It’s probably making you squirm
just thinking about it – your child comes home from school scratching his head.
He has lice. It’s every parent’s nightmare, but it is important to remember
that head lice is a nuisance, not a serious disease or a sign of poor hygiene.
An updated clinical report by the
American Academy of Pediatrics (AAP) “Head Lice
,” in the May 2015 issue of
Pediatrics (published online April 27), provides information to pediatricians
and other health practitioners on safe and effective methods for treating head
lice, including new products and medications.
Most cases of head lice are
acquired outside of school. In the report, the AAP continues to recommend that
a healthy child should not be restricted from attending school because of head
lice or nits (eggs). Pediatricians are encouraged to educate schools and
communities that no-nit policies are unjust and should be abandoned. Children
can finish the school day, be treated, and return to school.
Unless resistance has been seen in
the community, pediatricians and parents should consider using over-the-counter
medications containing 1 percent permethrin or pyrethrins as a first choice of
treatment for active lice infestations. The best way to interrupt a chronic
lice problem is with regular checks by parents and early treatment with a safe,
affordable, over-the-counter pediculicide. After applying the product according
to the manufacturer’s instructions, parents should follow with nit removal and
wet combing. The treatment should be reapplied at day 9, and if needed, at day
In areas with known resistance to
an over-the-counter pediculicide, or when parents' efforts on their own do not
work, parents should involve their pediatrician for treatment with a
prescription medication such as spinosad or topical ivermectin. These are new
medications that were introduced since the last time the AAP published
recommendations on head lice in 2010.
Once a family member is identified
with head lice, all household members should be checked. The AAP does not
recommend excessive environmental cleaning, such as home pesticides. However,
washing pillow cases and treating natural bristle hair care items that may have
been in contact with the hair of anyone found to have head lice are reasonable
While it is unlikely to prevent
all cases of head lice, children should be taught not to share personal items
such as combs, brushes, and hats. Regular observation by parents can also be an
effective way to detect and quickly treat head lice infestations.
# # #
American Academy of Pediatrics is an organization of 62,000 primary
care pediatricians, pediatric medical subspecialists and pediatric
surgical specialists dedicated to the health, safety and well-being of
infants, children, adolescents and young adults.