What Works to Prevent Head Lice and What Doesn’t


One of the more dreaded aspects of grade school, which you may have experienced in the past, is receiving a notice informing you that your child’s classroom has head lice. You do not have to resort to shaving your head or using poisonous sprays, thank goodness.

A former team physician for the Virginia Tech Hokies and the Blacksburg High School Bruins, Sarah Turner, DO, is now the director of osteopathic medicine at LewisGale Hospital Montgomery, Family Medicine in Blacksburg, Virginia, and she holds a doctorate in osteopathic medicine. She has gained a wealth of experience in treating young children and athletes of all ages over the years, which has provided her with invaluable insights towards overcoming these vexing animals.

In order for children, parents, and teachers to have the best chance of successfully avoiding head lice, the most crucial thing, as Dr. Turner argues, is to distinguish the realities regarding head lice from the fiction around them.

It’s a fact that most people get head lice.

In spite of the initial response that many parents have when they discover a louse on their child’s head (which is “Why me?! “), it is essential to keep in mind that head lice are extremely frequent among children who attend school.

In children aged three to eleven years old in the United States, the Centers for Disease Control and Prevention (CDC) report that each year there are an estimated six to twelve million cases of the disease.

According to the United States Food and Drug Administration (FDA), although outbreaks can occur at any time of the year, they are most likely to occur in the fall and again in January, when students are heading back to school.

The factors that contribute to the proliferation of lice

The first step in preventing head lice is gaining an understanding of how these parasites survive and spread.

According to Turner, “in order for lice to thrive and make eggs, they need heat—particularly the heat generated by the human body—and they need to feed on blood.” The combination of being in close proximity to one another and being in crowded conditions is another risk factor for infestation.

Because lice are transmitted from person to person most frequently through head-to-head contact, it stands to reason that younger children, particularly those who attend preschool, childcare, or primary school, are more prone to contract them than older children. The cause has more to do with social customs than it does with biological factors: Small children are more prone to play in groups in closer proximity to one another than are older children (or adults), and they are also more willing to share objects such as hats, scarves, and hair products with one another.

Although the causes for this disparity are not completely understood, it appears that females are more likely to be affected by head lice than males. There is a possibility that the length of the hair has a role; longer hair has a greater chance of coming into contact with other strands of hair, and several schools who are currently battling an infestation recommend that female students tie their hair back. The research on hair length, however, has not come to a definitive conclusion.

According to Turner, the type of hairstyle that a person chooses, whether it be pigtails or ponytails, will not have a significant impact. The way in which girls connect with one another in their social lives is the more likely cause.

According to Turner’s research, “female social standards place girls at a greater risk of becoming infested with head lice.” They are more likely to hug, snuggle, and talk head-to-head with one another. “They are more likely to have closer touch with one another.”

The first line of defence is the home.

According to Turner, establishing a regular routine of preventive combing “is probably a waste of time.” However, it does make sense to run your hands through your child’s hair on a regular basis in order to be on the lookout for live lice or eggs (nits).

She advises that you should get as near to the scalp as possible. If the hair is dry, it will probably be easier to view the eggs because the strands of hair will be able to be separated more easily.

Although shorter hair makes it simpler to scan, Turner cautions against going too far with a drastic haircut.

“The only haircut that has been found to be helpful against infestations and recurrences is a shaven head,” adds Turner. “A shaved head is the only hairdo that has been proven to be beneficial.” However, I would never suggest shaving the head of a young girl if she did not want to have her head shaved.

What to do if you suspect you have head lice

If you have any cause to suspect that one of your child’s classmates or friends may be infected with lice, the first thing you should do is take the precautions outlined in the following paragraphs:

Stay away from direct head-to-head contact. Because head-to-head contact is the most common route of transmission, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) recommend teaching children to avoid having close contact with their peers and friends (at home and at school).

Put an end to the headgear swapping. Both organisations recommend that children avoid sharing clothes, hats, scarves, headphones, and towels, as well as hair products such as combs, brushes, bandanas, and hair ties. The research is mixed on whether lice can be transferred via headwear or hair products; however, lice can be transferred via headwear and hair products. (The use of protective headgear, such as bicycle and sports helmets, is an exception to this rule because the advantage of reducing the risk of damage outweighs the possibility that lice will infest the wearer.)

Don’t pile on. It is also a good idea to avoid stacking things whenever you go, whether it be at home, a day care centre, or school. “When headwear or clothes from multiple children is left in a pile, a louse or a nit could be passed to a new child when the item is put on,” explains Turner. “This could lead to an outbreak of head lice or nits.” It is a smarter move to have individual hooks, lockers, or cubbies given to each student for the purpose of keeping clothing and other stuff; you should also consider using this strategy for guests that come to your home.

There are some tactics that aren’t going to be worth your attention (or money)

You may have heard of, or perhaps tried, sprays and shampoos that claim to repel lice and are produced with botanical substances like tea tree oil or rosemary. These sprays and shampoos are made with natural ingredients.

Turner asserts that there is no evidence to support the aforementioned claim. “Purchasing a shampoo that contains a tea tree blend is probably not going to cause any harm to your child, but it is not going to do much in comparison to identifying the source of the infestation and making sure that the source, as well as anyone else who has suffered the consequences of the infestation, are appropriately treated,” the article states.

if you have reason to believe there is an infestation in your home

If your child exhibits any of the telltale signs of head lice, such as itching, sores caused by scratching, a tickling or moving feeling in the hair, or irritability in bed or difficulty sleeping, you will want to determine for certain whether your child has lice. These symptoms include itching, sores caused by scratching, a tickling or moving feeling in the hair, or a feeling that the hair is tickling or moving.

Comb his or her hair with a fine-tooth comb as close to the scalp as you can, section by section, looking for live lice and nits. This is the best way for obtaining a diagnosis because it is the most accurate. It could be easier to glide the comb through the hair if you wet-comb it and use some kind of lubricant, like conditioner.

If you find any live lice, you will need to treat the problem. This is normally done by using a medicated shampoo, ointment, or lotion in conjunction with wet combing; however, it is possible that you will be able to treat lice by simply combing them out. Talk to your child’s paediatrician about the treatment options that are likely to be most effective given the child’s age as well as your level of ease dealing with chemical concoctions.

While you are dealing with an infestation in your house, you can also take some precautions to assist stop the problem from spreading to other places. These measures are not required, and they are not intended to take the place of actively addressing the issue with medication and/or thorough combing.

Maintain the cleanliness of your combs and brushes. Avoid sharing combs and brushes that have been used by someone who has head lice, and disinfect them by soaking them in water heated to at least 130 degrees Fahrenheit for five to ten minutes.

Always have a level head. You should avoid lying down on mattresses, cushions, sofas, rugs, or stuffed animals that have recently been in contact with a person who has lice, and you should also clean areas of your home, including furniture, where the person who is afflicted with lice has sat or laid down.

Make a laundry run. You should use very hot water (at least 130 degrees Fahrenheit) and a dryer set to a high heat to launder and dry any clothing, linens, and other items that have come into contact with the head of a person who has lice within the past two days. If an item cannot be washed, you can have it dry cleaned or store it for at least two weeks in an airtight plastic bag at room temperature. (The life cycle of a live louse cannot extend beyond two days without a blood meal, and the life cycle of a nit cannot extend beyond approximately one week without the warmth of a host.)

One preventative step you do not need to take is to apply a fumigant spray or fog. The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) advise against doing so because these products are not likely to be effective in preventing lice and may be harmful if breathed in or absorbed through the skin.

The key is education.

It is essential to be aware of the fact that head lice infestations can happen to anyone, regardless of how well they maintain their personal hygiene or the cleanliness of their environment.

According to Turner, “often, an epidemic at school may be pegged on the poor kid or the ‘dirty kid,’ but this has nothing to do with it.” She believes that it is critical to eradicate the stigma and misinformation surrounding head lice and to instead educate everyone who is working with populations that are at risk.

Along with the social shame associated with having nits, the “no-nit policy” that is imposed by some schools is another outdated practise that many industry professionals wish would go away. If these are present, it is against the law for a child to attend school as long as there are lice eggs found in the child’s hair.

According to Turner, “Not only has it been demonstrated that these policies do not work, but they also induce fear, lead to greater stigma, and unnecessarily keep kids out of school.”

Both the American Academy of Pediatrics and the National Association of School Nurses advise against the implementation of no-nit policies in schools. They argue that children should continue going to school even while they are receiving treatment for head lice at home. This is done to account for the fact that nits may remain in a child’s hair for a portion of the treatment process without putting the health of other children at risk of becoming infested.

The Centers for Disease Control and Prevention (CDC) states that no-nit laws are frequently ineffectual due to the fact that not all nits develop into lice and that lice are unlikely to spread to other persons (since they remain stuck to hair shafts). Additionally, school personnel may not always adequately diagnose nits, and the condition might be confused with dandruff.


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