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A child is contagious only while live lice are actively crawling in the hair. Nits (lice eggs) do not crawl, jump, or spread from one person to another.

Once an effective treatment has killed the crawling lice, the child is no longer considered contagious, even though nits may still remain attached to the hair.

 Note: Although nits are not contagious, they can hatch in 7–10 days if they remain viable. The newly hatched lice need another 7–10 days to mature. This is why follow-up treatment and rechecks are so important. 

Nits are simply eggs or empty egg casings attached to the hair shaft. While they may indicate a current or recent infestation, they are not what spreads head lice.

Key Takeaway:
Live crawling lice spread lice. Nits do not.

No. Finding nits alone does not necessarily mean a child is currently contagious.

Nits (lice eggs) do not crawl, jump, or move from one person to another. They are firmly glued to the hair strand by the female louse and remain attached until they hatch or grow out with the hair. A nit cannot move to another child's head on its own.

Live lice are often difficult to find during a routine dry head check because they move quickly away from light and disturbance. For this reason, school nurses often consider the location and appearance of nits, along with any other findings, when evaluating a possible infestation.

Nits found very close to the scalp (generally within about ¼ inch) are more likely to be viable because they require the warmth and humidity of the scalp to develop. Nits found farther down the hair strand are often empty egg casings or nonviable eggs from a previous infestation that have grown out with the hair.

Finding older nits alone does not necessarily mean treatment is needed, but nits found close to the scalp deserve a closer evaluation.

Key Takeaway:

Nits are glued to the hair - they don't spread lice. Live crawling lice spread lice.

Not necessarily. Nits themselves are not contagious because they cannot move from one person to another. However, removing nits can be helpful for monitoring progress and reducing confusion during future head checks.

Not everything that looks like a nit is a viable egg. After a louse hatches, it leaves behind an empty egg shell (casing) that remains firmly glued to the hair. These empty casings cannot hatch, cannot spread lice, and are not a sign that treatment has failed. They are harmless.

Children who have had a successful treatment - especially those who originally had a heavy infestation - may still have many empty egg shells (casings) attached to the hair. This is normal. Empty casings may remain attached as the hair grows and are often left behind even after careful combing because they are so small and lightweight. They will eventually wash out.

Finding empty casings alone does not mean a child still has an active lice infestation. If there is any uncertainty, examining a suspected nit under magnification can help determine whether it is a viable egg or an empty casing. If possible refer to the pictures included on the School Health page.

Key Takeaway:

Not every "nit" is a viable egg. Empty egg shells (casings) are common after successful treatment and do not mean a child still has an active lice infestation.

 Many professional organizations have moved away from no-nit policies because nits themselves are not contagious. However, schools should follow their own district or state policies. 

 Key Takeaway:
Always follow your district's head lice policy. 

No. Head lice are adapted to live on the human scalp, where they feed every 4 to 6 hours and depend on the warmth and humidity near the scalp to survive. Once off the head, they quickly become dehydrated and cannot recover.

Routine classroom disinfection, fogging, or spraying desks, floors, and furniture is not necessary for managing head lice. Head lice are spread primarily through direct head-to-head contact - not from classrooms, carpets, desks, backpacks, jackets, or other environmental surfaces.

In a well funded study of 2,230 children from a school with 118 classrooms, 466 students had lice. 14,033 lice were collected. When every inch of 118 classrooms were inspected,

"NO LICE WERE RECOVERED FROM THE CLASSROOM FLOORS".

Schools should always follow their own district's cleaning policies. If additional reassurance is desired, simple measures such as vacuuming fabric surfaces or using a sticky lint roller on shared fabric items may be reasonable.

Some schools also choose to lightly mist fabric items with a natural, non-toxic enzyme-based spray as an added peace-of-mind measure. This is optional and should never replace the primary focus of identifying and treating head lice on the child.

Key Takeaway:

Focus on the head - not the classroom.

Here are basic facts...

• Head lice are adapted to live on the human scalp. 
• They must feed every 4 to 6 hours. 
• Once off the scalp, they quickly become dehydrated. 
• They cannot recover after missing a blood meal. 
• This is why extensive environmental cleaning usually isn't necessary. 
• They can survive 24-48 hours, but off a head they just continue to starve and dehydrate, and die.

Key Takeaway:
Head lice survive on people - not in the environment.

• No. 
• Human head lice are species-specific. 
• Dogs, cats, and other pets do not carry or spread human head lice. 
• Families do not need to treat their pets. 
• 
  

Key Takeaway:
Human head lice live only on people - not on pets.

No. Head lice cannot swim, and they do not spread through pool water. The chlorine and constant movement of the water are not favorable environments for head lice.

Transmission occurs primarily through direct head-to-head contact, which can happen before or after swimming when children are playing together, taking group photos, sharing towels, or gathering closely around the pool.

Families do not need to avoid swimming pools because of head lice. Instead, encourage children with long hair to wear it in a braid or ponytail and avoid prolonged head-to-head contact whenever possible.

Key Takeaway:

Head lice spread through head-to-head contact - not through swimming pool water. 

 A child is contagious only while live lice are actively crawling in the hair. Once an effective treatment has killed the crawling lice, the child is no longer considered contagious, even if nits remain attached to the hair. The life cycle is 7-10 days to hatch, 7-10 days to mature. Lice eggs are not contagious, and they ONLY hatch very close to the scalp.

Simple prevention strategies can help reduce the risk of head lice, but no method is 100% effective.

Encourage children with long hair to wear it in a braid, ponytail, or bun during school, sports, camps, sleepovers, and other close-contact activities. Remind students not to share brushes, combs, hats, hair accessories, or headphones whenever possible.

During a known outbreak, encourage parents to perform occasional head checks at home. Early detection can make treatment much easier and help reduce the spread to others.

Head lice spread primarily through direct head-to-head contact. There is no need for excessive housecleaning, bagging belongings, or spraying classrooms.

Key Takeaway:

Focus on preventing head-to-head contact - not on cleaning the environment.

• Head lice are a nuisance - not a medical emergency. 
• Children should not be singled out or embarrassed. 
• Head-to-head contact is how lice spread. 
• Routine classroom cleaning is not necessary. 
• If teachers notice excessive scratching, they can discreetly refer the child to the health office. 
• Respect the student's privacy.

If a teacher notices frequent scratching or suspects a child may have head lice, they should discreetly refer the student to the health office rather than discussing it in front of classmates. Protecting the child's privacy helps reduce embarrassment and unnecessary stigma.

Remind teachers that head lice spread primarily through direct head-to-head contact during close play or activities. Routine classroom cleaning, separating desks, or removing classroom items is generally not necessary.

Teachers can also encourage simple prevention habits, such as avoiding head-to-head contact during group activities and reminding students not to share brushes, combs, hats, or hair accessories.

Key Takeaway:

Teachers should stay calm, protect the student's privacy, and refer suspected cases to the health office.

When notifying parents about a case of head lice, protect the student's privacy while providing calm, practical information.

• Never publicly identify the student with head lice.

• Share factual information without creating unnecessary alarm.

• Explain that head lice are a nuisance, but they do not spread disease.

• Encourage parents to check their own children at home if they have concerns.

• Provide trusted educational resources so families know what to look for and what to do if lice are found. (For example, the free downloadable Lice ID Card which has vital information a parent needs to know, in a nutshell. Printed version also available).

Clear, reassuring communication helps reduce fear and misinformation while encouraging parents to respond appropriately. When families understand the facts, they are more likely to treat head lice promptly and avoid unnecessary panic.

Key Takeaway:

Protect the student's privacy, communicate the facts, and help parents respond with confidence.

Begin by listening respectfully and encouraging an open, nonjudgmental conversation with the parent. Many parents are overwhelmed, unsure what to do, concerned about cost, or have received conflicting information.

• Listen to the parent's concerns without judgment.

• Share accurate information about head lice and available treatment options.

• Provide educational resources that explain how head lice spread and how they can be treated effectively.

• Encourage prompt treatment to help prevent the spread to others.

• Follow your district's policies for documentation, communication, and follow-up.

• Sometimes, the biggest fear is the expense, one of the least expensive options is a good lice comb (for example NitNabber or Nit Free Terminator), hair conditioner, and a good combout tutorial. There are short, easy to follow tutorials in this free downloadable video guide: LiceFreeKids.com/free-ebook).

Most parents want to do the right thing once they understand the facts and have a clear plan. A calm, supportive approach is often more effective than criticism or confrontation.

Key Takeaway:

Educate with empathy, encourage prompt treatment, and always follow your district's policies.

 The easiest resource is to offer a link to the free Video Guide E-book. 

Available at: LiceFreeKids.com/free-ebook

• Lice ID Card 
• Parent Video Guide 
• Will It Hatch? 
• Five Common Myths
• 1 Minute Video Answers To All The Most Common Questions

Key Takeaway:

Providing trusted educational resources helps families respond with confidence instead of panic.

Finding one live louse should be taken seriously, but it is not a reason to panic. One live louse confirms that the child has an active head lice infestation and the family should be notified.

• Notify the parent or guardian according to your school's procedures.

• Follow your district's head lice policy.

• Encourage the family to begin treatment promptly.

• Provide trusted educational resources so the family understands what to expect and how to manage the infestation.

Finding one live louse does not tell you how long the child has had head lice or how many lice may be present. During a dry head check, live lice can be difficult to find on a school check because they move quickly away from light and disturbance. Even finding a single live louse is definitely enough to confirm an active infestation, that needs to be treated.

Key Takeaway:

One live louse confirms an active infestation - follow your district's policy and notify the family.

Most children can return to class after they have been treated according to your school's or district's head lice policy. Current recommendations from many health organizations do not support excluding students until every nit has been removed.

• Follow your district's head lice policy.

• A child who has been appropriately treated is generally no longer considered contagious.

• Remaining nits do not necessarily mean live lice are present.

• Encourage parents to continue checking the hair and removing nits as needed over the following days.

Head lice are a nuisance, but they are not a health hazard or a sign of poor hygiene. Helping children return to class as soon as appropriate minimizes missed instruction while allowing families to complete follow-up care at home.

 Very often 1-2 more treatments 5-7 days apart, is suggested to make sure the all viable eggs, close to the scalp, are gone.

Key Takeaway:

Follow your district's policy—children who have been appropriately treated can usually return to class without waiting for every nit to be removed. 

The best way to know if a treatment worked is to look for live crawling lice—not just nits. It's common to continue finding empty egg shells (casings) or non-viable nits after a successful treatment.

• Follow your district policy re: checking before returning to school. (Some districts simply ask for 'proof', an empty treatment box, or clearance form from a lice service. Others might require the school nurse to do a 2nd lice check).

• Empty egg shells can remain attached to the hair long after treatment.

• Finding only empty casings (or nits that are off the scalp) does not mean the treatment failed.

• Ask parents to follow the treatment instructions carefully and repeat treatment if recommended for the product being used.

•If you do a 2nd lice check, after a student has been treated, and you see any sign of moving head lice, let the parents know they need to retreat. (What is most contagious is adult lice, the tiny hatched nymphs (babies) tend to just stay right on the scalp to mature).

Most treatments kill live lice but may not eliminate every viable egg. That's why follow-up is important. 

Key Takeaway:

Judge treatment success by the absence of live lice—not by the presence of remaining nits or empty egg shells.

Not necessarily. If a child has a moderate to severe case of lice (visible bug and eggs), it is a good idea to check siblings, and possible best friends at school, if time permits. Here are some recommendations for parents:

• Check everyone living in the household.

• Treat only those with live lice.

• Pay close attention to anyone who has shared close head-to-head contact.

• Possibly, do a quick follow-up lice check, 5-7 days later. Easiest way to check is with a good lice comb (NitNabber or Nit Free Terminator comb) and some conditioner/detangler.

Finding a child with head lice does not mean the entire family is infested. Careful head checks help identify who actually needs treatment while avoiding unnecessary expense, stress, and exposure to treatment products. 

Key Takeaway:

It's ideal for parents to check everyone in the household, but treat only those with live lice (hatched lice and/or lice eggs very close to the scalp).

Routine classroom-wide head checks are generally not recommended simply because one student is found to have head lice. Head lice are most commonly spread through prolonged head-to-head contact, not by being in the same classroom.

• Follow your district's head lice policy.

• Notify parents according to your school's procedures.

• Encourage families to check their own children at home if appropriate.

• Individual head checks may be appropriate if a child has symptoms or has had close head-to-head contact with someone who has live lice.

Classroom-wide screenings have not been shown to significantly reduce the spread of head lice and can be time-consuming. Focusing attention on children with symptoms or known close contact (siblings or best friends at school), is generally a more effective use of the school nurse's time.

Key Takeaway:

Routine classroom-wide head checks are usually unnecessary - focus on students with symptoms or known close head-to-head contact.

Routine cleaning or disinfecting of backpacks, headphones, helmets, costumes, nap mats, and similar items is generally not necessary. Head lice survive best on the human scalp, where they feed every 4 to 6 hours. Once off the head, they quickly become dehydrated and are unlikely to survive for long.

• Follow your district's head lice policy.

•  The normal cleaning routine is generally sufficient.

• Avoid unnecessary bagging, spraying, or disinfecting of classroom items.

• Focus on identifying and treating active head lice rather than cleaning the environment.

While it's reasonable to clean items that have had direct head contact as part of normal hygiene, extensive environmental cleaning has not been shown to reduce the spread of head lice. Time is better spent educating families, checking children with symptoms, and ensuring appropriate treatment.

Key Takeaway:

Routine cleaning is enough—focus on treating head lice, not disinfecting the environment.

The risk is considered low. Head lice are most commonly spread through direct head-to-head contact. While it is possible for a louse to crawl onto a personal item that has been in contact with the hair, this is not considered a common way head lice spread.

• Head-to-head contact is the primary way head lice are transmitted.

• Lice are attracted to a scalp, where there is food (blood). (They are NOT attracted to anything that doesn't smell like 'a juicy meal').

• Avoid sharing hats, helmets, headphones, brushes, combs, and hair accessories whenever possible.

• Routine cleaning of shared items is generally sufficient.

• Focus prevention efforts on reducing head-to-head contact.

• Lice have 6 tiny claws and can ONLY hold on to a human hair.

Sharing personal items is a good habit to discourage for many reasons, but it should not become a source of fear or unnecessary cleaning. Teaching children to bun or braid long hair, and avoid prolonged head-to-head contact remains the most effective prevention message.

Key Takeaway:

Head lice spread primarily through head-to-head contact - not by sharing hats, helmets, or headphones.

No. Head lice cannot jump, fly, burrow or swim. They don't have 'feet or legs' like other insects. They have 6 tiny claws, designed for crawling and gripping human hair.

• Head lice crawl from one person's hair to another.

• They spread most often through direct head-to-head or hair-to-hair contact.

• They do not jump from desks, furniture, or across a room, or from child to child.

• They are not carried through the air.

Many people imagine head lice behaving like fleas, but they are very different. Because lice can only crawl, close head-to-head contact is by far the most common way they spread. Understanding this helps reduce unnecessary worry and keeps prevention efforts focused where they matter most.

Key Takeaway:

Head lice cannot jump or fly - they spread by crawling during head-to-head contact.

No. Head lice are not caused by poor hygiene or an unclean home. Anyone can get head lice, regardless of how often they bathe or wash their hair.

• Head lice feed on human blood—not dirt or oils.

• They can affect people of all ages and backgrounds.

• Clean hair and dirty hair are equally suitable for head lice.                                                           

• Lice just need 'a bridge or a ladder' to get to a scalp where they can feed.

• Having head lice is not a sign that a child or family is unclean.

One of the most important roles of the school nurse is helping reduce the stigma surrounding head lice. Reassuring families that head lice are a common childhood nuisance - not a reflection of cleanliness - can ease embarrassment and encourage prompt treatment.

Key Takeaway:

Head lice have nothing to do with personal hygiene—they can affect anyone, anytime.

Many parents mistake dandruff, hair casts, lint, or other debris for head lice or nits. Helping families understand what to look for can reduce unnecessary worry and prevent unnecessary treatment.

• Live lice are small, fast-moving insects that crawl—they do not jump or fly.

•  The shape of a nit/egg is sometimes described as "tear drop shape, with what looks lie a tail". They are typically tan or brown.

• Viable nits are tiny eggs firmly attached close to the scalp and cannot be brushed away.

• Empty egg shells (casings) are often found farther from the scalp after the egg has hatched.

• If you're unsure what you're seeing, encourage parents to seek guidance rather than guessing. One option is offer a link to the Lice ID Card, or a free video guide: LiceFreeKids.com/free-ebook. 

Correct identification is the first step in making good treatment decisions. Explaining the difference between live lice, viable nits, and empty egg shells helps families avoid unnecessary panic and focus on treating active infestations.

Key Takeaway:

Accurate identification helps families avoid unnecessary treatment and respond with confidence.