Head Lice Awareness: National Pediculosis Association (HeadLice.org)
The No Nit Policy of the National Pediculosis Association encourages each family to do its part at home with routine screening, early detection, accurate identification and thorough removal of lice and nits. Establishing consistent guidelines and educating the public about procedures in advance of outbreaks helps minimize inappropriate responses.
Early intervention provides the needed assurance for those who have successfully eliminated an infestation that everything possible is being done to prevent new outbreaks when children return to groups where close contact is inevitable.
Repeated exposures to pesticidal products put children at risk. Parents need to be informed that chemical treatments may also be dangerous for children with certain pre-existing medical conditions and/or medication regimens. Families with pregnant or nursing mothers should be given advance notice that early detection with manual removal of lice and nits can serve as a safe alternative to pesticidal lice treatment products.
Opponents of No Nit Policies say that “overzealous” enforcement can lead to inappropriate exclusion of children with residual nits, but whose infestation has otherwise been “treated.” Those who judge enforcement to be “overzealous” may not consider the broader public health values and preferences of the community.
Without the No Nit Policy, communities are left with a hit-or-miss approach. Indifference about adopting a standardized management protocol permeates the attitudes of health professionals at every level. This in turn gives way to a maze of conflicting opinions and directives that are counterproductive.
The Food and Drug Administration recommends repeating chemical treatments in 7-10 days because none of the available treatment products are 100% effective against lice eggs and that remaining viable nits will hatch lice. Unfortunately, children being managed in this manner can infest others or become reinfested in the interim.
Mechanical removal of head lice and nits is less noxious and more likely to be successful than repeated chemical treatments.
A policy for head lice must consider not only the infested child, but also his or her peers who have already been successfully deloused or who have not yet been infested. All this considered, the No Nit Policy remains a sensible approach that sets the standard to serve and protect all the children in the group.