Just say the words head lice and you’ll have parents, teachers and pediatricians cringing. These little creatures, about the size of a sesame seed, mostly affect school-aged children between 2 and 12 years old. Lice also create unnecessary fear and panic.

As children return to school in the fall, our office starts getting calls from worried parents about lice and nits (lice eggs). In some cases, parents call us in tears and tell us that their son or daughter has been kicked out of school until all the lice and nits are gone. Not only do we have to work to get rid of the lice, but we have to fight to get the child back to class.

The American Academy of Pediatrics recently issued a report that provides good recommendations for dealing with lice.

Some of the key points of the report include:

  • School-based head lice checks are not cost effective. The organization says that your pediatrician should take a greater role to help diagnose and treat lice.
  • Accurate diagnosis is important. Often times, children with dandruff or other dirt and debris in their hair are mistaken for having lice or nits.
  • Treatment should follow proper use. Overdoing or underdoing treatment can cause the lice to survive. The academy recommends an over-the-counter permethrin (1 percent) treatment such as Nix®. It’s important that parents follow the instructions and remember to reapply the treatment about a week later to ensure all the lice and eggs have been killed. Wet-combing and hand-picking the lice and nits from your child’s hair is an effective, but time consuming treatment method. If your child still has issues with lice, work with your pediatrician to find an effective prescription-strength medication.
  • No nit policies should be discouraged. The report says that keeping kids away from school can have emotional and academic consequences. No child should have to stay home from school because of head lice. Most cases of lice are picked up in homes, not at school. Lice crawl – they don’t hop or fly so you have to get lice from direct head-to-head contact. Despite this, many school districts have no nit policies. Be sure to check on your options with your child’s school.

If your child has head lice they have probably been there for at least a month. Treat the lice right away and have your child avoid close head-to-head contact with others until you know the lice are gone. Follow all treatment instructions carefully.

Robert Rohloff, MD~ Robert Rohloff, MD, pediatrician, Southwest Pediatrics

Children’s Hospital of Wisconsin offers 20 primary care offices throughout southeast Wisconsin, including Southwest Pediatrics in New Berlin, Wis.

Learn more about Robert Rohloff, MD.


Head lice: The itchy and scratchy show — 1 Comment

  1. I get the jitters just talking about it, but it has started to become an issue again in schools and summer camps. I understand the over reaction parents display because kids do tend not to be conscious about their behavior. Any time a child has a secret to tell, they bump heads. Just their typcial physical behavior places them in closer quarters than adults many times who have usually built an imaginary barrier around ourselves before we hit the age of 21. Some call it the “safe distance” unwritten rule.
    Thank you for your article. I heard the other night on the news, where they have a nightly segment commentated by a medical doctor, that if your child has a lice is not necessarily a sign of filth. That was interesting to learn, because most of us associate it with uncleanliness. Thank you for the article. I am learning more and more about it. I see now that although they originate from filth, by the time they spread the lice have likely attached themselves to children or others who don’t live in the same kind of conditions.