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Head Lice

Pediculosis, or head lice, is a common problem for children and their families. The head louse is a wingless insect that lives on the human scalp and lays eggs (nits) in the hair. It cannot hop or fly, but crawls rapidly. Because the head louse is very difficult to see, it is usually diagnosed by the presence of nits. It is transmitted by personal physical contact or common use of combs, brushes or headgear.
Although more of a nuisance than a threat to health, pediculosis can create concern and anxiety for school personnel, parents and students. Most commonly, it is young children between the ages of 3 to 12 years that are affected, but pediculosis can occur at any age. Outbreaks of pediculosis among students cause classroom distraction and unnecessary absence from class. Education regarding prevention and treatment is crucial for parents, teachers and students. Adequate screening for pediculosis by parents and school personnel is also a necessary part of controlling head lice in schools.

Section 1 Prevention and Education

The school nurse will provide training for elementary teachers and other appropriate school personnel regarding classroom prevention and control techniques, screening and treatment at the beginning of each school year or as needed throughout the school year. This training will include:

  • Identification of head lice and nits
  • Classroom prevention techniques
  • Environmental safeguards
  • Education of students about prevention
  • Confidentiality and privacy of affected students
  • Treatment options
  • Precautions and myths regarding treatment
  • Resources for treatment
  • Exclusion and readmission of students

Section 2 Screening

The school nurse in each elementary school, as well as secondary schools as needed, will provide educational information about pediculosis, its detection and treatment to parents at the beginning of each school year. The nurse will also notify parents regarding the need to regularly screen their child for the presence of head lice (sample letter attached). Parents will be requested to notify the school at any time they detect evidence of head lice. The school personnel that receives notification of infestation will determine if the student has been treated and will refer the information to the school nurse for follow-up with the parent, if necessary.

Once notified by parents that a student has pediculosis, the teacher will be notified. All classmates and close associates such as playmates or carpool contacts will be checked immediately by the school nurse or other trained school personnel. Students will be screened in a private location. Extreme care and attention will be given to avoid embarrassment to any student. Confidentiality of all students identified with pediculosis is of major importance.

If other students are identified to have evidence of head lice, the parent will be notified immediately to pick the child up from school. When the parent arrives, the school nurse or other knowledgeable school personnel will confirm with the parent the presence of infestation and will discuss treatment of the child and the environment. Information regarding treatment will be provided in writing to parents as well. School personnel will assure privacy for this discussion, giving care to continue to maintain confidentiality.

If a teacher or other school personnel suspects that a student has head lice, the student should be sent to the health room for a private examination by the school nurse or other trained personnel. A parent will be notified if the student is determined to have evidence of pediculosis.

Routine screenings at school do not have a significant effect on the incidence of head lice and are not recommended by the medical community.

Section 3 Exclusion and Readmittance

Students with untreated pediculosis are to be excluded from school and all school activities. The student must have been treated with a recommended pediculocide before being readmitted to school. The student and a parent should report to the school nurse or other designated school personnel when returning to school after treatment is complete. Should the student still have remaining nits after appropriate lice treatment, the student may return to class. However, parents should be advised to closely follow the label directions on the pediculocide; many products require a second treatment to prevent re infestation. School personnel should encourage the parent's diligence regarding home cleanup as well. The nurse should recheck the student in one week/seven days to monitor the potential for reinfestation. 

Legal Ref: Recommended guidelines for the control of pediculosis in schools. (1997). Alabama State Department of Education, Alabama Department of Public Health; Clinical Report: head lice (September 2002).  American Academy of Pediatrics; Head lice: Information and frequently asked questions.  (November 2002). Harvard School of Public Health, Harvard University