The School Nurse Lice Battle Plan

What Are Head Lice?

Head lice are tiny, insects that live only on the human head. They are wingless critters and feed from the blood supply near the surface of skin on the scalp. A single, adult louse (single bug) is about the size of a sesame seed like the ones on the top of a hamburger bun. The louse’s egg, a nit, is about the size of a small flake of dandruff and is attached to the shafts of hair.

How Did You Catch Head Lice?

Head lice most commonly spreads by head-to-head contact. Some describe lice like an illness referring to lice as “contagious.” You can “catch” lice if your head comes into contact with a person who has lice and a female louse (single lice) crawls onto your head. Head-to-head is the most common way of “catching” head lice. Other possible ways you “catch” head lice are:

  • Sharing combs or brushes
  • Sharing hats or hair ornaments (hair ties, barrettes, scrunchies, and hair pins)
  • Sharing jackets with high collars / hoods
  • Sharing Scarfs
  • Sharing headphones
  • It is possible to “catch” lice from furniture, bedding, towels and even car upholstery.

High-Risk for Head Lice?

The most common group are children aged 3-11 years of age. These preschool and elementary school-aged students who have the highest risk of “catching” head lice are not always aware of the behaviors that result in transmission. Lice is not always “caught” at schools. Home-schooled children are also at risk as well as summer-time group campers. The location of contraction is not the concern; the behaviors of the child are. Avoiding hugs and sharing headwear from classmates and friends seems anti-social but actually it’s “anti-lice.” Family members of school-aged children are also at risk.

Symptoms of Head Lice?

Symptoms of head lice to watch out for are:

  • Frequent Itching of the scalp
  • Feeling like something is crawling on the head (tickling sensations)
  • Small sores from scratching
  • Small sores on the back of the neck (long hair)
  • Small “dot-like” or flake-like partials seen in the hair
  • Actually seeing a bug in the hair
  • Trouble sleeping (lice move better on a still head rather than one moving around)
  • Symptoms are usually not noticeable until well into the infestation stages

Head Lice Treatment

There are several head lice treatments available. But, the School Nurse Head Lice Battle Plan is the most comprehensive plan that I know of.

Day 1 - Battle #1:

  1. Go Shopping
  2. Attack #1 - Use a Pediculicide (Lice Shampoo)
  3. Attack #2 - Olive Oil Treatment
  4. Attack #3 - Clean the Environment
  5. Attack #4 - Nitpicking

Day 2 - Battle #1.1: (Do Not do this day unless you are Pediculicide-Free).

  1. Attack #1 - Olive Oil Treatment
  2. Attack #2 - Nitpicking

Day 5 - Battle #2

  1. Attack #1 - Olive Oil Treatment
  2. Attack #2 - Nitpicking

Day 9 - Battle #3

  1. Attack #1 - Olive Oil Treatment
  2. Attack #2 - Nitpicking

Day 13 - Battle #4

  1. Attack #1 - Use a Pediculicide (Lice Shampoo)
  2. Attack #2 - Olive Oil Treatment
  3. Attack #3 - Nitpicking

Day 21 - Battle #5

  1. Attack #1 - Olive Oil Treatment
  2. Attack #2 - Nitpicking

It’s as simple as that!

Some of the major treatments for head lice are described below.


There are both over-the-counter (OTC) and prescription head lice treatments.

Pyrethrum (RID) and Permethrin (NIX) both work on the nervous system of the louse. Depending on the stage of development of the nit will determine the effectiveness of either of these Pediculicides.

Use extreme caution or avoid either of these products if you are allergic to chrysanthemums, daisies, mums or flowers in the asteraceae family. I would even check with an MD if you had an allergy to any flower.

Pyrethrin is a pesticide that is derived from chrysanthemum flowers. It is approved for use in people 2 years old and older. Do not use pyrethrin if you are allergic to chrysanthemums or ragweed.

Permethrin (Nix) is a synthetic pesticide that is similar to pyrethrin. It is approved for use in people 2 months old and older.

The extract from the Chrysanthemum plant containing pyrethrins is called pyrethrum. Pyrethroids are synthetic, or man-made, versions of pyrethrins. ... One important difference between pyrethrins and synthetic pyrethroids is the behavioral effect they have on insects.

Prescription lice treatments may also include other chemicals.

ULESFIA® (benzyl alcohol) Lotion – Nurse Kevin does not suggest the use of this chemical. For one, it does not have ovocidal activity. This mean that the nits…the lice eggs…will survive the treatment. Will it kill the live bugs? Yes! Will it kill the eggs? No.

(Ovide) malathion topical (Pronunciation: MAL a THYE on TOP i kal). Nurse Kevin does not like this either. It works good for starting camp fires because it is very FLAMABLE. Will it kill lice? Sure will! So will Kerosene (no! don’t get any ideas).

Kwell or Lindane is definitely not a favorite of Nurse Kevin. This is a last resort kinda deal. Seizures and death can happen in people who use Lindane Shampoo too much or too often.

Do Not Use

Don’t use kerosene on your head and especially on your children’s heads. You may not think folks could be so desperate…but they can be. And, believe it or not, this is one of the “old ways” that were used “back then.”

Never use any flammable products.

Don’t use pet flea / tick shampoos or treatments (shouldn't have to explain why on these).

House Keeping

  • It isn’t necessary to treat your home or your belongings with chemicals and insecticides. Lice are like any other living critter; they will die within 48 hours if they do not have a blood meal.
  • Wash in hot water (at least 140F (or 60C)) and dry with heat for at least 20 minutes in a dryer all the clothing that has been worn in the past 72 hours.
  • Wash in hot water (at least 140F, (or 60C)) and dry with heat for at least 20 minutes in a dryer all the bed linens and other covering (like throw blankets).
  • If it cannot be washed and dried, bag it up and leave it for a few days. The lice will die.
  • Vacuum all chairs, sofas, headboards, and anything that may have come into contact with anyone’s head. Don’t forget the car upholstery.
  • Boil in water all of your combs, brushes, and hair ties. If the plastic will not tolerate the high temperatures, soak them in a 10 percent bleach solution for one hour. Another option (my vote): Throw them away and get new ones. Again, you can just bag / box them up and leave them for a week or so.

And that's it in an nutshell. Now...for the "rest of the story," visit




RID contains pyrethrum and NIX contains permethrin. But what does that mean? Is one better than the other at killing lice and what about all those eggs?


You’ve found lice on a head in your home. WHAT THE HECK!? Okay, don’t sweat. You’ve got this. Read this LICE BATTLE PLAN and get them bugs gone!!


Learn more about lice. You have an 2-3% chance of lice coming into your home this year. The more you know about these pests the better prepared you’ll be.

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