The AAP Now Says Having Lice Isn't a Reason To Miss School

Head lice is a pesky and dreaded issue. The American Academy of Pediatrics also says it's not a sign of poor hygiene or health hazard and is advising schools to allow students with head lice to remain in class.

The new recommendations, published in a clinical report titled "Head Lice" for the October 2022 issue of Pediatrics, mark the first update on guidance and treatment since 2015. The AAP Committee on Infectious Diseases, Committee on Practice and Ambulatory Medicine, and Section on Dermatology wrote the report, which appeared online on September 26.

"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, the report's lead author. "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 noted that school screenings have been ineffective in decreasing head lice and that they may stigmatize students who have it.

According to the new report, topical treatments like shampoos, lotions, and other Food and Drug Administration-approved products with pyrethroids should remain first-line treatments for head lice. Alternative options are available for children and teenagers who are resistant to these commonly prescribed items.

Head lice isn't fun, and parents may be concerned that the new guidance may increase the spread in school settings. But it doesn't spread easily—lice don't jump like mosquitos. The Centers for Disease Control and Prevention (CDC) says the most significant risk comes from direct head-to-head contact with an individual with head lice. Other possible but rare causes of spread include contact with clothing, such as hats and scarves, or personal items like combs used by someone with head lice.

"Personal hygiene or cleanliness in the home or school has nothing to do with getting head lice," the CDC says.

Good news for parents and other caregivers: Lice prefer kids' hair because the shafts are typically thinner and straighter than adults'. Over-the-counter and prescription treatments are available, and a pediatrician can help you decide what is best for your child.

In other words, head lice are mostly an annoyance and rite of passage. If your child gets them, they—and you—did nothing wrong.