Your wee one comes home from school furiously scratching their head. With a knot of dread, you lean in to take a look. Ah! Tiny grayish insects writhe and work their way through their hair, but don’t fret: with new treatment guidelines from the Canadian Paediatric Society (CPS), the pesky problem likely won’t persist.
“Head lice are extremely common,” Dr. François Boucher, a pediatric infectious disease specialist in Quebec City, says. “They are not a marker for lack of hygiene and they also are not dangerous because they do not transmit any diseases. They’re not like body lice or things like that, so people shouldn’t be ashamed of having them.”
Updating their 2008 treatment recommendations, CPS says that parents should employ topical insecticides such as pyrethrins and permethrin as the first line of attack against head lice.
“Once you’ve found live lice in the hair, treat them with an approved topical insecticide, properly applied to the head,” Dr. Carl Cummings, co-author of the updated CPS recommendations and chair of the CPS Community Paediatrics Committee, says. “If after two full applications of permethrin, you still find live lice, consider a different class of insecticide like pyrethrins, or a non-insecticide treatment.”
While silicone oil dimeticone (sold under the brand name NYDA) and isopropyl myristate/cyclomethicone (sold as Resultz) are effective non-insecticides, they are much more expensive and should only be used if insecticides fail, the CPS says. Lindane, once a popular treatment option, is no longer available.
The CPS recommends avoiding home remedies such as mayonnaise, petroleum jelly, olive oil, vinegar and margarine. While such substances may make it difficult for head lice to breathe, they probably won’t kill the little buggers.
The CPS also says that children should be sent back to school the day after treatment.
“Treatments are generally effective, so there’s no reason to keep one child at home just because head lice are circulating in school,” Dr. Boucher, who also sits on the CPS’ board of directors, says.
“If you caught it in school, then probably there are other children who have head lice in schools. No health organization supports exclusion policies in schools or daycare because they make no sense... Children would be out of school for months.”
According to Dr. Boucher, increased genetic resistance of head lice to insecticides has not rendered traditional treatments ineffective.
“The rate of treatment failure does not correspond to that high level of biologic resistance,” Dr. Boucher says.
“There is no direct correlation between the presence of that gene and treatment failure... The reasons for failure are misdiagnosis and misuse of the products. You have to tell parents to follow the instructions extremely carefully!”
To see the full list of updated head lice treatment recommendations, visit www.cps.ca.
