CPS updates head lice treatment recommendations

OTTAWA – Head lice continue to be a common nuisance for school-aged children, but lice don’t spread disease and are not from poor hygiene. The Canadian Paediatric Society (CPS) has updated its 2008 recommendations to include information about new treatment options and products that should not be used.

While the CPS continues to recommend topical insecticides, such as pyrethrins and permethrin, as the first choice for treatment of lice, silicone oil dimeticone (sold under the brand name NYDA) and isopropyl myristate/cyclomethicone (sold under the brand name Resultz) are effective but more expensive non-insecticides against live lice, nymphs and nits.  Lindane is no longer available.

“Once you’ve found live lice in the hair, treat them with an approved topical insecticide, properly applied to the head,” says Dr. Carl Cummings, co-author of the updated CPS recommendations and chair of the CPS Community Paediatrics Committee.

There have been reports of increasing resistance of head lice to insecticides like pyrethrins and permethrin. However, these products continue to be effective in most cases, and cases of resistance are often misdiagnosed.

“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,” says Dr. Cummings.

The CPS does not recommend home remedies such as mayonnaise, petroleum jelly, olive oil, vinegar or margarine. Although they may make it hard for lice to breathe, they probably won’t kill them.

Children with head lice should be treated and then attend school or child care as usual the next day. ‘No-nit’ policies that keep children with head lice or nits after treatment away from school are not necessary and do not prevent spread.

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About the Canadian Paediatric Society

The Canadian Paediatric Society is a national advocacy association that promotes the health needs of children and youth. Founded in 1922, the CPS represents more than 3,300 paediatricians, paediatric subspecialists and other child health professionals across Canada.