Head Lice

Head lice are usually a source of inconvenience and frustration, rather than a serious public health threat.

Facts

  • Head lice are tiny insects that live on the human scalp where they feed and breed.
  • Female lice lay eggs (or 'nits') which look like small, whitish specks about the size of a pinhead and are glued to the hair close to the scalp.
  • Nits hatch within six days and mature into adult lice in about ten days.
  • Lice live for about a month but cannot survive for more than two days away from the human head.
  • Head lice do not carry or transmit disease.  However, they are the most common cause of head itch and scratching which may lead to infection of the scalp and even swollen lymph glands.
  • Anyone can catch head lice. Head lice happen where people live, learn, work or play together.
  • Head lice cannot jump, fly or hop, so the only way they can be passed from one person to another is either via direct head-to-head contact or through indirect contamination such as the sharing of towels, hats, combs, brushes, hair accessories, etc.

Identification

  • Many head lice infections cause no symptoms and probably less than half cause itching.  Inspection of the child's hair is the only way to find out if head lice are apparent.
  • Eggs are fairly easy to see by using a strong light and looking on the hair shafts. They may be seen as small, whitish flecks securely attached to the base of the hairs, especially behind the ears and on the forehead.  Unlike dandruff they cannot be brushed off.  Newly-hatched eggs are usually within 1.5cm of the scalp while older eggs are higher up the hair shafts.
  • To find live lice, dampen the hair, apply conditioner and comb the hair with a fine-toothed comb. Wipe the conditioner from the comb on to a tissue and look for lice. Also, examine the comb for lice and eggs. If you find lice, the child should be treated.
  • Other signs are finding dry black powder, grey casts or skins on the pillow in the morning or an itchy scalp causing the child to scratch.

Treatment

  • Effective treatment involves the use of an approved chemical. There are four classes of chemical treatments: Pyrethrins, Synthetic Pyrethroids, Maldison and Herbal.
  • Within each class of treatment there are a number of different brands. These products are available from pharmacies without prescription.  In Australia, there is a problem with lice showing resistance to some of these products. It is necessary to test for resistance and then to treat with a different class of chemical if resistance is identified.
  • Preventative approaches just build up resistance in the lice to treatment.  Treatment is therefore only required if the infection has been identified. 
  • Consult a medical practitioner or pharmacist about safe head lice treatments to use if pregnant, or have sensitive skin, or for children less than 12 months of age.
  • Keep head lice treatments out of the reach of children as the treatments are toxic, but safe if used according to manufacturers' instructions.  Don't allow head lice treatment to get into the eyes and don't use a hairdryer following application of the treatment as heat may inactivate the product.
  • The itch may not go immediately. Persistent itch is not a reason for repeating the treatment.
  • Hair does not have to be cut short if the head lice treatment has been properly and thoroughly applied.
  • Any lice on combs, bedding or hair accessories should be dead or damaged.  However, you may wish to soak combs and brushes in hot water and detergent for ten minutes.  Wash bed linen and towels using the hot cycle in the washing machine.

How to Prevent Reinfestation

  • Being aware of how the lice are spread can help to prevent reinfestation.  Commercial head lice medications must be applied to all parts of the hair.  A complete regime consists of two treatments, seven days apart; the first to kill the currently active lice and the second to kill the juvenile lice that have hatched from the eggs over the intervening six days.
  • Washing contaminated clothing or other objects infested by head lice, in detergent and water, is an effective way of breaking the infestation cycle.  To protect against reinfestation it is important that all children are treated if necessary, and that they do not share objects which may be contaminated by head lice.  If one family member has head lice, all family members need to be treated.
  • Schools are not always the source of outbreaks.  Students can be infested during social and sporting activities.  Good hair care is the best way to discourage head lice. Daily brushing and combing should damage any lice, and make it less likely that nits will hatch and live. Regular hair washing cannot prevent or cure head lice.

Procedures

When a member of staff suspects a child is infested with head lice (i.e. when live lice or eggs within 1.5 cm of the scalp are found), the following procedures should be followed:

  • The child should be restricted from activities involving close contact with other children.
  • The Principal must be notified, and the parents contacted immediately and requested to collect the child from school as soon as possible and commence immediate treatment.
  • The Principal must ensure that parents are familiar with established head lice treatment.  If not, a copy of this policy must be given out.
  • The following day, a child may not return to the school unless the parent sends in a signed statement verifying that treatment commenced at least the previous day.  This is because the ACT Public Health (Infectious and Notifiable Diseases) Regulations require students with head lice to be excluded as soon as possible from school until the day after treatment has commenced.
  • Parents of other children in the class will be notified that infestation is suspected, asking them to check their children for head lice.
    If eggs are found more than 1.5cm from the scalp, the child need not be sent home but the parents should be notified.
“It is through Grace that we are saved! (Acts 15:11)”