28 Jul, 2010 in
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Researchers Suggest End to No-Nit Policies in Schools By Reviewed By 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 as well as 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 without money hygiene. They don’t spread any disease, as well as controversial no-nit policies, which state that incase 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 similar 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 kids — which includes kids with head lice infestation — should be in school learning.” Treatment-Resistant Head LiceThe recent report was final updated in 2002, as well as since that time, there has been a growing concern that lice are becoming resistant to some ordinary over-the-counter treatments such as permethrins (like Nix) as well as pyrethrins (like A-200, Cloudless Lice System, Pronto, R & C, as well as Rid). “They are still a pleasant first-line treatment for most since they possess been proven to be so protected as well as are available over the counter, [but] incase these products don’t work as well as you are sure you possess the correct diagnosis as well as possess 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 damp combing with a fine-toothed lice comb to make the lice easier to catch as well as remove, or suffocation (petroleum jelly or another product is massaged into your child’s hair, he or she wears a shower cap overnight as well as doesn’t wash their hair until the morning).
“Wet combing as well as 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, as well as 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 possess developed resistance. “There are several prescription options similar Ulesfia, Ovide, ivermectin, as well as your health care provider can help you weigh the risks as well as benefits for your child,” she tells WebMD. While effective, these treatments may possess some risks attached to them, as well as need to be studied for longer periods of time. Another prescription product used to treat lice is lindane shampoo (Kwell). Diagnosing Head Lice Is TrickyDiagnosis of head lice isn’t a slam dunk, as well as misdiagnosis of head lice may play a role in treatment resistance, says Cindy DeVore, MD, a pediatrician as well as school healthcare professional in New York State as well as the chair-elect for the Council on School Health of the American Academy of Pediatrics. “Parents may misdiagnose head lice when they see flecks of dandruff or debris as well as mistake it for head lice in the face of a classroom parent notification of lice,” she tells WebMD in an email. “Because self-treatment has been available, involvement of physicians in the care of a child with head lice tends not to occur, as well as overuse as well as misuse of OTC medicines likely possess complicated sorting out what is actual resistance as well as what is simply inadequate, inappropriate, or under-treatment.” Treatment should only be started incase there is a cloudless head lice diagnosis, she says. Bernard Cohen, MD, essential of dermatology for Johns Hopkins Children’s Center in Baltimore, agrees. “Despite resistance to treatment, I think the most ordinary cause of spread as well as treatment failure is failure to identify as well as effectively treat all infested kids.” Preventing Lice Not Easy EitherSo incase diagnosis is tricky, as well as lice are starting to outsmart some of the more ordinary treatments, what about prevention? Lice can’t hop or fly. Instead, they crawl from head to head. “Totally preventing head lice is probably impossible, incase you possess a normally active, social child,” Frankowski says. “Head lice is a common risk of childhood, just similar colds as well as scraped knees.” “Although most lice infestations are spread by direct head-to-head contact, many advise teaching kids not to share combs as well as brushes,” she says. That is OK, but “not using helmets for safety because you are afraid of lice is never an option,” she says. “Most cases of head lice are community acquired, often at sleepaway programs or parties, as well as not uncommonly in the summer,” Devore says. “Parents should do normal surveillance of immature kids, checking the napes of necks, behind ears, as well as throughout the scalp, looking for signs of live lice or “nits” cemented to hair shafts close to the scalp that are not readily pulled out,” she says. As well as “if there is a significant outbreak in a classroom of more than 20% of the kids, the parent can check with the primary care healthcare professional to see whether take of a permethrin rinse on an uninfested child may confer some protection until the infestation in the classroom calms,” she says. Not All In Favor of No-Nit PoliciesAlthough the researchers do stress abandoning no-nit policies to avoid prolonged, unnecessary absences from school, other organizations, including the National Pediculosis Association, still support them. The nonprofit group states that not removing nits is the main reason treatments don’t work, as well as incase kids with hatching nits are readmitted to school, the head lice outbreak will continue. “While absence from school or child care is a loss of educational opportunity as well as an encumbrance to working parents, readmitting an infested child isn’t the solution,” the group states. “A policy for head lice must consider not only the infested child, but as well as his or her peers who possess already been successfully deloused or who possess not yet been infested.” SOURCES: Frankowski, B. Pediatrics, July 2010; vol 126: pp 392-403. |
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