@article {96417, title = {Head Lice}, journal = {Pediatrics}, volume = {150}, year = {2022}, month = {Sep-26-2022}, pages = {14 pp}, abstract = {

AAP Committee on Infectious Diseases, Committee on Practice and Ambulatory Medicine, Section on Dermatology.

Head lice infestation is associated with limited morbidity but causes a high level of anxiety among caregivers of school-aged children and adolescents. Since the 2015 clinical report on head lice was published by the American Academy of Pediatrics, new medications have been approved, and an algorithm for management of affected patients is included. This revised clinical report clarifies current diagnosis and treatment protocols.

To cite: Nolt D, Moore S, Yan AC, Melnick L; AAP Committee on Infectious Diseases, Committee on Practice and Ambulatory Medicine, Section on Dermatology. Head Lice. Pediatrics. 2022;150(4): e2022059282

}, keywords = {head lice, lice, Lice infestation, lotion, Pediculicide, Permethrin, Pyrethrins}, issn = {0031-4005, 1098-4275}, doi = {10.1542/peds.2022-059282}, url = {https://publications.aap.org/pediatrics/article/150/4/e2022059282/189566/Head-Lice}, author = {Dawn Nolt and Scot Moore and Albert C. Yan and Laura Melnick} } @article {47428, title = {Lice, nits, and school policy}, journal = {Pediatrics}, volume = {107}, year = {2001}, month = {2001}, pages = {1011 - 1015}, url = {http://www.phthiraptera.info/sites/phthiraptera.info/files/46.pdf}, author = {Williams,I. Keoki and Reichert,Amanda and MacKenzie,William R. and Hightower,Allen W. and Blake,Paul A.} } @article {47424, title = {An Effective Nonchemical Treatment for Head Lice: A Lot of Hot Air}, journal = {Pediatrics}, volume = {118}, year = {2006}, month = {2006}, pages = {1962 - 1970}, abstract = {

Our findings demonstrate that one 30-minute application of hot air has the potential to eradicate head lice infestations. In summary, hot air is an effective, safe treatment and one to which lice are unlikely to evolve resistance.

}, keywords = {Control, heat, non-chemical}, url = {http://www.phthiraptera.info/sites/phthiraptera.info/files/46541.pdf}, author = {Goates,Brad M. and Atkin,Joseph S. and Wilding,Kevin G. and Birch,Kurtis G. and Cottam,Michael R. and Sarah E. Bush and Clayton,Dale H.} } @article {47253, title = {Lice, nits and school policy}, journal = {Pediatrics}, volume = {107}, year = {2001}, month = {2001}, pages = {1011 - 1015}, url = {http://www.phthiraptera.info/sites/phthiraptera.info/files/46364.pdf}, author = {Williams,I. Keoki and Reichert,Amanda and McKenzie,William R. and Hightower,Allen W. and Blake,Paul A.} } @article {47197, title = {Internal and external parasites}, journal = {Pediatrics}, volume = {1}, year = {1986}, month = {1986}, pages = {1 - 7}, author = {Alkinson,I. and Clore,E. R. and Kisel,B. E. and et al} } @article {46111, title = {Head lice infestation: single drug versus combination therapy with one percent permethrin and trimethoprim/sulfamethoxazole}, journal = {Pediatrics}, volume = {107}, year = {2001}, note = {LR: 20041117; JID: 0376422; 0 (Anti-Infective Agents); 0 (Insecticides); 0 (Pyrethrins); 52645-53-1 (Permethrin); 8064-90-2 (Trimethoprim-Sulfamethoxazole Combination); CIN: ACP J Club. 2001 Sep-Oct;135(2):71; CIN: Pediatrics. 2001 Dec;108(6):1393. PMID: 11731678; ppublish}, month = {2001}, pages = {E30}, address = {United States}, abstract = {BACKGROUND: Head lice infestation (HLI) is a vexing problem for pediatricians and families because lice are becoming resistant to approved antipediculosis agents. OBJECTIVE: This study compared the efficacy of 3 different treatments for HLI and determined whether combination therapy reduced treatment failures. DESIGN AND SETTING: A randomized, clinical trial performed in 3 private practices. PARTICIPANTS: The population was children ranging in age from 2 to 13 years. METHODS: HLI was diagnosed by direct inspection of the hair and scalp. Children were assigned to 1 of 3 groups: 1) 1\% permethrin creme rinse (1\% PER; n = 39); 2) oral administration of trimethoprim/sulfamethoxazole (TMP/SMX; n = 36); and 3) a combination of 1\% PER and TMP/SMX (n = 40). Follow-up visits were done 2 and 4 weeks later, and parents or caregivers of those who did not return were interviewed by telephone. If HLI was present at the 2-week follow-up, the child was retreated per their protocol. We defined successful treatment as the absence of adult lice and nymphal stage or eggs (nits). The presence of nits alone was not considered a treatment failure. RESULTS: At the 2-week follow-up visit, successful treatment for groups 1, 2, and 3 was 79.5\%, 83\%, and 95\%, respectively. At the 4-week follow-up, successful treatment was 72\%, 78\%, and 92.5\% for groups 1, 2, and 3, respectively. The absolute risk reduction for recurrence comparing group 1 versus group 2 was 6\%, group 2 versus group 3 was 14\%, and group 1 versus group 3 was 20\%. No major adverse complications were seen in any treatment group. CONCLUSION: Our findings indicate that a combination of 1\% PER and TMP/SMX is an effective alternative therapy for HLI. We recommend that the dual therapy with 1\% PER and oral TMP/SMX be used and reserved in cases of multiple treatment failures or suspected cases of lice-related resistance to therapy.}, keywords = {Administration, Oral, Administration, Topical, animals, Anti-Infective Agents/administration \& dosage/therapeutic use, child, Child, Preschool, Comparative Study, Drug Therapy, Combination, humans, insecticide, Lice Infestations/drug therapy, Pediculus, Permethrin, Pyrethrum, scalp dermatoses, Trimethoprim}, isbn = {1098-4275}, author = {Hipolito,R. B. and Mallorca,F. G. and Zuniga-Macaraig,Z. O. and Apolinario,P. C. and Wheeler-Sherman,J.} } @article {46096, title = {Lice, nits, and school policy}, journal = {Pediatrics}, volume = {107}, year = {2001}, month = {2001}, pages = {1011 - 1015}, abstract = {BACKGROUND: The epidemiology of head lice infestation is poorly understood. Many schools treat all children with nits as though they are contagious. Children with nits but no lice are often removed from school until they are treated and all visible nits are removed. OBJECTIVE: To investigate the probability that children with nits alone will become infested with lice. DESIGNS: Prospective cohort study. SETTING: Two metropolitan Atlanta elementary schools. PARTICIPANTS: A total of 1729 children were screened for head lice. Twenty-eight children (1.6\%) had lice, whereas 63 (3.6\%) had nits without lice. Fifty of the 63 children (79\%) with nits alone completed follow-up. OUTCOME MEASURE: Conversion (ie, becoming infested with lice) within 14 days after initial screening. RESULTS: Nine of 50 children (18.0\%) followed for nits alone converted. Although children who converted did not have significantly more nits than did nonconverters, having nits near the scalp was a risk factor for conversion. Seven of 22 children (31.8\%) with >/=5 nits within one fourth inch of the scalp converted, compared with 2 of 28 children (7.1\%) with fewer (relative risk: 4.45; 95\% confidence interval: 1.03-19.35). This risk remained statistically significant after separately stratifying for sex, recent treatment, and total number of nits. CONCLUSIONS: Although having >/=5 nits within one fourth inch of the scalp was a risk factor for conversion, most children with nits alone did not become infested. Policies requiring exclusion from school and treatment for all children with nits alone are likely excessive. Instead, these children may benefit from repeated examination to exclude the presence of crawling lice.lice, pediculus, lice infestations, pediatrics, school.}, keywords = {animals, child, Communicable Disease, humans, Lice Infestations/prevention \& control, Life Cycle Stages, Pediculus, Research Support, U.S. Gov{\textquoteright}t, P.H.S., scalp dermatoses, Schools/standards}, author = {Williams,L. K. and Reichert,A. and MacKenzie,W. R. and Hightower,A. W. and Blake,Paul A.} } @article {46075, title = {Head lice infestation: single drug versus combination therapy}, journal = {Pediatrics}, volume = {108}, year = {2001}, note = {LR: 20041117; JID: 0376422; 0 (Anti-Infective Agents); 0 (Insecticides); 52645-53-1 (Permethrin); 8064-90-2 (Trimethoprim-Sulfamethoxazole Combination); CON: Pediatrics. 2001 Mar;107(3):E30. PMID: 11230611; ppublish}, month = {2001}, pages = {1393}, address = {United States}, keywords = {animals, Anti-Infective Agents/therapeutic use, Drug Therapy, Combination, humans, insecticide, Lice Infestations/drug therapy, Pediculus, Permethrin, Trimethoprim}, isbn = {1098-4275}, doi = {https://doi.org/10.1542/peds.108.6.1393 }, url = {https://pediatrics.aappublications.org/content/108/6/1393.long}, author = {Richard J. Pollack} } @article {46042, title = {Head lice}, journal = {Pediatrics}, volume = {110}, year = {2002}, note = {LR: 20041117; JID: 0376422; ppublishCommittee on School Health the Committee on Infectious Diseases. American Academy of Pediatrics. }, month = {2002}, pages = {638 - 643}, abstract = {Head lice infestation is associated with little morbidity but causes a high level of anxiety among parents of school-aged children. This statement attempts to clarify issues of diagnosis and treatment of head lice and makes recommendations for dealing with head lice in the school setting.}, keywords = {animals, child, humans, Lice Infestations/diagnosis/epidemiology/prevention \& control/therapy, Pediculus, scalp, Schools/standards}, author = {Frankowski,B. L. and Weiner,L. B.} } @article {45925, title = {A simple treatment for head lice: dry-on, suffocation-based pediculicide}, journal = {Pediatrics}, volume = {114}, year = {2004}, note = {LR: 20050927; JID: 0376422; 0 (Fatty Alcohols); 0 (Insecticides); 0 (Nuvo); 151-21-3 (Sodium Dodecyl Sulfate); 57-55-6 (Propylene Glycol); CIN: Pediatrics. 2005 May;115(5):1452-3. PMID: 15867085; ppublish}, month = {2004}, pages = {e275 - 9}, address = {United States}, abstract = {OBJECTIVES: The emergence of drug-resistant lice has created the need for new therapies. This study assesses a new method without neurotoxins, extensive household cleaning, or nit removal. METHODS: One hundred thirty-three subjects participated in 2 open clinical trials. In the first trial, 93 subjects completed treatment using a nontoxic, dry-on, suffocation-based, pediculicide lotion, minimal household cleaning measures, and physical removal of the nits. In the second trial, 40 subjects completed treatment using an identical protocol except that the nits were not removed. Head lice infestation was defined as a wet combing test showing lice. Cure was defined as a wet combing test showing no lice, with an absence of symptoms. Subjects were contacted 6 months later, for assessment of their disease status. RESULTS: Cure was achieved for 97\% of the patients in the first trial and 95\% in the second trial. Remission at the follow-up assessment was reported for 77 of 82 subjects (94\%) in the first trial and 36 of 38 subjects (95\%) in the second trial. There was no statistical difference in cure rates or remission rates between the protocols with and without nit removal. The overall cure rate was 96\%, with a remission rate of 94\%. There were no adverse effects. CONCLUSIONS: Dry-on, suffocation-based, pediculicide lotion effectively treats head lice without neurotoxins, nit removal, or extensive house cleaning. These results are comparable or superior to the results previously reported for treatments with permethrin, pyrethrin, and malathion.}, keywords = {Administration, Topical, adolescent, adult, animals, Asphyxia, child, Child, Preschool, Fatty Alcohols/administration \& dosage/therapeutic use, humans, Infant, insecticide, Lice Infestations/therapy, Middle Aged, Pediculus, Recurrence, scalp dermatoses, Sodium Dodecyl Sulfate/administration \& dosage/therapeutic use, Treatment Outcome}, isbn = {1098-4275}, author = {Pearlman,D. L.} } @article {45883, title = {Nuvo lotion and the future of head-lice treatment}, journal = {Pediatrics}, volume = {115}, year = {2005}, month = {2005}, pages = {1452 - 1453}, keywords = {animals, Asphyxia, Fatty Alcohols/therapeutic use, humans, insecticide, Lice Infestations/therapy, Pediculus, scalp dermatoses, Sodium Dodecyl Sulfate/therapeutic use}, isbn = {1098-4275}, author = {Pearlman,D. L.} } @article {45838, title = {Cetaphil cleanser (Nuvo lotion) cures head lice}, journal = {Pediatrics}, volume = {116}, year = {2005}, note = {JID: 0376422; ppublish}, month = {2005}, pages = {1612}, isbn = {1098-4275}, author = {Pearlman,D.} } @article {40379, title = {Scalding, dust mites and lice, and your washing machine}, journal = {Pediatrics}, volume = {101}, year = {1998}, month = {1998}, pages = {1094 - 1094}, author = {Katzman,G. H.} }