(Texas Education Code, Section 38.031)

Prevention and Treatment of Head Lice

What are head lice?

Head lice are parasitic insects that feed on human blood several times a day and live close to the human scalp. Head lice is common among school-aged children, does not cause disease, and is not a public health hazard 

How do you get Head Lice?

Head lice are most commonly spread by direct head-to-head contact. According to AAP (American Academy of Pediatrics), most cases of head lice are acquired outside of school. Indirect spread through contact with brushes, hats, or combs are rare since lice found on these items are usually injured or dead and according to the CDC, live lice without blood meals, will die within 1 to 2 days off the host. Lice do not fly since they are not winged and are not able to jump due to feet specially adapted to grasp hair follicles. The louse’s specially adapted feet make holding on to smooth surfaces like plastic, metal, or other similar materials very difficult (i.e. helmets or headphones).

Typical Symptoms include:

  • Persistent itching of the scalp
  • Sores on the head caused by itching
  • Nits (eggs) near root of hair concentrated behind ears and at nape of neck
  • Live lice noted on scalp

What to do if live lice are found?

Treatment for head lice is recommended for persons identified with live lice. All household members and other close contacts should be checked; those persons with evidence of live lice should be treated.


We recommend you consult with a licensed medical provider for treatment if you suspect someone in your household has head lice. Should you decide to use an over-the-counter treatment, the CDC recommends you select an FDA approved product since most home remedies have not been proven to be safe or effective. You should follow manufacturer’s instructions strictly and treat all household members suspected to have live lice. Retreat according to product instructions (usually 7-10 days) and consider nit removal to decrease the chances of recurrence.

Helpful Hints:

  • If the person with live lice has very long hair (longer than shoulder length), it may be necessary to use a second bottle.
  • Pay special attention to instructions on the label:
    1. How long the medication should be left on the hair and how it should be washed out.
    2. When to re–wash the hair after the lice medicine is removed
    3. When to retreat (usually 7-10 days)
  • Comb dead and any remaining live lice out of the hair using a fine–toothed nit comb.
  • If, after 8–12 hours of treatment, no dead lice are found, do not retreat until speaking with your healthcare provider. A different treatment may be necessary.
  • Nit (head lice egg) combs, often found in lice medicine packages, should be used to comb nits and lice from the hair shaft.
  • After each treatment, checking the hair and combing with a nit comb to remove nits and lice every 2–3 days may decrease the chance of recurrence.
  • Continue to check for 2–3 weeks to be sure all lice and nits are gone. (CDC: Adult lice can live up to 30 days on a person’s head.)
  • Retreatment is meant to kill any surviving hatched lice before they produce new eggs.

How can we prevent head lice?

Prevention is focused on avoiding head-to-head contact (common during play at home, child care, school, sports activities, playgrounds, slumber parties, and camps) and by prompt treatment of persons identified with live lice.

The following are steps that can be taken to help prevent and control the spread of head lice: 2

  • Avoid head-to-head (hair-to-hair) contact during play and other activities at home, school, and elsewhere (sports activities, playground, slumber parties, camp).
  • Do not share clothing such as hats, scarves, coats, sports uniforms, hair ribbons, or barrettes.
  • Do not share combs, brushes, or towels. Disinfest combs and brushes used by an individual with head lice by soaking them in hot water (at least 130°F) for 5–10 minutes.
  • Do not lie on beds, couches, pillows, carpets, or stuffed animals that have recently been in contact with an individual with head lice.
  • Machine wash and dry clothing, bed linens, and other items that an individual with head lice has worn or used during the 2 days before treatment using the hot water (130°F) laundry cycle and the high heat drying cycle. Clothing and items that are not washable can be dry-cleaned OR sealed in a plastic bag and stored for 2 weeks.
  • Vacuum the floor and furniture, particularly where the individual sat or lay. However, spending much time and money on housecleaning activities is not necessary to avoid recurrence by lice or nits that may have fallen off the head or crawled onto furniture or clothing.
  • Do not use fumigant sprays or fogs; they are not necessary to control head lice and can be toxic if inhaled or absorbed through the skin.1
  • Additional information can be found at the CDC Prevention and Control site.

~Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/parasites/lice/head/biology.html

Returning To School:

  • Students absent for more than 48 hours will be considered truant.
  • Students may return to class, provided they have received proper treatment.
  • Your child will be readmitted to school once elimination of live lice has been confirmed by the school nurse or designated school personnel. 


  1. Centers for Disease Control and Prevention (CDC).https://www.cdc.gov/parasites/lice/head/gen_info/faqs.html
  2. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/parasites/lice/head/prevent.html  
  3. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/parasites/lice/head/treatment.html

Other Resources:

AAP Update: http://shar.es/1rW9Iv 

Department of State Health Services

National Association of School Nurses

 Headfirst Lice Lessons