Head Lice

See also frequently asked questions to the school nurses about head lice.

Information from the Montclair Public School Nurses

Head lice are usually not difficult to eliminate when early identification is made. The Montclair School Nurses want to assure you that most families can successfully eliminate head lice by using simple, scientifically approved methods.

Parents and guardians frequently ask the school nurse about the need for hiring a "lice lady" picker" (a person in the community who provides lice treatment for a fee). Sometimes parents may feel insecure or unsettled by the thought of lice in their child's scalp. While we appreciate that there are fee-based lice treatment services available for parents/guardians who can afford them, we hope that families will not feel pressured or compelled to pay for these services.

We want to remind all families that head lice are a temporary annoyance, not a major health concern. In our experience, head lice outbreaks are kept to a minimum when parents/guardians take the lead by inspecting their children's scalps routinely.

The following are a few "facts" about this condition based on the latest information.

  • Direct head to head contact is the most frequent mode of transmission; although the sharing of combs, brushes, hats and other head gear, as well as towels, bed linens, and upholstery cannot be ruled out. Current experts on the topic tend to believe these "inanimate" objects are not likely modes of transmission.

  • Lice are tiny (about 1-2 mm) grayish/brown parasites that live on the scalp of their human hosts. The do not hop or fly…they only crawl.

  • The condition is a "host disease". Lice die quickly when off a human head, usually within 24 hours because they need a "host" (feeding on blood) to survive.

  • Hair length, shampooing habits, or brushing habits have nothing to do with infestation.

  • The most common symptom is itching, caused by an irritant effect of the lice saliva on the scalp; though not all cases produce itching.

Lice lay eggs (referred to as "nits") on the hair shaft close to the scalp (3-4 mm from the scalp) which are firmly attached to the hair shaft by a "glue like" substance that they secrete when the eggs are laid. These eggs (nits) hatch in approximately 6-10 days. The new lice mature in about 2-3 weeks.

If nits are found at 8-9 mm from the scalp on the hair shaft, this is evidence of an old infestation, most likely due to having missed removing some nits at the time of treating the initial infestation. These nits are no longer "viable" (live or capable of hatching).

Most over-the-counter products are effective if used properly. Do NOT use prophylactically.


The American Academy of Pediatrics recommends the use of over-the-counter Permethrin 1%, as it has a low rate of toxicity for humans. Smothering agents, such as petroleum jelly, olive oil, or mayonnaise and all-natural holistic treatment have also been reported to be effective methods of treatment. It is necessary following treatment for parents/guardians to comb lice and nits from the hair shaft (nit comb). Best practice is daily for 3-4 weeks to reduce the chance of self-reinfestation, followed by weekly wet scalp checks.

What should be done?

Household and close contacts should be examined and treated if infested. Parents/guardians may wish to disinfect headgear, pillow cases and towels by washing them in hot water and machine drying, using a hot cycle. Combs and hair brushes can be washed with pediculicide shampoo, or soaked in hot water. Upholstery (where heads rest) can be vacuumed. Lice killing sprays are not recommended because the ingredients have a degree of toxicity. The most effective action that can be taken by parents/guardians is to keep a close check (inspection every few days) for the next two to four weeks. "Herculean efforts" at cleaning, as was often done in the past, is probably not necessary.

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