According to the Department of State Health Services of Texas, “there is no law in Texas that addresses excluding children with head lice from school. DSHS does not have authority to impose a set policy on the exclusion or inclusion of students with head lice in school districts. However, DSHS does urge school districts to ensure that its policies and procedures do not cause children to miss class unnecessarily. In addition, school districts’ policies and procedures should not encourage the embarrassment and isolation of students who suffer from repeated cases of head lice.
Lice are not a public health threat. They do not carry disease. Therefore, the Department of State Health Services does not monitor or track cases of head lice. It is up to each school district to create head lice policies and procedures, if they so choose…and some do. Talk to the school nurse or someone else in charge to find out what the school policy and procedures are in your school district. Refer to the topic "Setting Policies for School Districts" that appears on this page for policy suggestions.
According to a research article published by the American Academy of Pediatrics (AAP) in 2015, "No healthy child should be excluded from or allowed to miss school time because of head lice or nits. Pediatricians may educate school communities that no-nit policies for return to school should be abandoned." Information for schools is located at the end of the research article. (Source: American Academy of Pediatrics)
Notice to Parents
During the 2017 Legislative Session, Senate Bill 1566 passed into law and states the following: "The board of trustees of an independent school district shall adopt a policy requiring a school nurse of a public elementary school who determines or otherwise becomes aware that a child enrolled in the school has lice shall provide written or electronic notice of that fact to:
(1) The Parent of the child with lice as soon as practicable but not later than 48 hours after the administrator or nurse, as applicable, determines or becomes aware of that fact; and
(2) The parents of each child assigned to the same classroom as the child with lice not later than the fifth school day after the date on which the administrator or nurse, as applicable, determines or becomes aware of that fact.”
Additional information about confidentiality is included within the law.
A “no-nit” policy is one that excludes students from school based on the presence of lice eggs, whether or not live lice are present. The Department of State Health Services (DSHS) does not recommend a “no-nit” policy. We do recognize, however, that school districts may adopt one as a local option.
Head lice infestation is a social issue not a health threat. “No-nit” policies place a disproportionate amount of emphasis on head lice management than on real health concerns, which should be a higher priority. This over-emphasis can lead to unproductive use of time by school staff and parents, missed classes, unnecessary absences, and parents missing wor
Additional information on “no-nit” policies for schools can be found through the American Academy of Pediatrics and the National Association of School Nurses.
Setting Policies for School Districts
Creating school district policies and procedures should be a joint effort with the district’s school health advisory council, local health care providers, district administrators, school nurses, parents, and other stakeholders. Remember, there is no law in Texas that addresses excluding a child with head lice from school. School districts and campuses can create their own guidelines by developing written policies that:
- Facilitate efficient and consistent implementation by all campuses,
- Protect school nurses, teachers, and other school staff,
- Create peace of mind for administrators and parents, and
- Ensure all children are treated in a fair and equitable manner.
Considerations for Policy Development
When developing a policy, consider the following:
- Screening procedures – staying away from unwarranted mass screenings that disrupt student and teacher class time and take away from the nurses’ ability to address the needs of children who are sick and those with special healthcare considerations. Check the AAP study on head lice for guidance: http://pediatrics.aappublications.org/content/135/5/e1355
- Parent/Guardian Notification – including a lice information fact sheet or brochure with the student handbook at the beginning of the year and notification when there is an infestation confined to a specific classroom. Review Senate Bill 1566 for more information on head lice notification. Check the AAP study on head lice for Management on the Day of Diagnosis for guidance: http://pediatrics.aappublications.org/content/135/5/e1355
- Exclusion Protocol – including what happens if the parent is not home. Check the AAP study on head lice for Management on the Day of Diagnosis for guidance: http://pediatrics.aappublications.org/content/135/5/e1355
- Readmission criteria – consider stating that they should use an FDA-approved, medicated treatment. Check the readmission criteria stated in the AAP study on head lice for guidance: http://pediatrics.aappublications.org/content/135/5/e1355
- Definition of and district response to excessive absences – may help address the issue of parents who cannot keep their children free of lice. Texas Education Agency has criteria for excessive absences.
You may also want to address the following:
- How the school/district may want to address those families that cannot afford to pay for the treatment to rid their child of lice.
- Care in the classroom to prevent the spread of head lice.
- In-service training for school staff.
DSHS Infectious Disease Control Unit
Killeen School District
“Please reference information on head lice provided from the Texas Department of State Health Services on the School Website under Nurse Provided Information.
While we understand that lice can be a nuisance and can be expensive to clear, due to privacy regulations, we will not divulge any information that could potentially expose a child as a carrier of lice.
Children with live lice will be sent home for treatment. The next day, students will check in with the school nurse who will inspect hair for live lice. If no live lice are found, the student will be allowed to return to class. While nits could produce live lice, a student with nits is not excluded from school as long as live lice are not found in the child’s head.
KISD (Killeen Independent School District) does not promote random, mass screening of students for lice.
Students with live head lice may return to class after treatment and re examined for head lice.” (Source: KISD Student Handbook)
Copperas Cove Schools
“Copperas Cove ISD sends alert letters in the event of a high percentage of students infested in a classroom.
In Texas, there is no law that addresses lice so each school district develops its own guidelines. However, the Texas Department of State Health Services does urge schools to ensure its policies don't cause children to miss class unnecessarily or don't encourage embarrassment for those affected.
According to Copperas Cove ISD, the district developed the lice prevention, control and Treatment Protocol based on recommendations for American Academy of Pediatrics and an update to the Texas Administrative Code.
According to the American Academy of Pediatrics, head lice are not a health hazard and are not responsible for spreading a disease.” (Source: Copperas Cove ISD)
In early February 2017, parents circulated a petition as a backlash to the lenient lice policy that the district had implemented.
Petition to Copperas Cove School Board Feb 2017:
“The spread of lice in the schools has become an epidemic this year. The fact that the schools have no policies to combat this at all is not helping the situation. While we understand that no child should be embarrassed and many families have two working parents and cannot afford for people to be at home for lice when they do not carry disease, many children are allergic to these bugs and they do bite other children badly. There must be a compromise. We must be able to send a letter home letting parents know when children are attending school with lice and maybe have a special classroom where the children can go (such as the nurse's office) and do their work while they are infected so as not to infect other children. (Source: Change.org)
“The Centers for Disease Control (CDC), the National Association of School Nurses (NASN), the Texas Department of State Health (TDSH) and the National Association of Pediatrics recommend that students diagnosed with live head lice do not need to be sent home early from school; they can go home at the end of the day, be treated, and return to class after appropriate treatment has begun. Temple ISD Lice Screening Procedures are based on this recommendation.
Children should be assessed for lice only when demonstrating symptoms of head lice. School nurses will screen for lice on an individual student basis. Privacy shall be observed to avoid embarrassment and maintain confidentiality guidelines. In addition, educating and supporting the child and parents with factual information is an essential part of the head lice management process.
Entire classroom screenings, campus-wide assessments and “routine” lice screenings are generally not productive and result in a potential loss of privacy and decreased instructional time. Therefore a mass screening process will not be routinely used. A group screening may be performed on occasion at the request of the campus administrator when there is concern of an infestation in either a classroom or a specific grade. Parent permission is not needed to examine a student for possible head lice. Head lice are a common nuisance and effort should be made to avoid the spread of the condition.
A parent /guardian of a student with lice shall be notified by phone, in person, or by written message and the parent/guardian is instructed that the student should be treated with an appropriate lice elimination shampoo before returning to school. Information about lice detection and elimination is sent home with the student/parent. It may be appropriate to have the student's head checked upon return to school. Follow-up head checks may be done by school trained personnel to confirm lice management efforts. If future checks reveal an increased number of nits present or it is obvious to the screener that the student's hair has not been treated, the parent/guardian will be contacted for follow-up support.
Active head lice are indicated by the presence of live lice anywhere on the head and/or yellowish nits near the scalp. Students with clear nits (egg sacks) down the hair shaft, as determined by the campus nurse/screener, will not be excluded from school. These egg sacks are empty and are of no risk to the student or others.
It may be appropriate in the professional opinion of the school administrator and school nurse to consider a general parent/guardian notification for a high number of identified cases of head lice. These letters are sent at the discretion of the campus administrator with input from the Health Services Department.
Note: the presences of severe infestations of untreated head lice can be disruptive to the educational setting.
In the rare occasion that a student has either: 1) Chronic head lice infestation 2) Severe head lice infestation; and it is determined that Exclusion needs to be considered, the school administrator and school nurse will consult regarding implementing Exclusion. This measure will only be taken with careful consideration. A written notification will be provided to the parent and phone contact will be attempted and documented. The district's exclusion protocol is designed to protect the integrity of the school day, and to minimize embarrassment and unnecessary isolation of students with head lice. Students who have evidence of chronic/severe lice may be sent home from school at the discretion of the campus administrator and/or campus nurse so that treatment may begin as quickly as possible. The nurse shall provide the student’s parent/guardian information regarding appropriate treatment and prevention of head lice transmission.
Readmission Criteria: Students who have been excluded from school for lice shall be readmitted to school upon:
- Examination by the campus nurse prior to readmission to the classroom. Parents need to accompany their child to the clinic prior to readmission and be present during the scalp examination. The nurse will assess for effectiveness of treatment and will readmit the student to the classroom when no signs of live lice are present. Signs of improvement may include absence of live lice and a reduction in the amount of nits present. It may be appropriate to monitor progress of lice management over a period of time; the goal is to support the family in eradication of the lice infestation.
- Receipt of a statement signed by parent or guardian indicating that the student has been treated for head lice. The document should include the date of treatment, and name of treatment applied.
- A second statement signed by a parent or guardian indicating that the student has received a second treatment should be submitted to the school nurse within 7-10 days from the initial treatment. The document should include the date and name of treatment applied.” (Source: Temple ISD)
“Head lice, although not an illness or a disease, is very common among children and is spread very easily through head-to-head contact during play, sports, or nap time and when children share things like brushes, combs, hats, and headphones. If careful observation indicates that a student has head lice, the school nurse will contact the student’s parent to determine whether the child will need to be picked up from school and to discuss a plan for treatment with an FDA- approved medicated shampoo or cream rinse that may be purchased from any drug or grocery store. After the student has undergone one treatment, the parent should check in with the school nurse to discuss the treatment used. The nurse can also offer additional recommendations, including subsequent treatments and how best to get rid of lice and prevent their return.” (Source: Waco ISD)
LiceDoctors is available day or night to treat your family with an all-natural lice plan that is guaranteed to work; your child will be admitted to school the next day. Call LiceDoctors at 800-224-2537 for quick, safe, and affordable lice treatment in the privacy of your own home.