Got Lice? Come On In.

My kids’ school lets students with head lice stay in class. What a great policy!

Illustration of a redheaded child itching her head.
Robert Neubecker/Slate

This piece was originally published in Slate on March 26, 2014.

If you’re a parent, you’ve probably gotten the dreaded call from the school nurse, letting you know that your child has lice. It happened to our older daughter in kindergarten, and then again two years later when our youngest was in the same grade. Each head lice infestation was a mini nightmare: a work and school day lost to early pickup, chemical shampoos, vacuuming, and endless combing for nits (eggs). The days after, spent worrying that a stray louse might mean another call from the nurse and another day out of school. And that call always came: Your daughter has lice again. She’ll be waiting for you in the office. Last year we spent a couple hundred dollars on a professional lice remover, just because we could no longer face the hours every night we needed to spend nit-picking.

Our experience was not uncommon (though not everyone is crazy enough to call Lice Happens’ 24-hour “LiceLine”). At many schools, any discovery of live lice in a child’s hair warrants a phone call and the immediate removal of the child from school. At some schools, the child may return the next day if the parents have treated the child’s hair—that is, shampooed it to kill live lice. But in schools with “no-nit” policies, a child can’t return unless every last tiny louse egg has been combed from her hair—and schools may check returning students and send them home if any nits are found.

But then, this fall, everything changed. The schools here in Arlington, Virginia, have adopted what you might call a live-and-let-lice policy. No child will be sent home for lice or for nits. If a child has lice in her hair, the nurse will contact parents but send the child back to the classroom for the rest of the day. Parents are expected to treat the lice, but no one is checking in to enforce this expectation. No classes or groups will be screened for bugs. “No healthy child,” the policy reads, “should be excluded from or miss school because of head lice.”

When I told friends in other school districts about the shift in our school’s lice plan, their jaws dropped. That’s amazing, they said. Finally, they said. And, How can I persuade my school to do the same thing? But my friends are gross, so you may, understandably, have a different reaction to this news. Like, Ew, a school is letting a bunch of bug-covered, itchy kids rub heads in the classroom?

Sorry, your response is wrong. Arlington’s new stance on lice is being adopted by schools all over the country, encouraged by the American Academy of Pediatrics and the National Association of School Nurses. And it’s the right one. Lice are not particularly contagious, they hurt basically no one, and they’re not a public health risk. Lice don’t actually matter. It’s high time that squeamish parents and school administrators stop acting like they do.

Let’s start with many schools’ long-standing no-nits policies—policies that say kids can’t return to school unless every last tiny louse egg has been combed from their hair.
“No-nit policies don’t make any medical or scientific sense,” said Dr. Barbara Frankowski, professor of pediatrics at the University of Vermont. Frankowski, the lead author of the American Academy of Pediatrics’ study recommending changes in school lice policies, told me that, as any parent who has tried to remove nits knows, the eggs are firmly cemented to a child’s individual strands of hair. “They’re not going anywhere,” she said, “and pose no risk to other children.”

But even parents who understand the logic of not checking endlessly for nits get nervous about sending a child upon whom the nurse has just discovered live lice back to the classroom for the rest of the day. Shouldn’t those children go home so they won’t spread the lice to other kids? “If you find live lice during the school day, it’s likely that child has had lice for weeks,” said Carolyn Duff, the president of the National Association of School Nurses and the nurse at an elementary school in Columbia, South Carolina. “Allowing that child to remain in the classroom for a few more hours is not putting children at risk.”

After all, despite what you may think, “It’s not that easy to get lice!” Duff exclaimed. “They don’t fly. They don’t jump. They can barely crawl through your scalp. They can only spread through head to head contact, and children in schools don’t usually have head-to-head contact.” Even transmission through hats or hairbrushes is difficult—it can happen in families where such sharing is commonplace, but much less frequently in schools. (According to the experts I talked to, children are much more likely to spread lice during sleepovers or playdates, or at sleepaway camp.)

And even if they were highly contagious: The point that both the AAP and the NASN want to make is that it’s far more important to keep kids in school than it is to send them home in the hope of stopping the spread of lice. Because, again, lice don’t hurt anyone. “We’ve heard stories of kids missing weeks of school because of lice, even being held back a grade,” said Frankowski. “It’s unfair to kids. It’s unfair to parents who work or who have other difficulties that don’t allow them to go through hours of delousing.”

If your school still sends kids home for lice or (God forbid) for nits, what can you do? Find out who makes the decisions on those policies. Sometimes it’s a school-by-school choice, which means you can collect all the relevant scientific information and talk to your principal.
(Consider enlisting your school nurse, who almost certainly agrees with you, to help argue the case.)

Sometimes these policy decisions go through the school board. “I don’t want to disparage school boards,” said Frankowski. “But they don’t always make policy connected to what’s scientific—sometimes it’s just what’s easiest, or what they think parents want.” So you need to convince your school board that what parents want is a policy based on science, on expert recommendations, and on making life saner for busy parents.

Who would possibly disagree? Well, there are definitely parents who do. They can find support from Deborah Altschuler, the president and co-founder of the National Pediculosis Association, a nonprofit with a website touting the benefits of no-nit policies. In a phone interview, Altschuler told me that the school policy question was “a minefield” and said there is “a small club of people who follow the idea that there is some kind of scientific basis for allowing children with lice back in school.” She disagrees: “It’s a communicable disease that is easily transmitted among kids. We want to send kids to school lice- and nit-free, rather than lowering our standards to accommodate those who can’t do it for whatever reason.”

When I asked Altschuler about the AAP and NASN’s rejection of no-nit policies, she accused the organizations of being overly influenced by lice-chemical manufacturers. (For what it’s worth, Altschuler funds the anti-chemical National Pediculosis Association through sales of the LiceMeister® nit comb.)

Altschuler’s claim that lice transmit disease—that they are, themselves, a disease—is not supported by most scientists. In general, experts say, parents stress out way too much about head lice. “Head lice are a fact of life. It happens. It’s not a health issue, really,” said Marian Harmon, the school health bureau chief for Arlington County’s public health division who signed off on our schools’ new policy. “It’s not a sign of poor hygiene. It’s not an infection. It’s not a communicable disease. We treat it for the comfort of the child and the family.
It shouldn’t be escalated to such a high priority.”

What I wondered after talking with all these experts is whether lice even need to be treated at all. Treatment’s expensive, it can expose your kids to pesticides, it takes forever, and all it does is rid your child of a basically harmless pest—and then only until the inevitable next time it shows up. I certainly didn’t get any of the experts I spoke with to come right out and say that you can pretty much ignore lice. They all note that parents want their children to be lice-free, regardless of whether the lice pose any actual threat. “It’s an emotional issue!” allowed the NASN’s Duff. “It’s a live bug crawling on the head of your child.” But I wonder if emotions aren’t getting in the way of common sense. After all, as Frankowski wryly noted, “No one’s ever died from a head louse infestation.”

That’s what I often found myself muttering in years past, as my wife and I spent work days and weeknights washing and combing and washing and combing the heads of perfectly healthy children. In an educational environment in which intervention is the default, a message from a school district announcing that its new policy is for everyone to just relax is extremely welcome. My kids need to be in school to learn, and to play with their friends, and to build their bright futures, and to stay out of my hair. I don’t need them sent home because of the harmless things crawling in theirs.