Fear of Lice is in Your Head

Lice Happens featured on the Greater Annapolis Patch! Thursday, September 30, 2010 It’s embarrassing, it’s itchy, it’s expensive to treat, and it is a big nuisance for everyone involved. No rumor spreads faster through a school or a group of parents..

Lice Happens featured on the Greater Annapolis Patch!

Thursday, September 30, 2010

It’s embarrassing, it’s itchy, it’s expensive to treat, and it is a big nuisance for everyone involved. No rumor spreads faster through a school or a group of parents than word of a head lice infestation. An average of 1,000 cases of head lice are found among county students each year, according to the Anne Arundel County Department of Health.

Head lice are neither a health hazard nor a sign of poor hygiene but some parents fear the blood sucking, six-legged insects more than the flu.

“Head lice infestation is associated with little morbidity but causes a high level of anxiety among parents of school-aged children,” according to Pediatrics, the official journal of the American Academy of Pediatrics (AAP).

Head lice are different than body lice, which are often associated with people (especially homeless people or refugees) who don’t have the ability to wash their clothes regularly. Body lice are also larger than head lice, which can be so small that you can’t see them without magnification.

Parents at Rolling Knolls Elementary (RKE) panicked last week when their kids came home talking about lice. It turns out there were only two reported cases of live lice at the school, according to Bob Mosier, public information officer for Anne Arundel County Public Schools. Mosier added that the parents of both RKE students elected to keep their children home for treatment, and were screened upon returning to school and found to be “lice free.”

The Anne Arundel County Department of Health has a “no live lice” policy based on the recommendations of the AAP and the National Association of School Nurses. If a child is screened at school and found to have live lice or nits less than 1/4 inch from the scalp, the school will contact that child’s parents. In most cases, students can remain in school until the end of the day but must be treated (with either an insecticide shampoo or have all the nits removed) before returning.

“In collaboration with the individual school’s administrators and according to our Head Lice Policy, it is determined if a classroom letter should be sent home to parents,” stated Elin Jones, public information officer for Anne Arundel County Department of Health. “It is rare that middle or high school students have head lice issues, as in that age group they do not share brushes, combs and caps as frequently.”

Mosier said that each case is considered separately and factors that are considered include how many students were found to have lice and how their belongings are stored (whether they are in lockers).

Jones stated that school nurses often tell parents that they should routinely monitor their children’s heads for lice or nits. Parents should report cases of head lice to the school nurse, who can determine if screenings at school are necessary.

“Parents whose children are screened by school health nurses for head lice — whether they are positive or negative — get a ‘Head Lice Alert’ letter,” according to Jones, who added that school nurses can provide parents with resources for treatment and information about mitigation/prevention.

Some parents are upset that they’re not automatically notified by the school when a student in their child’s class has lice. One parent, whose daughter had head lice, said that when the school doesn’t tell parents that one student has lice, they’re not giving busy parents the “heads up” they need to take the time to inspect their child’s hair.

“There is no such thing as a school infested with lice,” said MJ Eckert, a registered nurse and former school nurse. “Lice must be on the head to feed several times a day and survive.”

Eckert and Nancy Fields are co-founders of Lice Happens, an Annapolis-based company that offers services to families “at their nits’ end” who are infested with lice. Eckert says that people have heard about bed bugs in the news and are mistakenly attributing their properties to lice.

“Any louse off the head is a dead louse,” Eckert said, who added that lice can survive off the head for about 24 hours and then they die.

Parents mistakenly blame the school environment for helping to spread lice when it’s actually more common that children get lice when they are outside of school.

“Children get lice when they have direct head-to-head contact,” explained Eckert.

That kind of contact may happen at school when kids put their heads together to share a book or tell a secret, but it’s more likely to happen at home or during sleepovers when children share pillows, use the same brushes, or play with each other’s hair.

Eckert said that parents should operate under the assumption that there is head lice in all of the schools and screen their children frequently at home. She said that 50 percent of people never itch so they may not realize they have lice for months.

Lice Happens’ motto is “no shame, no blame.” When a child has lice, Eckert strongly encourages people to tell the parents of their child’s friends as well as the school nurse.

So, how do you get rid of lice? Eckert warned against using the special shampoo unless live lice were found, saying insecticide treatment is not necessary for nits — the best way to remove nits is by combing them out. She said that some parents will use an over-the-counter insecticide shampoo, which usually instructs users to reapply in seven to ten days. Eckert said most parents see a live lice a day or two after treatment and “freak out.” They use the shampoo again instead of waiting, which makes the lice resistant to the treatment.

“It’s similar to antibiotics,” said Eckert. “If they [shampoos] are overused, they become ineffective over time.”

The insecticide shampoo attacks the adult nervous systems of lice so it doesn’t do anything to the nits, which are just eggs on the hair shafts. Lice like clean hair because it’s easier for a louse to put some sticky saliva on the hair shaft and lay the egg close to the scalp. A louse can lay five to ten eggs per day. No product will get rid of nits, she explained, so you just have to keep combing since the eggs are all on different hatching schedules.

Eckert said that their hair services include examining, sectioning, manual combing and nit-picking using pesticide-free non-toxic products. They charge $100 per hour and see about five families a day. The biggest part of her business is training people in prevention because she said they’re “not looking for repeat business.”

Signs of Lice

The professional nit-pickers at Lice Happens offer their wisdom for determining whether your child has lice:

Many symptoms are mistakenly diagnosed as head lice. Dandruff, gobs of hairspray and even small insects like aphids that have been blown into the hair on a windy day have all sent panicky parents to the pediatrician for treatment. The only foolproof diagnosis for pediculosis (a head lice infestation) is to catch sight of the elusive bugs, but look for these signs as well:

  • Persistent scratching of the scalp
  • Pink rash behind the ears and at the nape of the neck, resembling an allergic reaction
  • Tiny lice eggs (called “nits”) on the hair shafts, close to the scalp, that cannot be brushed off
  • The presence of tiny light brown bugs (the size of a sesame seed)