Debugging the Mysteries of Head Lice

Head lice infestations are common in the United States and affect all socioeconomic classes. Outbreaks typically occur in preschool or elementary school settings where children have direct head-to-head contact. Their household members and caregivers may also become infested. Traditional treatment strategies include application of topical products to kill lice and/or nits (eggs), followed by manual removal of lice and nits from the hair using fine-tooth nit combs. Alternative treatments are available, although most lack solid scientific evidence of efficacy. Misinformation about head lice is rampant, often leading to misdiagnoses and improper treatment. Many schools still have “no-nit” policies that prevent children from returning to school until they are nit free. The Association of School Nurses (NASN), the American Academy of Pediatrics (AAP), and the Centers for Disease Control and Prevention (CDC) have declared “no-nit” policies that are based on misinformation, not scientific facts, disrupt student learning, and stigmatize and shame children. Pharmacists can assist their communities by arming themselves with evidence-based facts to help dispel fallacies related to effective management of head lice.