Remember that head lice are generally passed from person to person or indirectly through contact with infested objects. Head lice do not fly or jump and can only live for 1-3 days off of a human host.
Following are best practices for prevention of head lice:
- Do not borrow combs, brushes, barrettes, hair bows, or other personal items.
- Do not share/borrow hats, helmets, scarves, pillows, book bags, or sleeping bags.
- Hang caps and coats separately from those belonging to others. Caps/hats can be tucked into coat sleeves or kept in book bags.
- If sharing earphones, headphones, or bicycle helmets, check them carefully and clean them before use.
- Avoid head to head contact with other children during lice outbreaks.
- If known to have lice, stay home from school until treatment has been completed.
Treatment of the Hair and Scalp
Correct use of an approved pediculocide (lice shampoo) on the hair/scalp and removal of all nits is important to eliminate head lice. All household members or other close contacts who are infested with lice should be treated at the same time. Follow these steps for best results. Also, follow the instructions provided with the lice shampoo, as well as any additional instructions given to you by your health care provider, pharmacist, health department or school nurse.
- Gather Supplies: lice shampoo, conditioner, clean towels and clothes, nit comb (preferably metal) and waste receptacle (or toilet) for disposing of lice and nits.
- Carefully read and follow the specific instructions provided with the lice shampoo. Apply the shampoo as directed, being sure to work the shampoo thoroughly into the hair. Note that hair should be treated in the sink, not in the bathtub or shower. Also, a different clean towel should be used to dry the hair after treatment with the shampoo.
- After treating the hair/scalp with lice shampoo, remove the nits using the nit comb. Hair conditioner may be used to loosen the nits that are attached to the hair shaft. With the conditioner on the hair, divide the hair into sections and comb each section thoroughly to remove all nits. As the nits become fewer in number, it is usually necessary to remove the remaining nits by grasping the nit with your fingernails and pulling it down the hair strand.
- Tips for using the nit comb:
- Part hair into four sections and pin each section with a clip.
- Choose one section at a time to work on and start at the top of the section.
- Lift a 1-inch strand of hair. With your other hand, place the teeth of the comb in the hair, as close to the scalp as possible.
- Pull the comb firmly away from the scalp to the end of the hair. Make sure the teeth of the comb are as deep into the hair strands as possible and comb all the way to the end of each strand. Resistant nits may be loosened by back combing the hair, especially near the scalp. Remove any remaining nits with your fingernails.
- After you finish combing each section, pin or clip the combed section up using clean pins or clips. Wipe nits from the comb often with a tissue and dispose of each tissue in a sealed bag or flush down the toilet.
- Repeat these steps in the remaining sections of hair.
- After initially combing the hair, check the hair and scalp again for remaining nits or lice. All nits, as well as any lice found, must be removed from the hair and disposed of by flushing them down the toilet or placing them in a waste receptacle which can be immediately removed from the home once treatment is completed.
- Once you have removed all nits, rinse the hair thoroughly, dry it with a clean towel, and have your child put on clean clothes that cannot possibly have been exposed to lice.
- Inspect hair daily for lice or nits. This should be done daily until no new lice or nits have been seen for two weeks. If new lice or nits are found, you may repeat the lice shampoo in 7 to 10 days or as directed on the product. Lice shampoo should not be repeated any sooner than 7 days from the previous treatment. Following each additional treatment with shampoo, you should remove all nits from the hair.
- If the lice infestation fails to resolve following two separate applications of an approved lice shampoo, removal of all nits, and proper treatment of the home environment, you should consult your health care provider, school nurse, or the health department for additional guidance/treatment.
- Treatment of all affected household members, as well as treatment of the home environment (see instructions below), should take place at the same time. It is also important to inspect the fingernails (your’s, the child’s, etc.) for the presence of lice or nits and remove any that are found by thorough hand washing. You may also want to contact parents of children who might have interacted closely with your child to request that they check their child for lice or nits.
Treatment of the Home Environment
Treatment of the home environment must be done along with treatment of the affected person’s hair and scalp in order to prevent reinfestation. The following measures must be taken:
- Do a mental inventory of the places your child and other affected persons might have shed lice or nits, such as the couch, carpet, bed, car, etc.
- Vacuum couches, carpets, floors, upholstered furniture, mattresses, pillows, and car upholstery. Seal the dirty vacuum bag in a plastic bag and remove it from the home immediately afterward.
- Launder and dry (on hot cycle, for at least 20 minutes) all possible contaminated items: sheets, bedding, pillows, clothes, coats, caps, scarves, etc. All items that cannot be laundered or cleaned (such as stuffed animals or dolls) should be placed in plastic bags outside the house for 2 weeks.
- Wash combs, brushes, barrettes, bows, etc. in hot soapy water. Soak them for at least 5-10 minutes and then rinse thoroughly.
- When possible, toys, book bags, and other articles used by your child should be washed, cleaned, or bagged up for 2 weeks.