Head Lice

Getting lice is an unpleasant fact of school life. They are neither a health hazard nor a sanitary problem, but they are a force to be reckoned with and we must work together as a community to tackle them.

A good nit comb is a powerful tool for both detecting and treating lice, and can be reused year after year. Here are some recommendations from PS9 families. 

1. Nit Free Terminator
2. NISSKA
3. LICEMEISTER

The PS9 PTO compiled this page of tips for dealing with lice, with resources and recommendations from families who have been there. Much of the information below was pulled from NYC DOE, Lice Busters, The Nice Lice Lady, and Lice Happens.

Head lice are small insects with six legs. They are usually the size of a sesame seed. Lice live on or very close to the scalp. They won’t wander far down the hair shafts for very long. Anybody can get head lice by coming into contact with an infected person, but spread of head lice requires direct head to head contact. Head lice are generally caught from close family and friends in the home and community. Nits are egg cases laid by lice. Nits are smaller than a pin head and are pearly white. 

Head lice are not a sign of poor hygiene and anyone can get them. Lice do not transmit infections and do not endanger a person’s health.

Pay particular attention if your child has been scratching the back of their head or around the ears. But not everybody who has lice has an itchy head. If you know of cases in your class or the community at large, it’s best to do a weekly check whether or not your kid is scratching their head.

These are the steps to follow:

• Comb through to remove all the tangles. You can use a regular brush or comb for this part. For long hair, use clips to separate it into sections. 
• Do a visual check for nits (lice eggs) and live bugs. Go through the hair section by section. You can do this part with your fingers or a regular comb, just be sure to get under good light. Look through the hair from different angles, looking over the hair and under the hair. Pictures: what they look like on dark hair and light hair.
• Wet the hair, apply conditioner, and comb. Here's where the real checking begins. Even if you didn’t see anything with a visual check, you’ll need to comb to confirm. It's most effective if you have a metal lice comb, but this can even be done with a plastic fine toothed comb. Wet the already detangled hair and coat it with some conditioner. Any conditioner, even something cheap, works great. Comb through the hair in all four directions and check the comb by wiping it on a white towel or tissue after a few strokes. If you comb 100 times and don’t see any bugs or nits, you can consider yourself in the clear. Here's a visual of what you might see on your towel or tissue if you do have lice.

Videos: Here are two visual guides to the process, for fine hair and African American hair.

Don't panic, you can beat this! 

1. Contact the school

If you find lice on your child’s head, it's very important that you notify your teacher and send an email to Assistant Principal Ms. Darress. (ldarress@schools.nyc.gov) Only once it has been reported can an email be sent to the class stating that there has been an anonymous case, along with information on checking for lice and treatment. 

New York City schools have a “no head lice” policy which means that any student who has lice in their hair or scalp is not allowed to attend school until they have been treated. 

Students may return to school the day after treatment. Bring your child to the school’s main office upon return for a lice check and to receive clearance. As long as there are no live lice upon re-inspection, they will be permitted to join their class. If they only have nits and no live lice are found, they can attend school.

Students will be re-inspected by our PS9 lice checker 14 days after the treatment to make sure there are no live head lice. You will be notified following that inspection.

2. Check everyone in your house for lice.  

Everyone in the household – adults included – should be checked for lice. Once you know who has lice, you only need to treat those individuals. 

3. Decide if you want to seek professional help or treat the lice at home.

Some professional places recommended by PS9 families include Lice Busters and Lice Free Noggins.

Home treatment can be just as effective if you have the time to devote to it. Follow the steps below.

Gather your tools.

If you have nothing but your hands, just get the person with lice in some good light and start picking out the bugs and eggs. You can pick lice and nits out faster than they can reproduce and so you can always get ahead of their cycle if you just put in the time. However there are some tools that can be of huge help in the fight.  

• A metal lice comb. A quality lice comb is a great investment. It saves you time, can be used with multiple people, and can be used for years. If you can't get one of these combs, still use the comb you have. Even a plastic comb with teeth close together can remove adult bugs during a wet combing. Recommendations from PS9 families include: Nit Free Terminator, NISSKA, LICEMEISTER.
• Hair conditioner. Water and conditioner make the combing go much more smoothly. Keeping the head damp is great because lice slow down or stop moving when wet. It also makes nits easier to remove.
• White towel, tissues, or paper towels to wipe your lice comb. 

Not essential, but also helpful: 

• Hair clips to section off the hair you have already combed. 
• Water spray bottle in case the hair starts drying out. 
• Towel to put over the shoulders to keep the person from getting soaked.
• Headlamp or flashlight. A head lamp gives you a good, hands-free light source, and a flashlight can help in low light.
• Magnifying glass. The nymphs and nits are so tiny that it can be hard to identify them without some kind of magnification. You can also take a picture with your phone and zoom in to magnify. 
• Garbage can or bag to throw any used toilet paper or tissues in.

Comb, comb, comb.

Be prepared to spend some time on the treatment. It might be helpful to put on a movie or game or grab a book for the child being treated to help them pass the time. Find a comfortable place for you both to sit that has good light. 

 Video: Here’s a great visual guide to the process.

1. Comb through the hair with a regular brush or comb to remove all the tangles. For long hair, use clips to separate it into sections. 
2. Wet the hair, apply conditioner, and comb. It's most effective if you have a metal lice comb, but this can even be done with a plastic fine toothed comb. Any conditioner, even something cheap, works great. Comb through the hair in all four directions and check the comb by wiping it on a white towel or tissue after a few strokes. 
3. Continue this process until you have gone through every section of hair and have been able to comb the whole head at least 100 times without finding a new egg or a louse. If you find another egg or louse, start counting strokes again at one. This can take a while the first time but will get quicker and quicker each day.

To sterilize any combs, brushes, or hair clips between using it on different people, put it in a cup and pour boiling water over it. Let it sit for a few minutes.

If you do not have a comb: 

1. Go through each section of hair looking at even smaller sub-sections of hair from different angles.
2. If you find a nit, pinch the hair between your index finger and your thumbnail and scrape the egg all the way to the tip of the hair, pull it off the hair and dispose of it.
3. If you find a bug, pick it off the scalp and dispose of it. Remember, baby bugs can be as small as a speck of pepper. If you are not sure if what you have found is a nit or bug or just a piece of sand or dandruff, just pick it out anyway.

Continue to check

Do a thorough check for new lice activity every 2-4 days until you have had two weeks of no nit or lice sightings. If you see more eggs or bugs, do not panic. You have the situation under control. Just remove any eggs or bugs that you find. Once two weeks have gone by with no sightings of eggs or bugs, you can just do routine combings every once in a while.

Topical treatments

Some people swear by topical treatments like the ones that come in lice kits from Suave, Nix, Rexall, or your local pharmacy. Others find that lice persists even after using these treatments. The American Academy of Pediatrics recommends using head lice medicine in combination with combing and has a list of USDA approved treatments, both over the counter and prescription. Most over the counter treatments kill lice but not the eggs; combing is key to removing both. Head lice can be resistant to the active ingredients in many over the counter treatments, so your mileage may vary. Your pediatrician can help you decide on next steps if lice persists after treatment.

What about cleaning? 

It might be a little hard to believe when you’re in the midst of an infestation, but it is not possible for your house to be infested with head lice.

Head lice cannot survive for very long away from a human host, so they will not successfully breed in your home, lying in wait for their next victim. Any head lice that come off a head will live for only a few hours to a day or so at most (scientific journals say between 6 and 24 hours), then perish. Nits attached to hairs that fall out are unlikely to hatch off the head. They need the heat and humidity of the scalp to incubate them.

The worst thing you can do is to spend too much time and energy cleaning and neglect to do proper combing. Make sure that msot of your time is spent working to get them off of the head and then you won't have to worry about having them in your home.

After combing if you want extra peace of mind, you can follow the DOE guidance on cleaning: wash and dry items that an infested person wore or used during the two days before treatment; vacuum surfaces where the infested person sat or lay; and soak combs and brushes used in hot water for 5-10 minutes. 

Similarly, some sources say there's no need to bag items. Others say to bag items that can't be washed (like stuffies, perhaps) in a plastic bag for 10-14 days.

Sources: NYC DOE, Lice Happens, The Nice Lice Lady 

Tips to avoid reinfestation 

Once two weeks have gone by with no sightings of eggs or bugs, the best thing you can do to avoid reinfestation is weekly screenings using a metal nit com. 

Lice cannot fly or jump. They can only crawl from one head to another. Teach your children to avoid head-to-head contact. But do not instruct children to avoid other contact with an infested child, as this will spread stigma and cause unnecessary stress. 

Less essential but potentially helpful: While cases are high, pull back long hair into a ponytail or braid. Do not share hats, scarves, brushes, or hair accessories. Use repellents like these recommended by PS9 families: Head Hunters Lemon Heads Lice Repellent, Fairy Tales Conditioning Prevention Spray, Grisi Kids Lice Repel.

What about pets?

Good news: animals do not harbor or spread head lice. Lice are a human parasite and only survive on human blood.