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Updated Guidelines for Managing Head Lice


The American Academy of Pediatrics has just issued a report that updates guidelines and protocols for the diagnosis and treatment of head lice. The report especially provides information on managing head lice in children in a school setting.

Head lice are a very common problem, especially among children ages 3 to 12 years, and they are more likely to affect girls than boys. Although head lice are not dangerous and do not spread diseases, they are contagious and can be extremely irritating, as bites from the insects cause an itchy, inflamed scalp. When children persistently scratch their scalp, they can cause an infection.

The American Academy of Pediatrics has stated that no-nit (lice eggs) policies for returning to school should be eliminated, and that no healthy child should be excluded from or stay home from school because he or she has head lice. Parents can help manage head lice by checking their child’s scalp before and after he or she has shared sleeping quarters, as can occur at camp or a sleepover. School nurses can be instrumental as well, helping with diagnosis and suggestions on how parents can treat their child.

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The recommended initial treatment for most cases of head lice is one percent permethrin lotion, followed by a second application 7 to 10 days after the first. Parents and caregivers should evaluate any treatment they are considering, looking for those that are easy to use, reasonably priced, and nontoxic.

Your doctor can recommend a medicated shampoo, cream rinse, or lotion if you need assistance. Medicated lice treatments usually kill the lice and nits, but it can take a few days before the itching stops.

Because lice treatments are insecticides, they need to be applied exactly as instructed by the manufacturer. Applying too much or too often can increase the risk of causing harm. Anyone who is treating a child who has head lice can also consult their pediatrician for treatment guidelines.

American Academy of Pediatrics