Just Say No to Lice, but not to Nits

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Lice inspections have become a fact of life in schools and children's programs across the country, with children required to leave school and other programs if they have any signs of lice or nits (egg casings). But nits can contain a developing head louse, which is contagious, or can be an empty shell, which would not be contagious. With an estimated 6-12 million lice cases in the U.S. every year, lice policies affect millions of families and thousands of schools and youth programs.

In this study of 1,729 children enrolled in two elementary schools, 5 percent had head lice. The study focused, however, on the children who had nits, but no lice.

According to school policy, all children found to have lice had to be picked up from school by their parents and could not return to school without proof of treatment. However, of 50 children with nits but no lice, only nine (18 percent) became infected with lice during the following two weeks. The total number of nits that a child had in his or her hair did not predict whether a child would become infected. Even more surprising, treatment for lice did not affect whether the children with nits actually ended up with lice.

The authors conclude that many children who are not infectious and will not themselves get lice are being removed from schools that have a "no nits" policy.  In addition, requiring treatment for nits may be inappropriate, since there was no evidence that it decreased the likelihood of subsequent infestation. (Although not mentioned in this article, lice treatment involves a highly toxic chemical which is unpleasant to use and presents some risks to children's health.)  Although this study is focused on schools, it has clear implications for other children and youth programs: There is no need to exclude (and stigmatize) children who have nits if they don't have lice. 

Diana Zuckerman, Ph.D., is executive director of the National Center for Policy Research for Women and Families, based in Washington, D.C. Contact: dz@center4policy.org.