School returns next week, as does the possibility of children catching head lice from their classmates.

Dr. Rachel Crudgington, pediatrician in The Longstreet Clinic’s Oakwood office, said she sees more children with lice during the school year, when they are in close contact with each other.

There were about 1,000 cases of lice last school year out of Hall County’s nearly 26,000 students, according to  Mamie Coker, registered nurse and health services coordinator for the Hall County School District. Many of those cases were repeat cases.

Priscilla Collins, chief professional services officer for Gainesville schools, did not know the exact number of lice cases in Gainesville City School System last school year, but they were “not significant.”

Both Collins and Coker said lice treatment is challenging for parents, and repeat cases can happen despite a parent’s best effort to treat.

“I’ve been a school nurse for 20 years, and we keep wishing they would come up with a better, more effective product to treat it that wasn’t so costly, or so toxic that the treatment would be worse than the lice itself,” Coker said. “I just wish we had better treatment options than what we have.”

However, lice are not dangerous, though they can irritate the scalp and cause itchiness.

If a child is found with lice at school, the local districts have guidelines for treatment. In Hall County, if a child is found with live lice or “viable nits,” the child is sent home.

In Gainesville City Schools, if a nurse finds live lice on a child, the parent will be asked to come get the student and perform a treatment at home.

Once that is done, the child may return to school.

“The nurse will need to check the student’s hair upon their return, and our goal is to see an improvement in the condition of the head — no live lice and less or no nits,” Collins said.

Gainesville asks that children do not miss more than one day of school for a case of lice, but if the school nurse concludes no treatment was performed at home, the child will not be allowed to stay in school.

Crudgington advised parents to check their children about once a week if they know lice is spreading in their school or neighborhood.

If lice is found, the best treatment is likely available at the drugstore without a prescription.

“We advise parents to talk to either their primary care physician or a pharmacist,” Coker said. “There are over-the-counter treatments like Nix and RID. You may have heard that there’s potential resistance because of overuse of these medications, but we encourage parents to follow instructions and use them properly.”

Crudgington said she typically recommends families try an over-the-counter product first.

There are available prescription products, but they are much more expensive.

“The new one on the market is called Sklice,” Coker said. “However, it’s very expensive, and a lot of people don’t have insurance. Even with copay, it’s cost-prohibitive, but it is effective.”

The cost of Sklice starts at $280. Coker said there are coupons available online for the one-time-use lotion.

Not all health insurance policies cover lice removal treatments. In some cases, lice removal services may be deductible on a personal income tax return. Over-the-counter treatments available at local drugstores cost anywhere from $10 to $25 per kit.

Coker said she’s heard of several alternative treatments that have been effective for parents, such as using Cetaphil lotion, mineral oils and suffocation methods like wrapping the child’s head in plastic wrap to suffocate the lice.

“We do not recommend some of the methods you’ll read on the Internet,” she said. “...We don’t recommend using mayonnaise, because it has salmonella when it gets to room temperature. And you have to be careful putting plastic wrap over a child’s head.”

Dave Palmer, public information officer for the Hall County Health Department, said using the medicated lotions or shampoos is important, but so is combing the child’s hair to remove the nits, or eggs. Most topical medications only kill the live lice, not the eggs.

Palmer said there are some ways parents and classroom teachers can prevent the spread of lice.

“Lice don’t fly — they crawl,” he said. “Typically, they spread through contact, either with somebody who has head lice or with their coat, the furniture they sit on or bedding.”

He said if a child has lice, parents and siblings should be careful not to rest their head on the same upholstered furniture or to hang their coats next to each other. Linens and bedding should be washed in hot water.