Head lice have been a feared pest for years, with some schools temporarily closed due to lice outbreaks. But while many schools and day care facilities have a policy that someone with lice should not have lice eggs (called nits) in their hair before returning, the American Academy of Pediatrics says that’s overkill.
In newly published guidelines, the AAP says it’s actually fine to send children to school with lice. In the guidance, the AAP notes that head lice “are not a health hazard or a sign of poor hygiene.” However, the AAP says that sending a child with head lice into quarantine could cause “significant stigma and psychological stress.”
The AAP guidelines echo recommendations from the Centers for Disease Control and Prevention (CDC), which say students diagnosed with live head lice “do not need to be sent home early from school.” Instead, the CDC says, “they can go home at the end of the day, receive treatment, and return to the classroom after appropriate treatment is initiated.” Lice “may persist after treatment,” the CDC says, “but successful treatment should kill crawling lice.”
Given how many lice are commonly feared, it’s understandable to have questions. Here are some facts about lice that every parent should know.
Lice are spread through close contact
Head lice are about 2 to 3 millimeters long and usually infest the head or neck and attach their eggs to the base of the hair shaft, according to the CDC. They feed on the blood of their host and will die within a day or two without a blood meal, the CDC says. Lice crawl around, but cannot jump or fly.
The CDC notes that head lice are most often spread by close person-to-person contact. “It’s spread when a child has lice in their hair and they touch their head to another child,” Dr. Danelle Fisher, a pediatrician and chair of pediatrics at Providence Saint John Health Center in Santa Monica, California, tells Yahoo Life. “It’s not like lice are going to jump 50 feet across a classroom to land on another kid’s hair.”
There are certain signs of lice to look out for
Keep these lice symptoms on the back burner, according to the CDC:
Tickling sensation that something is moving in the hair
Itching, caused by an allergic reaction to louse bites
Irritability and difficulty sleeping (head lice are more active in the dark)
Head wounds caused by scratching
You can also spot lice and their nits. Nits look like tiny grains of rice that are attached to hairs near the base of the scalp. They can easily be mistaken for dandruff, scabies, or hairspray droplets, the CDC says. Live lice are about the size of a sesame seed, have six legs, and are brown to grayish, the CDC says.
There are treatments for lice
There are a few different options when it comes to treating lice. Topical treatments such as shampoos and lotions containing pyrethroids are usually considered first-line treatments for head lice, says the AAP.
“There are some non-drug ways that lice can be treated, but they don’t have FDA approval or clinical trials,” Margaret Quinn, a clinical associate professor at Rutgers School of Nursing, tells Yahoo Life. The AAP also emphasizes that they have not been approved or approved by the Food and Drug Administration (FDA) or the AAP for this use. These may include:
Essential oils such as tea tree oil, geranium oil and lavender oil
Melted butter or margarine
“These can coat and suffocate the lice, but they’re not considered as effective as pyrethroids,” says Fisher.
It’s also a good idea to do the following, according to the CDC:
Wash and dry items used by the infected person up to two days before treatment, such as hats, scarves, pillowcases, bedding, clothing, and towels.
Items that cannot be washed can be dry cleaned or sealed in a plastic bag for two weeks.
Vacuum furniture and floors that may contain infested hair (which could have nits attached).
It may take some time to completely get rid of lice
Getting rid of lice can be a tedious process. A pyrethroid treatment must be reapplied in nine or 10 days to be effective, the CDC says. You’ll also need to use a special hair comb and really try to pick out the nits you spot, Fisher says. “That’s the key,” he says. (Otherwise, the nits may hatch and cause problems again).
Dr. Jennifer Haile, a pediatrician at Connecticut Children’s, tells Yahoo Life that it’s important to make sure you see everyone in the house as a potential target for lice. “The biggest thing is, if you have close household contacts, make sure you treat those household contacts and treat the home appropriately,” he says. “Anything you can’t wash or vacuum should be in a sealed plastic bag for two weeks. You don’t want to reinfect anyone.”
Dr. Fred Archer, clinical assistant professor of pediatrics at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo and with UBMD Pediatrics, tells Yahoo Life that this whole process can take a while. “Barring reinfection, it can take anywhere from 14 to 21 days to completely clear an infection,” he says. “Most active lice and nits are removed in the first round of topical treatments, although 20% to 30% may survive the initial treatment.”
Anyone can get lice
According to CDC data, an estimated 6 to 12 million head lice infestations occur each year in the U.S. among children ages 3 to 11. It’s more common in preschoolers who attend child care, elementary school-aged children and household members of infected children, the CDC says.
“It’s more common in younger kids because they’re more likely to be all over each other,” says Fisher. However, “anyone can get lice,” Quinn says, noting that “lice affect all homes, all demographics, and all people.”
If lice enter your home, you need to be careful. “Living with a child—or adult—with head lice creates a lot of these opportunities for lice to spread from person to person,” Dr. Gary Reschak, a pediatrician at Northwestern Medicine McHenry Hospital, tells Yahoo Life.
If your child develops lice, Fisher says it’s important to watch yourself for symptoms. “If your child has been near you, laid on your pillow or used your hairbrush, it’s wise to do the same treatment and wash your bedding and clothes in hot water,” she says.
Haile adds: “If you don’t stop it, it just doesn’t leave the house. It can be really frustrating.”
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