Head lice is a huge issue for parents of school-age kids. Not only does it gross us out, but treating it is a total pain in the butt. In recent years, many schools have adopted no-nit policies that exclude kids from class when they have any signs of lice. It seems like a common-sense way to keep the bugs from spreading, but it turns out these policies actually have serious consequences for kids, and our attempts to keep lice out of the classroom could be doing more harm than good.
Many schools follow a common protocol when it comes to dealing with head lice. First, the affected student visits the school nurse to have his or her head checked. After that, parents are called, and the child is sent home until every last nit, or lice egg, has been removed from his or her head. The only problem is, keeping kids out of school for lice doesn't really make any sense, says Deborah J. Pontius, RN, health services coordinator and school nurse for the Pershing County School District in Nevada.
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First of all, sending kids home doesn't actually eliminate the problem. "At any one time, the evidence says between 1 and 10 percent of students in the elementary school ages will have head lice ... I can say that at any one time, there will be someone in the school who has head lice," says Pontius, who is an executive committee member of the National Association of School Nurses. "There's never not lice."
But, the issue isn't just that head lice are impossible to avoid; it's that no-nit policies operate on a fundamental misunderstanding of how lice and nits work. Nits are the eggs lice lay. They're usually found at the base of the hair shaft, and they're cemented to the hair, so they can remain long after the actual lice are gone. But the presence of nits does not mean you have live, active lice.
"You can have a head full of nits and have absolutely no lice," Pontius says. "And that's part of the reason why no-nit policies are so archaic, because excluding somebody for having old nits in their hair doesn't make any sense."
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But the biggest argument against no-nit policies is that keeping kids home comes with serious consequences for parents, schools, and most importantly, the children. Kids around the US miss 12–24 million school days annually due to head lice. Per lice episode, Pontius says the average parent loses up to $2,700 in lost wages, childcare costs, and expenses for treatment. Schools also lose money, to the tune of $280–325 million per year in lost funding for the days they don't get paid because students aren't in school. Most importantly, no-nit policies create a stigma that can follow kids even after their head lice is gone.
"If you have a no-nit policy, it usually means that child has to be excluded immediately ... If the child leaves class and doesn't come back, it's very easy to determine who had lice, and then that child can become the child that no one is allowed to sit next to or no one can go to that child's house," Pontius explains. "That is much more damaging for that child than any case of lice ever could be. That emotional stigma is long-lasting."
In response to this shaming and emotional stigma, some schools have tried canceling their no-nit policies, but Pontius says they usually end up getting pushback from concerned parents. "[Head lice] is perceived as being dirty when that has nothing to do with it because it crosses all economic boundaries, all lifestyles -- it doesn't make any difference," Pontius says. "Everyone is an equal opportunity lice host."
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So, what does Pontius say parents and school administrators should do when a child has head lice?
First, make sure what you're looking at is actually nits and/or live lice. "About 50 percent of the time, even health-care professionals get it wrong," Pontius explains. "It's mistaken for sand, glitter, dandruff, flaking off of hair products -- all of those can look like nits and even like lice, unless you have a lot of experience."
Once you've verified with a health professional or school nurse that your child does, indeed, have an active case of lice, choose a treatment option. You can use a chemical treatment or manually remove nits via combing. A quick Google search will also bring up tons of alternative treatments, like olive oil or essential oils, but "there is not one study out there that proves alternative treatments are truly effective," says Pontius. "Stick to the FDA-recommended treatments or a wet-combing method."
Finally, you should notify your child's school of the issue, but they should take it in stride. "The school's policy should basically be not having a policy. This isn't something that needs to be excluded for ... The school nurse needs to know so she can determine if there are other actions that need to be taken, but generally the student can return to school or stay at school," Pontius advises.
Head lice aren't anybody's favorite part of raising a school-age kid, but they're also not the existential threat many of us perceive them to be. Even the American Academy of Pediatrics now recommends keeping kids in class when they have lice. It's time we get over our collective squeamishness and stop punishing kids for catching lice.