Children's Health

Parents, Schools Overreact to Head Lice, Expert Says

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Pollack says he doesn't believe the "No Nits" policy is a good one because even a dead egg is seen as a bad egg and is enough to keep a child out of school. And treatment, he says, should be reserved only for cases of confirmed, active infestation.

"What I am saying is this: These things do not generally cause disease ... therefore, it is not a medical issue, it is not a public-health issue. Why are we invoking health policy if it is not a health issue?" he asks. "My view is a very unpopular one."

Pollack is certainly right about that. Deborah Z. Altschuler tells WebMD, "Yes, parents need help; yes, they don't always know what they are looking for; yes, they sometimes do the wrong thing. But no, they don't want kids to keep lice." Altschuler is the president of the National Pediculosis Association, a nonprofit organization that educates parents and others about head lice.

"I can appreciate what [Pollack] has to say," Carol Steltenkamp, MD, tells WebMD. "But both from a physician standpoint and as well as a mother of school-aged children, I think his suggestions are not reasonable " Steltenkamp is an assistant professor of pediatrics and the associate chief of staff at the University of Kentucky Medical Center.

"Medically this is not a problem, my physician mind tells me," Steltenkamp says. "But when my child got it, my mother mind freaked out. I knew that it was OK and nobody was going to die or get a horrible disease, but it was nasty!"

Family practitioner and Emory University instructor David Clifford, MD, agrees that there is much unwarranted hysteria over head lice. "But it is aggravating and the patient feels dirty," he says.

Both Clifford and Steltenkamp agree with Pollack that we probably overtreat head lice, but neither can see a way around it.

"If you are not going to treat them and you are going to send them to school, you'll have 20 more patients next week," says Clifford. "The bottom line is, you just have to treat it -- you can't always tell [if the case is active]. The eggs can be dead and it can take a while for the nits to disappear, but that is why it is important that you rinse the hair properly, that you use the comb. "