Insecticides still recommended treatment for head lice, advise paediatricians

They're common, contagious and dreaded by parents of school-aged children, but head lice are not a health hazard, says the Canadian Paediatric Society. Still, they do carry persistent social myths that can lead to misdiagnosis and overreaction.   
"Head lice are not a sign of poor hygiene. Parents should not panic," says Dr. Jane Finlay, member of the CPS Infectious Diseases and Immunization Committee and co-author of Head lice infestations: A clinical update, a new CPS position statement to be published Friday in Paediatrics & Child Health. "They are not a medical threat. It's more of an inconvenience."  

Head lice spread easily, especially where people are in close contact. To confirm a case of head lice, you need to find live lice.
"People think they see eggs or nits," said Dr. Finlay, "but these are easily confused with dandruff or the outer shell of the hair or flakes of skin."
The CPS recommends treating head lice with an approved topical insecticide such as pyrethrins, permethrin or lindane. Lindane should only be used as a second-line therapy because of its toxicity. The treatment of choice depends in part on a child's age.
"Lindane must be used with caution," says Dr. Finlay. "It is not appropriate for children under 2."
A non-insecticidal lotion called isopropryl myristate/cyclomethicone has also been approved for use in Canada. However, it should not be used on children under 4.
Alternative and homemade treatments—such as mayonnaise, petroleum jelly, olive oil, margarine, hair gel or wet combing—don't work. Nits do not survive for long away from the scalp and cannot hatch eggs in room temperature, so there is no need to disinfect a home or school because of head lice.
Children with head lice should be treated and can attend school or child care as usual.

For inquiries and to access the full statement and a fact sheet about head lice, contact:

Emma Wadland
Communications Coordinator
Canadian Paediatric Society
613-526-9397, ext. 247
613-850-4868 (cell)