I want to preface this post with the caveat that as registered nurses we are not able to diagnose any condition but we can perform our examination and give recommendations as to what we believe the issue might be. The students would always have to follow up with a doctor or nurse practitioner for diagnosis and treatment.
A Wood’s Lamp is an ultraviolet light or “blacklight” that comes in many sizes and shapes and can be used to check for certain skin conditions, head lice, or corneal abrasion (which we would not be doing at school as that is a procedure to be performed by a doctor). The Wood’s lamp was invented in 1903 by physicist Robert Wood. It was used starting in 1925 to diagnose fungal infections in the hair and has found practical use ever since. It is frequently used by estheticians and dermatologists to examine skin and skin conditions.
What would we use the Wood’s lamp for in the health room?
Head lice/nits: live nits (lice eggs) will glow white under the woods lamp. empty nit cases will glow grayish. This can help determine if the student is suffering from dry skin or hair product flakes (will not glow under the lamp), or if the white spots in the hair are nits. Live lice can be seen without the light but will also glow.
Ringworm and Tinea Capitis (ringworm on the scalp), Pityriasis Versicolor or Tinea Versicolor (fungal skin infection) and other fungal skin infections: While it seems fairly obvious what ringworm looks like through the naked eye (red circle, clear in the center, maybe flaky), the Wood’s lamp can help confirm that the student needs to cover the area and see a doctor as soon as possible. This fungal infection on the skin would glow bright blue-white or yellow-green under the lamp. While it might be beneficial to know ringworm vs other fungal infections, again, we can’t diagnose so a generic “likely fungal, need doctor to evaluate and treat” is sufficient. No need for specific diagnoses.
Scabies: Will fluoresce under woods lamp. No diagnosis can be made but strong suspicion can be suggested and recommend seeing doctor for evaluation and treatment.
Bruises: Bruises don’t glow but you can see the demarcation of the bruise and often get a better idea of the shape and size under the lamp if needed. Honestly, I would be unlikely to be examining a bruise that closely in a school health room setting. If anything, I would be using this knowledge to determine something like if it is a bruise or if it is a stain on the skin.
Urine: Glows yellow/green under the blacklight. Again, I would be unlikely to be determining urine stains vs other fluid stains in a school health room setting but the need for this knowledge could come up for some reason.
Germs: a blacklight or a Wood’s lamp can show poorly or unwashed hands! A great educational tool for students to show the importance of washing hands and how germs are spread.
A Wood’s Lamp can also show a corneal abrasion with the use of Fluorescence strips, however, a school nurse can not perform that examination and would require a doctor, PA, or NP to perform, diagnose, and treat.
- Have the client position themselves comfortably.
- Explain to the client that the Wood’s light has the same characteristics as a typical black light; the room will be darkened, and the black light will be turned on to examine for fluorescence of the lesion in question.
- Have all lights turned off.
- Ideally with a real Wood’s Lamp (as opposed to a blacklight) the lamp should warm up for approximately 1 minute before using to have the best visualization.
- Hold the Wood’s light approximately 6 to 8 inches from the lesion in question, and observe the characteristics of the fluorescence of the lesion.
Where can you get your own Wood’s Lamp?
I got a little rechargeable one from Amazon found here (click the picture to link to the product):
Amazon also has many options or battery powered, corded, or rechargeable lithium ion battery. (Click the pictures for links to the products):