National Association of School Nurses - Head Lice 101

Head Lice 101 What You Should Know
About Head Lice

Overview

Head lice are a common community problem. An estimated 6 to 12 million
infestations occur each year in the United States, most commonly among children
ages 3 to 11 years old. 1 Though a head lice infestation is often spotted in school,
it is usually acquired through direct head-to-head contact elsewhere, such as at
sleepovers or camp. 2

Head lice are not dangerous, and they do not transmit disease. 1 Additionally,
despite what you might have heard, head lice often infest people with good
hygiene and grooming habits. 3/4 Your family, friends, or community may
experience head lice. It's important to know some basics, including how to
recognize symptoms and what to do if faced with an infestation.

What are head lice?

Head lice are tiny, wingless insects that live close to the human scalp. They feed
on human blood.1  When checking for head lice, you may see several forms: the
nit, the nymph, and the adult louse.

Nits are tiny, teardrop shaped lice eggs that are often yellowish or white. Nits are also what you

call the shells that are left behind once the eggs hatch. Nits are attached to the hair shaft and

often found around the nape of the neck or the ears. Nits can look similar to dandruff, but cannot

be easily removed or brushed off.1

Nymphs, or baby lice, are small and grow to adult size in 1 to 2 weeks.1

Adult lice are the size of a sesame seed and appear tan to grayish-white.1

How are head lice spread?

• Head lice move by crawling and cannot jump or fly 1

• Head lice are mostly spread by direct head-to head contact-for example, during play at home
or school, sleepovers, sports activities, or camp 1

• It is possible, but not common, to spread head lice by contact with items that have been in
contact with a person with head lice, such as clothing (for example, hats, scarves, or coats) or
other personal items (such as combs, brushes, or towels) 1

• Head lice transmission can occur at home, in the community, or-very infrequently-in school. 2

What are the signs and symptoms of infestation?

Signs and symptoms of infestation include1 :

• Tickling feeling on the scalp or in the hair

• Itching (caused by the bites of the louse)

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

• Sores on the head (caused by scratching, which can sometimes become infected)

Finding a live nymph or adult louse on the scalp or in the hair is an indication of an active
infestation. They are most commonly found behind the ears and near the neckline at the back
of the head.1

Head Lice 101 What You Should Know
About Head Lice

Lice Lessons

What if my child gets head lice?

If you suspect your child might have head lice, it's important to talk to a school
nurse, pediatrician, or family physician to get appropriate care. There are a
number of available treatments, including new prescription treatment options that
are safe and do not require nit combing. Other things to consider in selecting and
starting treatment include:

• Follow treatment instructions. Using extra amounts or multiple applications of the same
medication is not recommended, unless directed by a healthcare professionals 5

• A 2016 study showed that 48 states now have lice that are genetically predisposed to
resistance to commonly used treatment.s 6

• There is no scientific evidence that home remedies are effective treatments. 7

• Head lice do not infest the house. However, family bed linens and recently used clothes, hats,
and towels should be washed in very hot water and dried on the high settings. 5

• Personal articles, such as combs, brushes, and hair clips, should be soaked in very hot water
for 5 to 10 minutes if they were exposed to someone with an active head lice infestations. 5

• All household members and other close contacts should be checked, and those with evidence
of an active infestation should also be treated at the same times. 5

Myths and facts about head lice

Myth: Only dirty people get head lice.

Fact: Personal hygiene and household or school cleanliness are not factors for infestation. In
fact, head lice often infest people with good hygiene and grooming habits. 3/4

Myth: Head lice carry diseases.

Fact: Head lice do not spread diseases.1

Myth: Head lice can be spread by sharing hair brushes, hats, clothes, and
other personal items.

Fact: It is uncommon to spread head lice by contact with clothing or other personal items, such
as combs, brushes, or hair accessories, that have been in contact with a person with head lice.1

Myth: Head lice can jump or fly, and can live anywhere.

Fact: Head lice cannot jump or fly, and only move by crawling. It is unlikely to find
head lice living on objects like helmets or hats because they have feet that are
specifically designed to grasp on to the hair shaft of humans. Additionally, a louse
can only live for about a day off the head.1

Myth: You can use home remedies like brushes, hats, clothes, and other
personal items. mayonnaise to get rid of head lice.

Fact: It is uncommon to spread head lice by contact Fact: There is no scientific
evidence that home with clothing or other personal items, such as combs,
remedies are effective treatments.7  Consult your healthcare provider to discuss
appropriate treatment options, including prescription products.

References

1. Centers for Disease Control and Prevention. Frequently asked questions (FAQs), http://www.cdc.gov/parasiles/lice/head/gen_
info/lags html. Accessed April 20, 2017

2. Pontius DJ Demystifying pediculosis: school nurses taking the lead Pediatr Nurs. 2014.40(5):226-235

3. Meinking T, Taplin D. Vicaria M. Iniestations. In: Schachner LA, Hansen RC, eds. Pediatric Dermatology, 4th ed. Mosby
Elsevier; 2011:1535-1583

4. Centers for Disease Control and Prevention Epidemiology & risk factors http://www.cdc.gov/ parasites/lice/head/epi.html.
Accessed April 20, 2017.

5. Centers for Disease Control and Prevention Treatment http://www.cdc gov/parasites/lice/head/treatment html Accessed April
20, 2017.

6. Gellatly KJ, Krim S, Palenchar DJ, et al Expansion of the knockdown resistance frequency map for human head lice
(phthiraptera: pediculidae) in the United States using quantitative sequencing J Med Entomol 2016 1-7.

7. Centers for Disease Control and Prevention (CDC) Treatment frequently asked questions http://www.cdc.gov/parasites/lice/
head/gen_info/tags_treat html Accessed April 20. 2017,

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