Head Lice

  • LICE 



    Head lice are a common problem in school age children.  While head lice is a nuisance, it does not pose a significant health hazard and is not known to spread disease.  Head lice can be acquired anywhere.  Once discovered, the infestation usually has been present for weeks or months.   


    One of the most challenging aspects of head lice is the reaction of others in the community, family, and school personnel.  Commonly those reactions are fear, anger, frustration, and blaming of others.   This overreaction can lead to teasing or alienation of the child and inappropriate management of the head lice both of which could be potentially harmful.   


    The Centers for Disease Control, the American Academy of Pediatrics, and the National Association of School Nurses all recommend that students not be excluded from school for having nits or live lice and that the management of head lice should not disrupt a student’s educational process.  The AAP further recommends that since a child with an active head lice infestation has likely had the infestation for a month or more by the time it is discovered, poses little risk to others, and does not have a resulting health problem.  The student should remain in class with a few exceptions at the nurse's discretion.  All students should be discouraged from close or direct head to head contact (games, whispering, sleeping, etc).  If a child is assessed as having head lice, confidentiality must be maintained so the child is not embarrassed.  The child’s parent or guardian should be notified that day and educated on the prompt, proper treatment of head lice.   

    What are Head Lice?

    • Head lice are tiny gray to brown insects about the size of a sesame seed that live in human hair and must feed on human blood to live.
    • They lay tiny white oval-shaped eggs about the size of a knot in a thread.  Lice glue their eggs to each strand of hair close to the scalp. A nit is an empty egg casing after the louse has hatched or died.  Although it is hard to see head lice, a person can see the eggs if they look closely.
    • Lice eggs and live lice are most often found in the hair behind the ears and at the back of the head and neck. The first sign of lice is itching of the head which is caused by the bite of the head lice.

    How do You Get Head Lice?

    • Head lice happens mostly with elementary school-aged children.
    • Children get lice from other children through head to head contact during play or sports or nap time.
    • Sometimes sharing combs, hats or school lockers with a louse infested child can spread head lice.
    • You can’t spread the eggs…only live lice.
    • Head lice do not spread disease - they are not a public health threat and therefore lice cases are not tracked by the Department of State Health Services. 
    • Any child can get head lice. It doesn’t matter where they live or go to school, boy or girl, black, white or brown. It doesn’t mean the child is sick or unclean. It certainly doesn’t mean they have bad parents.
    • Children get head lice almost as much as the common cold. Millions get it at least once a year.

    How Do You Get Rid of Head Lice?
    The Texas Department of State Health Services recommends the following treatment for head lice and their eggs:

    1. Use an over-the-counter FDA-approved shampoo treatment that you find at the drug or grocery store. Follow the directions on the packaging exactly.
    2. Remove as many eggs as possible with a special comb that comes with the head lice treatment.
    3. Treat your home at the same time you treat your child. Do the following:
      • Soak combs and brushes for 5-10 minutes in some of the lice shampoo for 1 hour or in very, very hot water.
      • Wash sheets, blankets and other bedding in the hottest setting of water in the washing machine.  Dry in a hot dryer.
      • Dry-clean non-washable items or seal these items in a plastic bag for 1 week or tumble them in a very hot dryer. 
      • Vacuum furniture, carpets and mattresses thoroughly.
    4. Treat hair a second time 7 to 10 days after the first treatment (or follow the instructions of the manufacturer of the lice treatment) to make sure that you kill any lice that may have hatched from eggs that might have been missed during the combing.
    5. There is no need to cut hair. Lice like to crawl on short hair just as much as long hair and they need the same treatment.

    How Do You Keep Lice From Coming Back?

    • Teach family members to recognize eggs and how lice is spread and check everyone’s hair periodically.
    • If you find lice, follow the recommended treatment closely. It should be reported to the school nurse, who may want to check close contacts.
    • Remind children not to share combs, brushes, hair accessories, headphones, hats, clothing, bedding, coats and so forth.
    • Ask the teacher at your child’s school if there is a space to keep jackets, hats and other personal items separate for each child. Ask what you can do to help.
    Helpful Resources:
    Find these information sheets at: https://www.dshs.state.tx.us/schoolhealth/lice.shtm

    Lice Fact Sheets - English

    • What Are Lice? (Publication # E05-12864)
    • How Do I Know if My Child Has Lice and How Did They Get It?  (Publication # E05-12865) 
    • What Should I Do If My Child Has Lice?  (Publication # E05-12866)
    • How Do I Keep Lice From Coming Back?  (Publication # E05-12867)
    • Misconceptions and Truths about Lice Treatment  (Publication # E05-12868) 
    • Lice Resources  (Publication # E05-12869)

    Hoja informativa sobre los piojos de la cabeza - En Español

    • ¿Qué son los piojos?  (Publication # E05-12864) 
    • ¿Cómo sé si mi hijo tiene piojos en la cabeza? Y, de ser así, ¿cómo se le pegaron?  (Publication # E05-12865) 
    • ¿Qué debo hacer si creo que mi hijo tiene piojos en la cabeza?  (Publication # E05-12866) 
    • ¿Cómo evito que vuelvan los piojos?  (Publication # E05-12867) 
    • Mitos, ideas erróneas y verdades sobre el tratamiento de los piojos de la cabeza  (Publication # E05-12868 
    • Recursos sobre los piojos de la cabeza  (Publication # E05-12869)