A few months ago, just before the end of first grade, Sara’s daughter mentioned that one of her friends had been sent home from school with head lice.
Luckily, when officials at the charter school checked other children, Sara’s own daughter “was declared clear,” says Sara (who asked that her last name not be used in this story).
Problem was, Sara noticed that her daughter seemed to be scratching her head an awful lot. And, after a quick check under a magnifying lens, the icky truth was revealed: Sara’s daughter had lice, too.
Sara reacted in the calm, measured way any parent would.
“I freaked out,” she says. “I’m a pretty logical, reasonable person, and I was completely grossed out. Freaked out. Like, ‘eww.’ ”
It’s a natural response. But after spending a few moments indulging in a minor emotional meltdown, a parent might focus on these grounding thoughts: Head lice aren’t uncommon. They’re not an urgent medical condition but merely a nuisance, and dealing with them probably isn’t as icky or as complicated as you might think.
Head lice are a year-round problem. However, many parents do associate lice outbreaks with school, and there’s probably at least something to that. After all, lice are spread mostly by head-to-head contact, and gathering bunches of kids together in classrooms and on playgrounds probably offers lice greater opportunities to hop among heads.
However, it’s just as likely that the lice that seem to arrive when school starts go back to a child’s stay at summer camp, or just playing with neighborhood kids during summer vacation. Michelle Lohrli, owner of Lice Happens, a Las Vegas mobile lice treatment service, notes that she usually detects a peak in calls in late summer.
It’s also possible that the start of school just makes already existing infestations more likely to be detected by teachers or school health officials. Nonetheless, Lohrli says, “anytime you have a room full of kids, you have a higher chance of getting it.”
Lohrli says children ages 3 to 13 seem to be most susceptible to contracting lice, “because they have a very small space bubble. They whisper, they giggle, they’re huggers. So it’s anytime there’s head-to-head-touching.”
Dr. Matthew Martin, a family practice physician and an assistant professor at Touro University Nevada College of Osteopathic Medicine, says the most common complaint among people who have head lice — and, he notes, “infestation” is a more precise word than “infection” to describe what’s going on — is itching of the scalp.
“(Lice) tend to be more active in the evening or early morning, and kids wake up scratching at night,” he says.
There may be small red sores on the head. Finally, an examination probably will reveal tiny active lice on the head and scalp, and nits, or tiny eggs that may look like dandruff, attached to hair shafts.
Brian Labus, senior epidemiologist for the Southern Nevada Health District, says that because head lice don’t transmit disease, head lice infestations are not reportable diseases here.
“So we don’t get incident reports of head lice. We don’t track (infestations),” he says. “But we know it’s not an uncommon sort of thing. So we do hear about it.”
Lynn Row, the Clark County School District’s health services director, notes that whether a child’s lice were actually contracted at school, “we’re usually the bearers of bad news.”
Often, it’ll be classroom teachers, a school administrator or a school health officer or aide who will detect signs of a head lice infestation in a student. “It’s the classroom teacher or somebody who says, ‘Will you check out so-and-so? They’ve been itching their head,’ ” Row says.
Typically, the child will be examined by school personnel and, if live lice are seen, will be sent home with a fact sheet for parents that outlines school policies and treatments for lice. The child may return to school once he or she has been properly treated, Row says, and the child may be rechecked at least once in a week or so to ensure that live lice or nits, and the new generation of active lice nits represent, haven’t hatched.
Contrary to what many believe, head lice aren’t associated with uncleanliness or bad hygiene. Sara says one of her first reactions after learning that her daughter had lice grew out of that very misconception.
“Seriously, we are superclean. I have our home meticulously cleaned,” she says. “So my first thought was, ‘Oh my gosh, how can this happen? We’re clean people.’ ”
Sara then did what most people do, picking up an over-the-counter preparation at the drugstore and performing the shampoo/treatment regimen it called for.
“We used it and did what it said, and three or four days later she’s still itchy,” Sara says.”We tried it again and finally, after two or three times, I called Michelle.”
Sara said Lohrli’s in-home intervention lasted a few hours.
Lohrli used what she describes as an enzyme-based preparation to treat Sara’s daughter’s hair, then went over the girl’s entire scalp with a fine-toothed comb to remove nits. She also inspected other members of the family during her visit and educated the family on what they should do next and how they can prevent reinfestation.
“She left us a comb and instructions on what to do,” Sara says. “Over the process of a couple of weeks, we kept combing every single day. Now it’s just once a week to make sure. We never want to encounter it again.”
Typically, over-the-counter lice removal preparations include a shampoo/lotion that is applied to the hair and, perhaps, a fine-toothed nit comb. Most preparations require at least one reapplication, typically in seven to 10 days, to ensure that a second generation of lice doesn’t hatch. Then, parents often choose to launder pillowcases and similar items in hot water to kill eggs and lice, and treat such items as stuffed animals by putting them in sealed plastic bags and leaving them in the sun.
Normally, Labus says, you don’t have to take special steps.
“Just normal cleaning, normal vacuuming,” Labus says. “Once (lice are) off of the human body, they’ll die within a day. If clothing or bedding is a concern, just wash it in hot water that goes over 128 degrees to destroy lice.”
Lohrli says an at-home session for one child with medium-length hair will cost about $300 and last several hours. Just as important as the shampooing and painstaking nit removal she offers — “I’ll comb through every square inch of the head,” she says — is the education she offers to clients.
“We teach them. We educate them,” she says. “We make sure they understand the correct way to screen kids to move forward, and make sure they know how to use the tools properly. And we can’t stress enough that they really need to check kids’ heads at least once a week.”
“We help to dispel the myths,” Lohrli adds. “I always tell my families I have a Ph.D. in lice and by the time I leave you you’re going to have a master’s. We tell parents they need to be proactive. They need to be checking their kids’ heads at least once a week.”
Here’s a happy thought: Lice do not spread as easily as people think, Labus says.
“You really need close personal contact, head-to-head contact, to get lice moving from one person to another,” Labus says. “They’ll attach really well to the hair, and they’re not necessarily looking for a new host. They don’t like to be off the human body. Most head lice will not survive very long off the human body. They want to be next to your skin where it’s warm and they have blood to feed on.”
Sara’s family continues to do everything they can to be inhospitable hosts to head lice.
“We comb like every week or so,” she says. “It’s just that double-check, because school has started.”
The only lasting casualty of the family’s skirmish with head lice has been her daughter’s desire for more luxurious tresses.
“She wasn’t freaked out about the lice,” Sara says. “What her biggest irritation now is, we make her do a braid or a high pony every day, and she really wants to wear her hair down, like Rapunzel.
“That’s her biggest thing: ‘Why can’t I wear my hair down?’”
Contact reporter John Przybys at firstname.lastname@example.org or 702-383-0280.