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AAP issues new guidance for head lice in schools

(NEXSTAR) – Of the many illnesses, accidents and other classroom mishaps parents dread, a lice infestation is high on the list.

New guidance from the American Academy of Pediatrics (AAP) issued Monday lists a number of treatment options and reiterates its stance that forcing a child with lice to stay home may do more harm than good.

The full clinical report, “Head Lice,” points out that, while it may cause discomfort, head lice don’t spread disease and are not a sign of poor hygiene — but highlighting a case by sending the child into quarantine may cause “significant stigma and psychological stress.”

“Head lice are an unpleasant part of the human experience, but they can be successfully managed and are no reason for a child to miss school,” said Dawn Nolt, MD, MPH, FAAP, lead author of the report. “The AAP encourages pediatricians to serve as an educational resource for families, school districts and communities so that head lice may be treated and managed without stigma.”

The AAP says that in-school screening programs are costly and haven’t been shown to reduce cases of head lice in children. Instead, schools should be offering educational programs for families “to help increase understanding and management of head lice in the community,” according to the AAP.

The Centers for Disease Control and Prevention recommends that students diagnosed with live head lice not be dismissed from school early and should return the following day after starting treatment to kill the lice.

Some schools have instituted a “no-nit” policy, referring to the egg of a louse or the empty shell casing, but both the AAP and the National Association of School Nurses (NASN) suggest discontinuing the practice. Nits very often don’t translate to crawling lice, and keeping a child out of school can be a burden for both the child and the parents. A 2006 study found that 4-8 million children were treated unnecessarily for lice and kept out of school annually, forcing parents to miss millions of work days, resulting in an estimated $4-8 billion loss to the U.S. economy.

What are lice and how can I avoid them?

Lice are about the size of a sesame seed and are grayish-white in color, according to the AAP.

The tiny pests can’t jump or hop like fleas and can only crawl, so in most cases there has to be head-to-head contact for lice to spread.

It’s possible for lice transmission to happen indirectly via combs, brushes, hats, sports helmets and other items, but that is much less likely, the AAP says. They are also specific to humans, so you don’t have to worry about getting lice from your dog or cat.

While lice will die in about a day or less without feeding on a human, they can survive under water for several hours and are unaffected by chlorine levels in swimming pools.

The AAP suggests using a fine-tooth louse comb to check for the parasites or any nits. Nits found more than 1 centimeter away from the warmth of the scalp likely won’t ever turn into a crawling louse.

As part of Monday’s report, the AAP offered a variety of treatment options in the case of a confirmed lice infestation, ranging from manual removal and home remedies to topical medication.

Parents are encouraged to call their pediatrician to ensure a proper diagnosis and decide on a treatment plan. For more information on lice and treatment options, see the AAP’s Healthy Children page.

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