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Taking a rational approach to head lice

Young students close together indoors invariably leads to colds, the flu and sometimes…head lice.

“At some point every year, the school nurse informs us that she has discovered a child with head lice,” said Barringer Road Elementary Principal Jeremy Rich.

With that discovery, he said Central Valley schools and their nurses immediately follow the district’s established protocol as outlined on the district website. If a child has live lice or nits, they are sent home and may not return unless the nurse determines he or she is nit-free.

“We notify the child’s parents or guardians and our nurse checks the rest of a class to make certain the lice have not spread to other children. If the child has siblings in other Central Valley buildings, we notify those schools, so staff can follow up,” said Mr. Rich.

School nurses provide families with information to help identify and treat the problem. It is then the parents’ responsibility to treat the child. School nurses check any child upon his or her return to school.

“Our goal is to identify and treat the problem while respecting the privacy of the child and the family. For that reason, we do not sound the alarm when we find signs of head lice,” said Mr. Rich.

Changing protocol in the future?

Graph depicting the unrealistic fear of head lice compared to the actual risk

This chart from Harvard University attempts to put the fear of head lice into perspective.

The district’s protocol aligns with current recommendations of state and federal health agencies, but even those standards are changing.

The medical community is reexamining the head lice discussion, trying to put in into perspective. The current thinking is that society’s fear of head lice is disproportionate to the risks. According to Harvard University, people’s fears have created school policies that are inconsistent with scientific fact.

As of September 2015, the Center for Disease Control and Prevention (CDC) no longer recommends sending children with nits home. According to the CDC website:

Both the American Academy of Pediatrics (AAP) and the National Association of School Nurses (NASN) advocate that “no-nit” policies should be discontinued. “No-nit” policies that require a child to be free of nits before they can return to schools should be discontinued for the following reasons:

  • Many nits are more than ¼ inch from the scalp. Such nits are usually not viable and very unlikely to hatch to become crawling lice, or may in fact be empty shells, also known as ‘casings’.
  • Nits are cemented to hair shafts and are very unlikely to be transferred successfully to other people.
  • The burden of unnecessary absenteeism to the students, families and communities far outweighs the risks associated with head lice.
  • Misdiagnosis of nits is very common during nit checks conducted by nonmedical personnel.

“Our goal is to educate our Thunder. Needlessly excluding students from class or creating panic helps no one. The same way we do not notify the entire community when a child has a cold, we don’t do either in the case of head lice,” said Mr. Rich.

Prevention is key

The easiest way to control head lice is to avoid getting them in the first place. Steps parents can take include:

  • Routinely checking their children’s hair around the neckline and ears for:
    • Live lice are small, brown, fast-crawling insects roughly the size of a sesame seed, see image;
    • Nits are egg cases that firmly attach to hair, unlike dandruff that is easily brushed away, see image; and
    • Red patches or irritation from lice, see image;
  • Reminding children to not use another child’s hairbrush or comb;
  • Reminding children to not wear another child’s coat, hat, scarf, hair accessory or headphones;
  • Reminding children to not place personal items in a shared space (i.e. coats on the same hook);
  • Pulling back long hair to minimize head-to-head contact; and
  • Using a lice-repelling shampoo. Note: According to the Mayo Clinic, “A number of small studies have shown that ingredients in some of these products—mostly plant oils such as coconut, olive, rosemary and tea tree—may work to repel lice. However, these products are classified as “natural” so they aren’t regulated by the Food and Drug Administration (FDA), and their safety and effectiveness haven’t been tested to FDA standards.”

Other resources: