International guidelines for effective control of head louse infestations.

Head louse infestations are increasing or remain high in most countries. In order to reduce the proportion of children infested with head lice and slow down the emergence of strains of lice resistant to pediculicides, more active involvement of health and educational authorities, as well as parents, is of paramount importance. We suggest that health authorities should introduce more efficient methods for evaluating pediculicides and more stringent regulations for adoption of new anti-louse products. Baseline studies are also essential for new pediculicides. Children should be properly screened, especially in problematic areas. The media should be used to educate parents on louse control. Health providers need to be aware of which anti-louse remedies are demonstrably effective and be capable of assisting families with louse control. Academic institutions should conduct baseline and efficacy studies on pediculicides and other treatment modalities, as well as research on the biology and epidemiology of lice. Parents should regularly inspect their children, treat as necessary, and try to avoid creating stigmas and emotional problems for the child. The pharmaceutical industry should aim to introduce pediculicides based on new chemical compounds, especially natural products. Companies should develop effective and safe repellents and nit removal remedies. General recommendations are given on how to diagnose and treat louse infestations with chemicals, biological agents, and louse combs and how to protect children from infestations. The no-nit policy, based on the persistence of empty egg cases, is not justified and does more harm than good; therefore, we recommend that it be immediately halted.