Head Lice

Facts About Head Lice for Parents/Guardians

Listed below are several facts about head lice that will help you understand what these insects are and how an infection may be spread. The facts may help you understand how to manage this problem at home.
 

1. Head lice are tiny wingless insects that live in human hair. They hatch from small eggs, called nits, which are attached to the base of individual hairs. The nits hatch in ten days and reach adulthood in about two weeks. As the louse feeds on its host, it injects saliva into the wound resulting in local irritation and itching.
2. In their early stages, lice are very difficult to see and blend into the hair. Often, their eggs (or “nits”) are easier to see and appear as small white specks on individual hair shafts. These specks can be confused with dandruff but they are more difficult to remove because they are attached to the hair with a strong glue-like substance.
3. Lice come from a family of parasites that must stay on their host to survive. If they are off the body from two to five days, they die.
4. Direct head-to-head contact is by far the most common means of transmission. They do not have wings nor the leg structures necessary for jumping. Head lice do have six short legs that enable them to crawl very quickly.
5. There is a small chance that inanimate objects (rugs, toy, stuffed animals, school buses, backpacks) may be the source of head lice transference. However, remember that a louse that is not attached to a person will die after 2-5 days.
6. Lice can be found on persons of any age, race, sex, or socioeconomic class. Lice do not discriminate and actually prefer clean hair to dirty hair because it’s easier for the egg to be cemented to the hair shaft.
7. Lice can infest people with any length of hair. Cutting or shaving the hair is not necessary. Shampooing the hair with medicated shampoo is necessary as well removing nits by thorough combing with a lice comb or manually removing them with your fingers.
8. Nits can remain attached to the hair shaft for months because they are secured with a waterproof, cement like substance. Treatment is warranted only when active lice or viable eggs are present. No one should be treated “just in case.”  This leads to resistance of head lice to chemicals in treatment.  Shampoos containing insecticides can be toxic if used improperly.

 
Treatment:

1. Should only take about 1 hour. Careful removal of as many nits as possible is very important. Daily combing is a critically important part of the process to prevent re-infestation if any remaining nits hatch.
2. Follow the directions on the label very carefully.
3. Retreat in exactly 10 days after the initial application.
4. If your child has a case of head lice, please follow the attached Guidelines for complete instructions on what to do at home and what you’ll need to do when your child returns to school.

 
Please feel free to contact your school nurse directly or Health Services @ 435-4145.
 

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Guidelines for the Treatment of Head Lice (English)

If your child was examined and found to have live lice:
Consult your physician for the appropriate medicated shampoo.

1. Read and follow the directions on the box very carefully.
2. Remove all clothing from the waist up.
3. Apply lice medicine according to the label instructions. If your child has very long hair, you may need to use a second bottle.
4. Comb hair thoroughly with a louse comb to remove all dead lice and eggs. Many flea combs made for cats and dogs are also effective. To make combing easier, it may be helpful to apply a crème rinse.
5. Have the child put on clean clothing after treatment.
6. Do not re-wash hair for 1-2 days after treatment.
7. If some live lice are still found 8-12 hours after treatment, but are moving more slowly than before, do not retreat. Comb dead and remaining lice out of the hair. The medication sometimes takes longer to kill the lice.
8. If no dead lice are found 8-12 hours after treatment and lice seem as active as before, the medicine may not be working. See your doctor for a different medication and follow their treatment instructions.
9. REPEAT TREATMENT WITH MEDICATED SHAMPOO EXACTLY 10 DAYS AFTER THE FIRST TREATMENT. This step is essential in preventing a reoccurrence of head lice.

DATE OF INITIAL TREATMENT_________ DATE OF TREATMENT AT DAY 10__________

10. Check the heads of others living in the home or close contacts using lice combs every 2-3 days.
11. Follow directions below regarding care of the home.

Return to School:

1. Accompany child to school following treatment for a follow-up examination prior to sending him/her back to class.
2. Bring the box that the medicine came in and give this to the nurse.

 
Care of the home:
Launder bedding and clothes that have been used by person with head lice during past 2 days in hot water. Use the hot water cycle to wash clothes. Dry in the dryer on hot setting for at least 20 minutes. Dry cleaning clothing and bedding is also effective. Ironing items is helpful.

1. Even though there is no scientific evidence that head lice is transferred in any way other than direct head-to-head contact, it is still advised some household items need to be attended to. Toys, personal articles, bedding, other fabrics, and upholstered furniture that cannot be laundered with hot water and a dryer or dry-cleaned, can be kept in a plastic bag for 14 days.
2. Soak combs and brushes in disinfectant solution (1/4 cup bleach to 1 gallon of water) for at least 10 minutes. Soaking in shampoo that kills lice or hot water for 5 minutes or soaking in a 2% Lysol solution for one hour also works.
3. Vacuum floors, carpets, mattresses, and furniture. Do not use fumigant sprays; they can be toxic if inhaled.
4. Have separate storage areas for each child’s clothing.
5. Encourage children not to share head gear, towels, and bedding.

 
If your child’s physician states that your child may not use additional medication:

1. A note from the physician must be sent to the school nurse.
2. Comb hair thoroughly with a louse comb. Most lice will be removed during this first combing.
3. Repeat combing every day. Each combing will remove a portion of the remaining lice and some that may have hatched in the meantime.
4. Continue daily combing until there has been two weeks without any live lice seen.
5. Removal of nits is a personal choice, as these are likely to be all dead or hatched.

 
Things to avoid:

1. Whole house clean-ups. Adult lice can’t live off a person’s head for more than a day or two.
2. Pesticide sprays. They are unnecessary and not worth even the small health risk.
3. Mayonnaise, margarine, petroleum jelly, olive oil, tea-tree oil. There is no evidence that this works.
4. Cutting your child’s hair or shaving their head. It’s needlessly upsetting to the child.
5. Gasoline or kerosene. These folk remedies kill or maim a few children each year when the volatile fumes accidentally ignite. These substances should NEVER be applied to the hair.

 
Managing Infectious Diseases in Child Care and Schools, American Academy of Pediatrics, 2005. Statewide School Health Services Website, CDC
 

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RECOMENDACIONES PARA EL TRATAMIENTO DE LA PEDICULOSIS

Si su hijo/a fue examinado/a y se le encontraron piojos vivos:
 

1. Consulte a su médico para saber cuál es el champú con medicamento adecuado.
2. Lea y siga las instrucciones que se encuentran en la caja con mucho cuidado.
3. Retire todas las prendas de la cintura para arriba.
4. Aplique el medicamento para piojos de acuerdo con las instrucciones de la etiqueta. Si su hijo/a tiene cabello muy largo, es posible que necesite usar otro envase.
5. Peine el cabello meticulosamente con un peine para piojos y retire todos los piojos muertos y los huevos. Muchos peines para pulgas diseñados para perros y gatos también dan resultado. Para que sea más fácil peinar a su hijo/a, tal vez sea útil aplicar crema de enjuague.
6. Haga que su hijo/a se ponga ropa limpia después del tratamiento.
7. No vuelva a lavar el cabello durante 1 o 2 días después del tratamiento.
8. Si aún se encuentran algunos piojos vivos entre 8 y 12 horas después del tratamiento, pero se mueven más lentamente que antes, no repita el tratamiento. Con el peine retire del cabello los piojos que estén muertos y que hayan quedado. A veces se necesita más tiempo para que el medicamento mate a los piojos.
9. Si no se encuentran piojos muertos entre las 8 y 12 horas posteriores al tratamiento y los piojos parecen estar tan activos como antes, es posible que el medicamento no esté funcionando. Consulte a su médico para obtener un medicamento diferente y siga las instrucciones para el tratamiento.
10. REPITA EL TRATAMIENTO CON UN CHAMPÚ CON MEDICAMENTO EXACTAMENTE 10 DÍAS DESPUÉS DEL PRIMER TRATAMIENTO. Este paso es esencial para prevenir la recurrencia de piojos.

FECHA DEL TRATAMIENTO INICIAL_________ FECHA DEL TRATAMIENTO EL DÍA 10_________

11. Revise las cabezas de otras personas que vivan en el hogar o que estén en contacto cercano utilizando peines para piojos cada 2 o 3 días.
12. Siga las instrucciones que figuran a continuación sobre el cuidado del hogar.

Regreso a la escuela

1. Acompañe a su hijo/a a la escuela después de realizado el tratamiento para que se le haga una revisión de seguimiento antes de enviarlo/a de nuevo a clases.
2. Lleve la caja donde venía el medicamento y entréguesela a la enfermera.

 
Cuidado del hogar:
 

1. Lave en agua caliente la ropa y ropa de cama que haya usado una persona con pediculosis durante los últimos 2 días. Utilice el ciclo de agua caliente para lavar la ropa. Seque la ropa en la secadora a temperatura alta durante por lo menos 20 minutos. Secar la ropa de limpieza y de cama también es eficaz. Es útil planchar las prendas.
2. Aunque no hay prueba científica que indique que los piojos se contagian de una manera que no sea el contacto directo de cabeza con cabeza, igualmente se recomienda que se preste atención a algunos artículos del hogar. Juguetes, artículos personales, ropa de cama, otras telas y muebles tapizados que no pueden lavarse con agua caliente y una secadora o limpiarse en seco pueden guardarse en una bolsa de plástico durante 14 días.
3. Remoje los peines y cepillos en solución desinfectante (1/4 de taza de blanqueador en 4 litros de agua) durante por lo menos 10 minutos. También sirve remojarlos en champú pediculicida o en agua caliente por 5 minutos o remojarlos en una solución de Lysol al 2 % durante una hora.
4. Aspire pisos, alfombras, colchones y muebles. No utilice fumigantes en rociador; pueden ser tóxicos en caso de inhalarlos.
5. Designe lugares de almacenamiento separados para la ropa de cada hijo.
6. Incentive a los niños a no prestarse gorras, toallas y ropa de cama.

 
Si el médico de su hijo/a le indica que su hijo/a no puede utilizar medicamentos adicionales:
 

1. Debe enviarse a la enfermera de la escuela una nota del médico.
2. Peine el cabello meticulosamente con un peine para piojos. La mayoría de los piojos se eliminarán al pasar el peine por primera vez.
3. Vuelva a pasar el peine todos los días. Cada vez que pase el peine se eliminará parte de los piojos restantes y es posible que en el ínterin, algunos se hayan incubado.
4. Pase el peine todos los días hasta que hayan pasado dos semanas sin que se vean piojos vivos.
5. Retirar las liendres es una decisión que usted puede tomar, ya que posiblemente todas estén muertas o incubadas.

 
Cosas que se deben evitar:
 

1. Limpiezas generales en el hogar. Los piojos adultos no pueden vivir fuera de la cabeza de una persona por más de uno o dos días.
2. Pesticidas en rociador. Son innecesarios y no vale la pena poner en riesgo la salud en absoluto.
3. Mayonesa, margarina, vaselina, aceite de oliva, aceite de árbol de té. No existe prueba alguna de que esto funcione.
4. Cortar el cabello de su hijo/a o raparle la cabeza. Es frustrante para el niño e innecesario.
5. Gasolina o kerosene. Estos remedios caseros matan o dejan lisiados a varios niños cada año cuando los gases inflamables ocasionan un incendio. Estas sustancias NUNCA deben aplicarse en el cabello.

 
Control de enfermedades infecciosas en el cuidado de niños y escuelas, Academia Estadounidense de Pediatría, 2005.
Sitio web de Servicios sanitarios escolares estatales (Statewide School Health Services)
CDC