Health: With schools back in session, head lice are not far behind

By Debbie Bell/Health Department, Published:

Although National Head Lice Prevention Month is normally observed in September, I can’t think of a more timely topic as our children return to their normal routines which include spending lots of time together at school, during intramural activities and the occasional slumber party/sleepover.  

The head louse, or Pediculus humanus capitis, is a parasitic insect that can be found on the head, eyebrows, and eyelashes of people. Head lice feed on human blood several times a day and prefer to live close to the human scalp.  Head lice have three forms: the egg (also called a nit), the nymph, and the adult.  The chart  on C3 illustrates the life cycle of head lice.

In the United States, head lice are most commonly found among pre-school children attending
childcare, elementary schoolchildren and their household members. The Centers for Disease Control and Prevention estimate 6-12 million infestations occur each year among children ages 3-11.

Infestation with head lice is much less common among African-Americans than those of other races.

Many believe that head lice can spread very easily from person to person; however, research shows that lice are much harder to get than a cold, the flu, pink eye and strep throat from another person in close quarters. Lice are typically spread through head-to-head contact with an infested person while sharing a bed, pillow or playing together in close proximity.

They cannot hop or fly, but move by crawling. Anyone who comes in head-to-head contact with someone who already has head lice is at greatest risk. The CDC further says that the spread of lice by contact with clothing (such as hats, scarves or coats) or other personal items (such as combs, brushes or towels) used by an infested person is uncommon.

In addition, personal hygiene or cleanliness in the home or school has nothing to do with getting head lice.

Signs and symptoms

The CDC shares these possible signs and symptoms of a head lice infestation which include: a tickling feeling of something moving in the hair; itching, caused by an allergic reaction to the bites of the head louse; irritability and difficulty sleeping as head lice are most active in the dark; sores on the head caused by scratching.

The diagnosis of a head lice infestation is best made by finding a live nymph or adult louse on the scalp or in the hair of a person. If crawling lice are not seen, finding nits firmly attached within a ¼-inch of the base of the hair shafts strongly suggests, but does not confirm, that a person is infested and should be treated. Nits are often confused with other things found in the hair such as dandruff, hair spray droplets, and dirt particles.

Treatment for head lice is recommended for persons diagnosed with an active infestation. All household members and other close contacts should be checked; those persons with evidence of an active infestation should be treated too.

A common treatment may include: 

>Applying lice medicine, also called pediculicide, according to the instructions contained in the box or printed on the label.  Pay special attention to instructions regarding how long the medication should be left on the hair and how it should be washed out.  

>Nit combs, often found in lice medicine packages, should be used to comb nits and lice from the hair shaft. 

>After each treatment, checking the hair and combing with a nit comb to remove nits and lice every 2–3 days may decrease the chance of self–reinfestation. Continue to check for 2–3 weeks to be sure all lice and nits are gone.

>Retreatment is meant to kill any surviving hatched lice before they produce new eggs. For some drugs, retreatment is recommended routinely about a week after the first treatment (7–9 days, depending on the drug) and for others only if crawling lice are seen during this period. 

Remember, any person with hair on their head can “catch” head lice by direct head-to-head contact with another person who already has head lice.  Preventing head lice is best accomplished simply by properly treating those who already have head lice.

For more information regarding the prevention and treatment of head lice, visit

Debbie Bell is a Registered Dietitian and Certified Diabetes Educator in the Community Health Education Department at the Franklin County Health Department, 100 Glenns Creek Rd.


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