For many families, a child getting sent home early due to head lice is a common occurrence during the school year. But parents may be surprised to learn that the latest guidance from the Centers for Disease Control and Prevention says students with head lice infestations can stay in the classroom longer.
"Students with lice can go home at the end of the day, be treated, and return to class after beginning appropriate treatment," the CDC said in February of 2024, stressing that the guidance has "not changed."
"Unnecessary days off cause a burden to the students, families, and communities, and far outweighs the risks associated with head lice," the CDC went on to say.
The protocol is in line with a recent study from the American Association of Pediatrics that says head lice infestations are not a health hazard or sign of poor hygiene, and that the stigmas associated with the diagnosis can "result is psychological stress."
“Head lice are an unpleasant part of the human experience, but they can be successfully managed and are no reason for a child to miss school,” said Dawn Nolt, MD, MPH, FAAP, lead author of the report, written by the AAP Committee on Infectious Diseases, Committee on Practice and Ambulatory Medicine, and Section on Dermatology.
Prior to the 2022 student, the AAP last updated its head lice treatment guidance in 2015.
What do the current CDC guidelines about lice say?
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According to the CDC, students with lice infestations not need to be sent home early from school. It also noted that the misdiagnosis of nits -- the eggs laid by head lice -- is very common during checks conducted by nonmedical professionals.
The AAP, headquartered in Itasca, Illinois, says that this is the first time it has updated its head lice treatment guidance since 2015.
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"Nits may stay in hair after treatment, but successful treatment will kill crawling lice," the CDC said. "Many nits are more than ¼ inch from the scalp and are unlikely to hatch to become crawling lice, or may in fact be empty shells (i.e., casings)."
The guidance goes on say that while nits bond to hair shafts, they are very unlikely to transfer to other people.
Both the AAP and the National Association of School Nurses believe schools with "no-nit," or "nit-free" polices -- where a child must be free of nits before returning to school -- should be discontinued, the guidance said.
"Unnecessary days off cause a burden to the students, families, and communities, and far outweighs the risks associated with head lice," the CDC said.
What lice treatment does the CDC recommend?
According to the Illinois Department of Public Health, head lice can be passed from person to person through direct contact, or transferred indirectly among clothing items, or when infested hair brushes or combs are shared.
"Once present in a home, school or institutional environment, head lice usually spread rapidly," the IDPH said.
If your child has symptoms of head lice infestation, the CDC recommends examining their head, especially behind the ears and at the nape of the neck, for crawling lice and nits.
"If you find crawling lice or nits, examine all household members for head lice every 2 – 3 days. Treat anyone with live (crawling) lice or nits within a quarter-inch or less of the scalp."
According to the CDC, both over-the-counter and prescription products can treat lice.
What are the guidelines for schools in Illinois?
School guidelines may vary. And according to the CDC, most health departments do not require reporting of head lice infestation.
The Illinois Department of Public Health website said head lice is not reportable and reinforced the CDC guidelines, saying "students diagnosed with live head lice do not need to be sent home early from school."
"They can go home at the end of the day, be treated, and return to class after appropriate treatment has begun," the IDPH said.
