for lice. I would tell them there was nothing wrong with them except that a little pest was living in their hair sort of like fleas on a dog or cat. This usually relieved their fears and anxiety. Head lice are a nuisance but not dangerous.

Symptoms:

Itching or a feeling of something crawling on their head.
Small red bumps (like flea bites) or sores. These areas can also become infected
If infection occurs lymph glands may become enlarged.

Prevention:

Advise your children not to share combs, hats, headbands, etc. Avoid head to head contact. If someone in class is known to have a case of head lice avoid sleepovers for a while.

Treatment:

Doctor recommended medicated shampoos usually work well if used correctly (read instructions thoroughly). Remember that there are pesticides in the shampoo so misuse or overuse can cause harm. If infection occurs antibiotics may be prescribed. Use the lice comb after regular shampooing every three to four days for two weeks. Wash all bedclothes in very hot water and put on hot cycle in dryer for twenty minutes. Do not use pesticide sprays on furniture and rugs just vacuum well. Wash hats, headgear, coats with hoods, combs, brushes, etc. in disinfectant solution such as alcohol, then rinse thoroughly. Dry hats, headbands, etc. in hot dryer. I also recommend trying to pull out as many nits as you can. They are tiny tannish-brown dots before they hatch. After they hatch the casing is white. Lice lay their eggs on the hair shaft close to the scalp. You cannot shake them off like dandruff but have to scrape them off the hair shaft.

Comments:

I know how frustrating head lice can be from a parent’s point of view as well as a school nurse’s. When we lived in Washington D.C. my two oldest boys were ages three and four. They slept over a friend’s house and came back with some extra visitors. It took almost two months and a lot of pulling out of nits and washing of clothes to get rid of those pesky little creatures. I also have done head checks on thousands of student when I worked elementary (over an eight year period). I have had parents calling irate that their child picked up lice at school (like we were giving out free samples), I have gone to people’s homes to pull out nits and show parents how to do the same. I have seen children humiliated after frustrated parents shaved off all their hair (girls included). I only have empathy for parents and school nurse that have to struggle through a siege of head lice.