Dealing with lice and ring worm

The start of a new school year is the perfect time to discuss lice and ring worm. These parasites may gross you out—I admit that just writing about them makes me itch—but both are very common, especially in schools. By the end of the academic year many parents will become reluctant experts in their treatments.

Fortunately, even though both conditions are annoying, in most cases they are harmless and can be effectively eliminated.

Head lice are small insects that are most often found among children between the ages of 3 and 12. With nearly 12 million infestations per year in the United States, it has been estimated that one out of every 10 children will acquire head lice at some point. Girls are infected more often than boys.

In our society where extreme cleanliness is the norm, many parents think that lice is a sign of poor hygiene, but that’s not true. Lice are not transmitted by being dirty. Insetad they are passed on by direct contact with someone who is infected or by contact with their infected belongings, like a hoodie or a catcher’s mask, since a louse (singular for lice) can live for up to two days outside of the hair.

Signs of the bugs

Lice are usually found on the head around and behind the ears and near the neck line. They are rarely found in eyebrows or lashes. They hold tightly to the hair shaft with claws and can be difficult to remove. They feed on human blood, so one of the first signs of infestation can be itching. Children may also have a tickling feeling of something moving in their hair. At that point it’s best to take a look and see if there are any visible lice. Lice eggs are often mistaken for dandruff, but they don’t shake loose from the hair shaft easily since they are fixed in place by a glue-like substance. Once they hatch the louse grows to 2-3 mm long (about the size of a sesame seed) and is tan to grayish white. It may be seen moving within the hair. The females will continue to lay eggs and the lice will multiply until they are killed.

If you think you see lice in your child’s hair, call your doctor. Treatment is usually very effective even with over-the-counter medications. It’s important to follow specific guidelines for getting rid of lice completely, though, because the child or other family members can become re-infected if their clothing, hair brushes and bedding aren’t also treated.

Most schools have a policy on head lice that tells parents when children may return to school, so be sure to check. Many schools require the eradication of the infestation before returning.

Not a worm at all

Ring worm is another common skin condition and, despite the name, it has nothing to do with worms. It’s actually caused by a type of fungus whose relatives cause everything from athletes foot to jock itch. The poorly named ring worm is known as tinea corporis in the medical community, or tinea for short.

Tinea looks like a reddish to brownish raised or bumpy patch of skin. The edges are defined and the center may be lighter, which gives the appearance of a"ring.” Sometimes the patches itch. Tinea is spread by skin-to-skin contact and also by contact with contaminated items like hair brushes, towels, locker room benches, wrestling mats, etc. It can be contagious even before the rash shows up, which makes it hard to avoid.

Although it’s only mildly contagious, some people catch it more easily than others. An infected person can spread the fungus around their own body by scratching the rash and then touching uninfected skin. Some unfortunate people catch it over and over again.

Most doctors can diagnose tinea on sight, but the fungus can also be seen under a microscope or under special light if necessary. Treatment generally consists of ointments or lotions, but if the infection is widespread, oral medications may be prescribed.

What to do

There are steps you and your children can take to avoid these parasites.

Tinea likes warm, moist places, so avoid ring worm and other kinds of tinea by wearing shoes in the locker room and sitting on a towel at the poolside, sauna or in any warm, moist public place.

To avoid both lice and ring worm, teach your children to never share clothing (that includes dress up areas at school), sports equipment (like helmets), towels, sheets or shoes. Remind your child of this rule from time to time throughout the school year and, hopefully, your family can avoid these common conditions.

Dr. Lisa Thornton, a mother of three, is director of pediatric rehabilitation at Schwab Rehabilitation Hospital and LaRabida Children’s Hospital. She also is assistant professor of pediatrics at the University of Chicago. E-mail her at

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