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NEW YORK (Reuters Health) - Kids shouldn't be forced to miss school because they have head lice, according to a new report from the American Academy of Pediatrics.
The report also says that pediatricians should be more involved in the management of lice because parents might not always know the best treatment - or if treatment is really necessary.
Head lice affects up to 12 million kids in the United States every year, according to federal health officials, and as much as $1 billion is spent annually on treatment. While head lice do not spread infection, their itch-inducing effects are well known.
Adult lice are about the size of sesame seeds, but often hard to spot because they can move around the head quickly. Easier to spot are nits -- small, empty egg casings that look like they could be dandruff but are stuck on to the root of the hair.
The report, the first update to the Academy's head lice guidelines since 2002, emphasizes that "no-nit" policies -- which keep kids with lice at home as long as they have any evidence of an infestation -- don't benefit these kids or their classmates and "should be abandoned."
"It makes no medical sense because the nits ... they're really stuck on the kid's hair," Dr. Barbara Frankowski, co-author of the report and a pediatrics professor at the University of Vermont, told Reuters Health. "I think it just sort of increases the hysteria and it makes kids miss school unnecessarily," she added.
What's more, kids who get sent home with a few nits on their heads might not ever have a full-on infestation, the authors note. Checking a whole class or school for lice also hasn't proven effective, according to the report. Instead, parents or a school nurse can check kids when they might be at a higher risk for getting lice, such as after a sleepover, or kids who are itching.
Parents often go to extreme measures when their kids do have lice, but "herculean" measures aren't necessary, the authors say. Lice die in environments that are too hot or too cool, so washing bedding in hot water, or quarantining stuffed animals in bags for a couple weeks should be enough to get rid of the lice and their eggs, they advise.
The report also warns that many common lice "treatments" have not been well researched or are not approved by the Food and Drug Administration. While there have been reports of some resistance to some of the first-choice treatments, products including Nix and RID should still be at the top of the list in most cases. "They're very safe (and) they're relatively straightforward to use," Frankowski said of these products.
However, kids should only be treated if it's clear they have an infestation, the report states.
Other drug treatments that need a prescription are a second choice for when a doctor does diagnose a resistant case. These treatments might be more expensive - up to $100 for patients without insurance, Frankowski said, versus first-line measures, which often cost $15 to $30.
A range of other methods used by parents might be effective, the authors say, but haven't been rigorously tested - such as mayonnaise and Vaseline. Some, they note, aren't worth the risk at all, like bleach and WD-40.
School nurses can help recommend the best lice treatments, Frankowski said, but parents also shouldn't hesitate to talk to their pediatricians if they're not sure what to do. What's most important, she said, is that parents not panic when their kids come home with lice.
"Calm down as best you can," she said. "The bugs are on your kid's head, they're not in your child's body - how much worse would that be?"
"Try to maintain your sense of humor and concentrate on your child's head," she advised.
SOURCE: link.reuters.com/ges59m Pediatrics, online July 26, 2010.