St. Benedict’s Primary

Head Lice Policy

Rational:

Head lice are a common problem, which can affect the whole community, adults and children alike. However, head lice infection is most common amongst children and this guidance is intended to offer advice to education professionals on managing head lice infections in school.

Aim:

This guidance seeks to disseminate learning from the Stafford Report and take forward implementation of some of its recommendations.

Effective management of head lice infections depends on the ability of all relevant professionals/ agencies to offer clear, accurate and impartial advice and support to parents on detection and treatment.  This guidance therefore seeks to promote a more consistent approach to policy and practice.

Objectives:

Identification of head lice

Head lice are small, six-legged wingless insects which are pin-head size when they hatch, less than match-head size when fully grown and are grey/brown in colour. They are difficult to detect in dry hair even when the head is closely inspected. Head lice often cause itching, but this is not always the case.

Head lice live on, or very close to the scalp at the base of the hair, where they find both food and warmth. They feed through the scalp of their host. The female louse lays eggs in sacs which hatch in 7 to 10 days. Nits (egg sacs) are usually white in colour and are often easier to see than the head lice themselves. Many people mistake 'nits' for head lice or believe that it is evidence of a head lice infection. This is not true.  A head lice infection cannot be diagnosed unless a living louse has been found on the head.  During their life span of one month, head lice will shed their skin up to three times. This skin, combined with louse droppings, looks like black dust and may be seen on the pillows of people with head lice.  Head lice cannot fly, jump or swim; they are contracted only by direct head to head contact. Contrary to popular belief, the length, condition or cleanliness of hair does not predispose any particular group to head lice infection.  Anyone with hair can catch head lice, meaning that the problem, whilst often more prevalent in children, is not unique to them.  Whilst cleanliness is not related to contracting a head lice infection, regular hair washing and combing does offer a good opportunity to detect any infection so that it can be treated.

Responsibility

The Stafford Report recommends that parents are best placed to be responsible for regularly checking their children for head lice. There are sound reasons for this.  The first, and most important, is that 'wet combing' (see below) is the only truly effective way to carry out an inspection. Inspections in school by the school nurse were conducted on dry hair and were not, therefore, effective. To be effective, inspection also needs to be done on a regular basis. Inspection of a whole class of school children on one day will not detect a child who may become infected the next or any other day. School inspections are time consuming and can never be done on a sufficiently regular basis to make any real impact.  The Stafford Report also highlighted the importance of de-stigmatising the identification of head lice for children and parents, by moving away from school inspection.   Education and health professionals do, however, have a key responsibility to offer supportive advice to parents about how to identify and treat infections effectively and current, up to date advise should always be available on our web site.

Treatment

Once infection is detected, there are two treatment approaches. One option is the use of insecticide lotions and another is mechanical removal called 'bug busting'.

Insecticides

There are a number of different insecticide lotions available and pharmacists. 

One treatment using insecticide lotions involves two applications, seven days apart. This is because insecticide lotions do not kill any eggs that may be present at the time of the first application. If eggs hatch and are not treated, the infection will continue. This treatment should be applied by parents at home.  If live head lice are discovered after the second application, the advice of a health care professional should be sought before any further lotion treatment is applied.  Insecticide treatment should never be used as a preventative measure. Insecticide lotions should not be used unless a living louse has been found on the head.

'Bug Busting'

An alternative option for dealing with head lice is 'Bug Busting'. This is a non-chemical approach that involves mechanical removal of all lice from the hair after the hair has been washed and conditioned. With the conditioner still in, the hair is combed gradually using a fine tooth comb, section by section, in order to remove the lice.  'Bug busting' is time consuming and to be effective, must be sustained for as long as 3 weeks.

'Alert Letters'

'Alert letters' should not be sent to the parents of other children in the class of a child who may be infected. There is more than one reason for this.  Firstly, 'alert letters' are not routinely sent out for other, more communicable diseases or infections. Secondly, most schools are likely to have a few pupils with head lice at any one time. On that basis, an 'alert letter' could potentially be required every day of the school year.  'Alert letters' also often lead parents to believe there is an 'outbreak' when in fact, only one child in the class may be infected. Those parents might then treat their own child preventatively, which is not necessary or advised.  If a teacher identifies head lice in a child she/he may speak sensitively to the parent/carer privately or may ask a member of the management team to speak to the parent/carer.  Consideration should be given to the level of understanding of parents when English is not their first language and whether an interpreter is required.

St Benedict’s will helpfully provide parents with information about the detection and treatment of head lice infection in a proactive and systematic way by directing parents to the information on the website via newsletters at the start of the school year or when a general (rather than individual) problem has been identified.

Exclusions

The 1975 Regulations state that education authorities shall not exclude a pupil from school unless certain specific circumstances prevail. The Scottish Executive does not consider attendance of a pupil infected with head lice to constitute any of those specific circumstances.  Exclusion should not be used to manage a head lice infection.

Persistent or recurrent head lice infection

A distinction between re-infection and a continuing infection should be made. If a child still has head lice following full treatment, they should be taken by their parents or carers to a health care professional to establish whether it is a re-infection, or if previous treatment has not been effective.  If insecticide lotions are not applied properly or the second application is not given, the treatment will not be effective. Similarly, the 'bug busting' approach will not be effective unless parents continue the process for three weeks and have successfully removed all the head lice.  Re-infection can occur if a child comes into contact with someone else who has head lice. It is likely that a child will become re-infected unless the whole family, and all those who have been in close contact with the child, have been checked and, if necessary, treated.   If a child presents with consistent or repeated head lice infection despite information and support to parents to treat the recurring head lice infection, school staff should consult with school nurse and an agreement should be reached about what action to take next. If the family is experiencing difficulties which prevent the parents from treating head lice infection effectively, they may need additional or special help from the health service or local authority social work services to deal with the problem. The Children (Scotland) Act 1995 requires the local authority to safeguard and promote the welfare of children in need, with the assistance of other agencies, including health services, and any decisions taken should have the child's welfare as the paramount consideration.

Policy Reviewed:            January 2017