Kids With Head Lice Should Stay at School: New Guidance

There is no need to send kids with head lice home from school, according to new guidance from the American Academy of Pediatrics (AAP).

In the United States, head lice are most common among preschool and elementary school-aged children and their household members. Anywhere between 6 and 12 million infestations occur every year among children ages 3 to 11, according to the Centers for Disease Control and Prevention (CDC).

The AAP's recommendation to keep children with head lice at school, issued on September 26, updated its previous guidance from 2015. The AAP noted that head lice are neither a health hazard nor a sign of poor personal hygiene, and are not known to spread any disease.

Despite this, significant stigma has developed around head lice in high-income countries, leading to "children and adolescents being ostracized from their schools, friends, and other social events," said the group. As a result, head lice can be "psychologically stressful" for the affected person.

Children checked for head lice
Here, parents check children's hair to see if they have head lice at a school in Scheveningen, the Netherlands, on August 31, 2016. There is no need to send kids with head lice home from school, according to new guidance from the American Academy of Pediatrics (AAP). REMKO DE WAAL / Stringer/AFP

Missing school because of head lice or nits can also create an academic disadvantage for healthy students. Along with the CDC and the National Association of School Nurses (NASN), the AAP has advised that "no-nit" policies, which require a child to be free of nits before returning to school, should be abandoned.

"Such policies would have negative consequences for children's or adolescents' academic progress, may violate their civil rights, and stigmatize head lice as a public health hazard," said the AAP.

Many nits are very unlikely to hatch and become lice, or may actually be just empty casings—misdiagnosis is very common during nit checks conducted by nonmedical staff, according to the CDC. Nits are also unlikely to transfer to other people because of how they adhere to hair shafts.

Meanwhile, head lice screening programs in schools are not cost-effective and have not been shown to significantly affect the incidence of lice in school settings, according to the AAP. A student found to have an active infestation has likely had it for four to six weeks already, since that is the usual time needed to start itching from an allergic reaction to lice saliva.

"Given this duration of exposure and that the child or adolescent poses little risk to others from the infestation, he or she should remain in class but be discouraged from close direct head contact with others," the AAP said.

When a student is diagnosed, school staff should maintain confidentiality to minimize social stigma, added the association. The staff should notify their caregiver through a phone call or a note sent home with the student, using "common sense and calm" when determining how "contagious" they may be.

Newsweek reached out to the American Academy of Pediatrics for comment.