AAP: Head Lice Shouldn’t Keep Kids Away from School


New guidelines from the American Academy of Pediatrics (AAP) say that outbreaks of head lice in children can be treated without banning the infected kids from school.

The AAP is of the opinion that health officials and doctors should educate school leaders and communities that policies which require children to be “nit-free” are unfair and should not be the standard procedure, writes Robert Preidt for WebMD.

If a child is found to have head lice or nits, that child may finish the school day, be treated and return to school. (Nits are the eggs of head lice.) If the lice are active, live infestations, the child can be treated with over-the-counter medicines which contain 1% permethrin or pyrethrins. After application, removal of nits and wet combing should follow. This treatment should be repeated nine days and 18 days after the first treatment, if needed.

New prescription medications may be discussed with the family doctor, such as spinosad and ivermectin, if the over-the-counter medications do not work. Many strains of head lice have already grown resistant to permethrin, says Dr. Dassi Leader, director of inpatient pediatrics at Staten Island University Hospital in New York City.

If one family member is infested, all members of the family should be checked, according to the AAP. Household pesticides are not recommended as a treatment, but pillows should be washed and natural bristle hair brushes should be treated. Children can learn that sharing personal items such as combs, brushes, and hats is not a good idea, but regular checks by parents, which  help in quick detection and treatment, is an excellent practice.

Still, it is a good idea not to overreact to a case of head lice.

“Lice create unfounded anxiety among students, parents and school personnel,” said Dr. Ron Marina, associate chair of pediatrics at Winthrop-University Hospital in Mineola, N.Y. “They are a nuisance and not a significant health hazard. Common sense and over-the-counter medications is generally enough to contain and treat this problem.”

Head lice can produce itching, but there are no known diseases which are spread by this type of lice, and the insects are not likely to spread in a classroom from one child to another. Normally, it takes head-to-head contact to spread the lice, says LiveScience’s Rachael Rettner. Also, screening students at schools for head lice does not reduce the occurrence of a head lice infestation over time, so the AAP says screenings should be eliminated. It is still prudent for parents to check their children for head lice, and school nurses may check children who are exhibiting symptoms of the lice.

Home remedies have not been tested in clinical trials and should be avoided, and herbal products are not regulated by the Food and Drug Administration and could prove to be unsafe. Some try other substances such as vodka, bleach, and WD-40 which could be dangerous and have not been proven to eliminate a head lice infestation, adds the AAP.

In the US, according to the CDC, head lice is more common among children ages 3 to 11. The center has estimated that about 6 to 12 million infestations occur per year, especially among girls, reports Kathleen Lees of ScienceWorldReport.

“Many of our unwanted scalp visitors simply won’t be killed by this long trusted and safe treatment,” Dr. Dassi Leader , director of inpatient pediatrics at Staten Island University Hospital in New York City, said via Health Day. Permethrin still may be a good place to start – it’s safe, cheap and over-the-counter. But if the lice are still happily crawling, your pediatrician has other options the lice may not be expecting.”