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Head Lice Grow Resistant to Treatments

Researchers Suggest End to No-Nit Policies in Schools
WebMD Health News
Reviewed by Louise Chang, MD

July 26, 2010 -- There is little else that triggers such a visceral reaction from parents than the words "head lice," especially when they are uttered in conjunction with an outbreak in their child's classroom or summer camp.

But when it comes to these creepy, crawly, head-dwelling creatures, there is nothing to fear except fear itself, say researchers in an updated report on the diagnosis and treatment of head lice in the August issue of journal of Pediatrics.

Yes, head lice are gross, but they are not a health hazard or a sign of poor hygiene. They don't spread any disease, and controversial no-nit policies, which state that if your child has any sign of lice or their eggs (nits) they should be kept home, should be abandoned, they say.

"It's only a bug on your child, not in your child like the flu or pneumonia," study author Barbara L. Frankowski, MD, MPH, professor of pediatrics at the University of Vermont in Burlington, says in an email. "Healthy children -- which includes children with head lice infestation -- should be in school learning."

Treatment-Resistant Head Lice

The new report was last updated in 2002, and since that time, there has been a growing concern that lice are becoming resistant to some common over-the-counter treatments such as permethrins (like Nix) and pyrethrins (like A-200, Clear Lice System, Pronto, R & C, and Rid).

"They are still a good first-line treatment for most since they have been proven to be so safe and are available over the counter, [but] if these products don't work and you are sure you have the correct diagnosis and have used the product properly, then you would want to talk to your health care provider about second-line prescription medications," Frankowski says.

Another option is wet combing with a fine-toothed lice comb to make the lice easier to catch and remove, or suffocation (petroleum jelly or another product is massaged into your child's hair, he or she wears a shower cap overnight and doesn’t wash their hair until the morning).

"Wet combing and suffocation methods are more time consuming, but can be helpful for parents who wish to avoid chemicals," she says. "None of the methods are 100% effective, and often need to be repeated for two or three cycles," she says. This includes nonprescription products.

There are some newer treatments available that target lice that have developed resistance. "There are several prescription options like Ulesfia, Ovide, ivermectin, and your health care provider can help you weigh the risks and benefits for your child," she tells WebMD. While effective, these treatments may have some risks attached to them, and need to be studied for longer periods of time. Another prescription product used to treat lice is lindane shampoo (Kwell).

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