This fall, school district officials in Everett and elsewhere might be scratching their heads over what to do about a new nationwide policy regarding head lice.
On Aug. 1, the American Association of Pediatrics issued revised guidelines that state that healthy children should not be kept out of school because they have head lice. The AAP said they were changing the rules because lice don’t pose a health risk, are not a sign of poor hygiene and do not spread disease.
Everett School District’s policy is that nits must be manually removed from a child’s hair before the child can return to school. It remains to be seen whether Everett or other districts revise their rules this school year.
In the meantime, dealing with lice and other contagious childhood conditions can make you feel like you’ve gone buggy. Here’s a simple primer that might help keep your children keep free from ickies:
Lice
How do you get it? Lice are reddish-brown insects the size of a sesame seed that live in a child’s hair — they prefer clean hair — close to the scalp where they lay their eggs or nits. Lice can’t fly or hop but crawl from one head to another or spread when one kid with lice shares items such as coats, hats, helmets, pillows and brushes with another kid. Pets do not spread lice.
How does it manifest? Children who have lice suffer from itching, which can lead to sores on their scalp and skin. They might also feel like something is moving in their hair and may be cranky and have difficulty sleeping because lice are more active at night.
How do you treat it? The most important treatment is to comb the child’s hair daily for two to three weeks with a fine-toothed nit comb. A variety of lice medicine can also be applied and retreatment is often recommended. Suspect items such as hats and pillows can be washed in 130-degree water and put in the dryer for 30 minutes on high. Brushes, combs and hair ornaments can be soaked in ¼ cup bleach mixed with 1 quart of cold water for one hour.
How do you prevent it? Make sure your child does not share personal items with other kids. Regularly check your child’s hair and scalp. Keep long hair pulled back and don’t wash your child’s hair every day. Children should use their own bedding during sleepovers and preferably, children sleep apart or arranged head-to-foot.
Ringworm
How do you get it? Ringworm has nothing to do with worms. It’s caused by a fungus and can appear on the skin or scalp, the groin area (jock itch) or the feet (athlete’s foot). The fungus spreads through direct contact with an infected child or from a shower stall or gym mat or from animals. Cats are common ringworm carriers.
How does it manifest? Ringworm develops first as a small, round red spot and grows to the size of a dime when the center clears and lesions form a ring shape. On the skin, the edges become dry and scaly and crusty. On the scalp, hair turns brittle and breaks off easily. A bald patch might also develop. An aggressive case can become an abscess or the infection can spread to the lymph nodes or blood.
How do you treat it? Topical antifungal medications can be used on the skin. Scalp infections generally require oral antifungal drugs.
How do you prevent it? Don’t share clothing or other personal items. Children should wear sandals or shoes at the pool or gym. Keep an infected area covered. Pets with ringworm should go to the veterinarian, and have your child avoid petting an animal with bald spots. Good handwashing is also recommended.
Impetigo
How do you get it? Impetigo is caused by two types of bacteria, strep and staph. It’s spread by direct contact with a child who has impetigo, but the bacteria can also invade cuts, cold sores, insect bites and areas of eczema; sometimes scratching poison ivy can cause impetigo.
How does it manifest? Impetigo usually appears around the nose, mouth and hands as either large, clear blisters or as small blisters that crust over and look as if the child has been smeared with brown sugar or honey.
How do you treat it? Children can be treated with a topical antibiotic cream or with an oral antibiotic.
How do you prevent it? Frequent hand-washing and washing the infected areas with warm soap and water can help prevent the spread. Sanitize personal items. Cover infected areas with a clean bandage.
Resources
Snohomish County Health District: www.snohd.org
Centers for Disease Control and Prevention pages on lice and ringworm
MedlinePlus page on ringworm
KidsHealth (also provides information in Spanish) page on impetigo
Mayo Clinic page on impetigo
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