Going to School on Head Lice
Getty Images/Digital Vision.
New Approaches to an Old Nemesis
US.IVE.13.03.021
Key Points to Cover Today!
1. Head Lice: Getting to Know You
2. The Key Role of the Clinician in Head Lice
Diagnosis and Treatment
3. The School Nurse’s Pivotal Roles
in Head Lice Management
4. Strategies for School Nurses:
When Lice Go to the Head of the Class
5. Background Information on Approved
Head Lice Products
2
Head Lice:
Getting to Know You
Head Lice Infestation:
A Common Pediatric Condition
• Pediculosis is the most prevalent
parasitic infestation among humans1
• Head lice infestations are pervasive
among school-age children in the
United States2,3
• ~6-12 million infestations occur each
year in children 3-11 years of age3
Getty Images/Peter Dazeley.
– More common in females4
• All socioeconomic groups are affected2,4,5
– Contrary to myth, “head lice prefer clean, healthy hosts”4
References: 1. Hodgdon HE, et al. Pest Manag Sci. 2010;66(9):1031-1040. 2. Frankowski BL, et al. Pediatrics. 2010;126(2):392-403.
3. Centers for Disease Control and Prevention (CDC). Head lice. Epidemiology & risk factors. http://www.cdc.gov/parasites/
lice/head/epi.html. Accessed January 13, 2013. 4. Meinking T, et al. Infestations. In: Schachner LA, Hansen RC, eds. Pediatric
Dermatology. 4th ed. Mosby Elsevier; 2011:1535-1583. 5. Meinking TL, et al. Int J Dermatol. 2013;52(1):106-112.
4
Common Myths About Head Lice1
MYTH: Head lice can fly or jump from head to head
FACT: Head lice have no wings and can only crawl.
MYTH: Head lice are a health hazard and are more common
in people with poor hygiene.
FACT: Head lice prefer a clean, healthy head; they are not a health
hazard and do not transmit disease.
MYTH: Transmission of head lice in the classroom is common.
FACT: Classroom transmission is considered rare.
MYTH: You can get head lice from a house pet.
FACT: Dogs, cats, and other house pets do not play a
role in head lice transmission.
Reference: 1. Pontius DJ. NASN Sch Nurse. 2011;26(6):356-362.
CDC. Dr. Dennis D. Juranek.
5
The Head Louse:
A Closer Look
• The adult louse is 2-3mm long (about
the size of a sesame seed)1
• Usually pale gray; color may vary1
•
•
– Red when engorged with blood
– May adapt color to surroundings
The louse feeds by injecting small
amounts of saliva and taking tiny
amounts of blood from the scalp
every few hours1
Lice usually survive less than 24-48 hours
away from the scalp at room temperature1,2
•
•
•
CDC.
Lice that fall off the head are usually dead or dying
Must find a host to survive
Eggs need warm temperatures (like those near the scalp) to hatch
References: 1. Frankowski BL, et al. Pediatrics. 2010;126(2):392-403. 2. CDC. Head lice. Prevention and control.
http://www.cdc.gov/parasites/lice/head/prevent.html. Accessed March 26, 2013.
6
The Life Cycle of the Head Louse1,2
Female lays 1st egg
1-2 days after mating
Become adults
9-12 days after
hatching
3
Lays up to
10 eggs per day
Female lives 3-4 weeks
Without treatment,
the cycle may repeat
every 3 weeks
Eggs tightly
attached to hair,
close to scalp
2
3 nymph
stages
Eggs hatch in
7-12 days
1
Illustration by Penumbra Design Inc.
References: 1. Frankowski BL, et al. Pediatrics. 2010;126(2):392-403. 2. Meinking TL, et al. Infestations. In: Schachner LA,
Hansen RC, eds. Pediatric Dermatology. 4th ed. Mosby Elsevier; 2011:1535-1583.
7
Know Your Nits!
•
Nits are tiny, teardrop-shaped eggs attached to 1 side
of the hair shaft with a waterproof, glue-like substance1-4
– Often found on nape of the neck and behind the ears 5
•
•
•
Viable nits with an egg inside may be tan to
coffee-colored or darker1
Nonviable nits are white or yellowish
shells, or casings1
Nits attached >1cm from the scalp
are usually not viable2
– In some warmer climates, viable nits
may be found several inches from the scalp3
– Close inspection is needed4
CDC/Dr. Dennis D. Juranek.
Nits may be confused with:
• Dandruff1-5
• Dirt and other debris2,4,5
• Droplets of hair spray, gel2-4
• Hair casts (pseudonits)
encircling the hair shaft1,3,5,6
• Plugs of skin cells5
• Fungal infection of the
hair (piedra)1,3,5
• Psoriasis1,3
References: 1. Meinking TL, et al. Infestations. In: Schachner LA, Hansen RC, eds. Pediatric Dermatology. 4th ed. Mosby Elsevier;
2011:1535-1583. 2. Frankowski BL, et al. Pediatrics. 2010;126(2):392-403. 3. Paller AS, Mancini AJ, eds. Hurwitz Clinical Pediatric
Dermatology. A Textbook of Skin Disorders of Childhood and Adolescence, 4th ed. New York, Elsevier Saunders; 2011:424-427. 4. CDC.
Head lice. Diagnosis. http://www.cdc.gov/.parasites/lice/head/diagnosis.html. Accessed January 13, 2013. 5. American Academy of
Pediatrics. Pediculosis capitis (head lice). In: Red Book. 2012 Report of the Committee on Infectious Diseases. Pickering LK, ed. 29th ed. Elk
Grove Village, IL, American Academy of Pediatrics; 2012:543-546. 6. Franca K, et al. Int J Trichology. 2011;3(2):121-122.
8
Head Lice:
The Truth About Transmission1-3
• Transmission of lice typically occurs
by direct head-to-head contact with
an infested individual
• Children can get head lice anytime
they come in close contact with
others—during play at home or
school, slumber parties, sports
activities, or camp
• Indirect spread by contact with
personal items (combs, brushes,
hats, headgear) is less likely but
can occur
Getty Images/Jamie Grill.
References: 1. Frankowski BL, et al. Pediatrics. 2010;126(2):392-403. 2. CDC. Head lice. Epidemiology & risk factors.
http://www.cdc.gov/parasites/lice/head/epi.html. Accessed January 13, 2013. 3. Meinking TL, et al. Infestations.
In: Schachner LA, Hansen RC, eds. Pediatric Dermatology. 4th ed. Mosby Elsevier; 2011:1535-1583.
9
Typical Symptoms
of Head Lice Infestation
• Itching is the most common symptom1-3
– Caused by an allergic reaction to louse saliva
• If someone is infested for the first time,
itching may take 4-6 weeks to develop1
– If a person has had previous head lice
episodes, itching may develop within
48 hours3
Getty Images/Westend61.
• Irritability, difficulty sleeping1
– Lice are more active in the dark
• Sores, crusting, secondary bacterial infection
on the scalp1-3
– Not common; caused by excessive scratching
• In some cases, no symptoms are present3
Gordon SC. Dermatology Nursing.
2010;22(4):18-20. Reprinted with
permission of Jannetti Publications, Inc.
References: 1. CDC. Head lice. Disease. http://www.cdc.gov/parasites/lice/head/disease.html. Accessed March 28, 2013.
2. Frankowski BL, et al. Pediatrics. 2010;126(2):392-403. 3. Meinking TL, et al. Infestations. In: Schachner LA, Hansen RC, eds.
Pediatric Dermatology. 4th ed. Mosby Elsevier; 2011:1535-1583.
10
The Key Role of the
Clinician in Head Lice Diagnosis
and Treatment
The Traditional Approach
to Head Lice1,a
Head lice suspected
70%
of Households
of Households
Treat On Their Own
Contact a Health Care Provider
• Desire to avoid delay
• Easy access to over-thecounter (OTC) products
• Limited parent knowledge of
Rx choices
a
30%
• Office may treat “over the
phone” by recommending an
OTC option or calling in a
prescription treatment
Independent market research conducted in the US; data shown are based on responses from 201 households.
Reference: 1. Sanofi Pasteur Inc., Data on file (ICR Research; Excel Omnibus Studies H8824-26, I8823). July 2009. MKT26505.
12
A New Approach:
Getting Clinicians More Involved1
• The American Academy of Pediatrics (AAP) calls for
a new approach to diagnosis and treatment of head lice
• The rationale:
– Self-diagnosis by families, plus easy availability of OTC products,
have removed clinicians from the treatment process
– The potential for misdiagnosis leading to improper use of
pediculicides raises concerns about unsafe use of these products,
especially when no lice are present or when products are used
excessively
– Emergence of resistance to some head lice products and
introduction of new products call for increased provider involvement
in the diagnosis and treatment of head lice
Reference: 1. Frankowski BL, et al. Pediatrics. 2010;126(2):392-403.
13
A New Approach:
Getting Clinicians More Involved (cont)
• According to the AAP, clinicians should:
– Be knowledgeable about head lice infestations and the
range of treatment options, both OTC and Rx1
– Take an active role as information resources for families,
schools, and community agencies1
– Take time to instruct families in the proper use of head lice
products1
• The AAP and National Association of School Nurses (NASN)
support collaborative efforts to educate communities and
develop sensible, evidence-based approaches1,2
References: 1. Frankowski BA, et al. Pediatrics. 2010;126(2):392-403. 2. Pontius D, Teskey C. Pediculosis management in the
school setting. NASN position statement, 2011. http://www.nasn.org. Accessed March 28, 2013.
14
An Alternative to Self-Treatment
School nurse
identifies head lice,
communicates with family
Family contacts their
health care provider
Treatment
successful
Treatment
unsuccessful
Instruction
given on
proper use
of product
Diagnosis
confirmed
by clinician
Rx and
OTC
options
discussed
Treatment
choices
made
15
Who Needs to be Treated?
• Treatment should never be initiated without a clear
diagnosis of head lice1,2
• Definitive diagnosis is made by finding a live louse or nymph
on the scalp or head2,3
• Misdiagnosis is common3-5
• If no nymphs or adults are seen, and the only nits are >1/4 inch
from the scalp, infestation is probably old and no longer active3,a
• When 1 member of a household is diagnosed, everyone in the
household—and other close contacts—should be checked1
– Anyone with evidence of active infestation should be treated
– All such persons should be treated at the same time
a
Some authorities use a guideline of >1cm from the scalp.2
References: 1. CDC. Head lice. Treatment. http://www.cdc.gov/parasites/lice/head/treatment.html. Accessed March 26, 2013.
2. Frankowski BL, et al. Pediatrics. 2010;126(2):392-403. 3. CDC. Head lice. Diagnosis. http://www.cdc.gov/parasites/lice/head/
diagnosis.html. Accessed April 4, 2013. 4. Pollack RJ, et al. Pediatr Infect Dis J. 2000;19(8):689-693. 5. Burkhart CG. Mayo Clin Proc.
2004;79(5):661-666.
16
Guidance on Managing Infestations
• In recommending treatment, the clinician should consider
the product’s:1





Effectiveness
Safety
Ease of use
Cost
Local patterns of resistance (if known)
• There is no scientific evidence that home remedies are
effective1,2
– Remedies not based in science can be expensive and frustrating,
leaving the child and family ineffectively treated
– Treatment recommendations should be evidence-based and come from
medical, public health, and nursing experts rather than anecdotal
experience or commercial advertisements3
References: 1. Frankowski BL, et al. Pediatrics. 2010;126(2):392-403. 2. Takano-Lee M, et al. J Pediatr Nurs. 2004;19(6):393-398.
3. Pontius D, Teskey C. Pediculosis management in the school setting. NASN position statement, 2011. http://www.nasn.org.
Accessed March 28, 2013.
17
Guidance on Managing Infestations (cont)
• Resistance to some head lice products has been
reported, but the prevalence is not known1
• According to the AAP, 1% permethrin or pyrethrins
(OTC products) can be used to treat active infestations—
unless resistance has been noted in the community1
• If a treatment does not seem to be working, possible
causes include incorrect use of the product or
resistance2
• Newer prescription treatment options are available
to help families resolve head lice episodes
References: 1. Frankowski BL, et al. Pediatrics. 2010;126(2):392-403. 2. CDC. Head lice. Treatment.
http://www.cdc.gov/parasites/lice/head/treatment.html. Accessed March 28, 2013.
18
Careful Instruction:
Key to Avoiding Misuse, Overuse
• The clinician should offer families careful instruction
in the proper use of head lice products1
– Need for second treatment? Use of nit comb?
• Products vary; families should be advised to follow
the specific instructions that accompany the product
• Parents should not use extra amounts of any lice
Getty Images/Photodisc.
medication unless instructed to do so by their health care provider2
– Drugs used to treat head lice can be dangerous if misused
or overused
• An infested person should not be treated more than 2-3 times
with the same medication if it does not seem to be working2
– In such situations, it is important to seek the advice of a health care
provider, who may recommend an alternative medication
References: 1. Frankowski BL, et al. Pediatrics. 2010;126(2):392-403. 2. CDC. Head lice. Treatment.
http://www.cdc.gov/parasites/lice/head/treatment.html. Accessed March 28, 2013.
19
Cleaning Up: What’s Really Needed?1
• Use of pediculicides is part of an overall approach
to head lice management that may also include:
– Wash in hot water or dry-clean all clothing, hats,
bed linens, and towels used by an infested person
during the 2 days prior to treatment
– Wash personal care items such as combs,
brushes, and hair clips in hot water
– Vacuum floors and furniture, especially where
the infested person sat or lay
Shutterstock.
• Fumigant sprays or fogs are not needed to
control head lice
– These products can be toxic if inhaled or absorbed
through the skin
Photos.com.
Reference: 1. CDC. Head lice. Prevention & control. http://www.cdc.gov/parasites/lice/head/prevent.html. Accessed March 26, 2013.
20
The School Nurse’s
Pivotal Roles in
Head Lice Management
The School Nurse:
First Responder to Head Lice Infestation
• School nurses are often the first to assess a child
for the presence of head lice1
• The NASN encourages parents to talk to their school
nurse about head lice
• When a case of head lice is suspected, school nurses
should
– Provide accurate information to families and
– Encourage them to contact their physician or other health care
provider to confirm the diagnosis and discuss treatment options
Reference: 1. Schoessler SZ. Am J Manag Care. 2004;10(9 Suppl):S273-S276.
22
The School Nurse: Educator
• School nurses play an essential role in educating
families, teachers, and school officials about head lice1
–
–
–
–
Calming fears
Dispelling myths and stigmas regarding pediculosis
Maintaining student privacy and confidentiality
Building awareness of effective head lice management
“School nurses are in a pivotal position to dispel myths and stigmas
regarding pediculosis by providing education on the life cycle of the
louse, methods of transmission, treatment options, and care of the
environment to the student’s family, school, and community at large.”
—NASN1
Reference: 1. Pontius D, Teskey C. Pediculosis management in the school setting. NASN position statement, 2011.
http://www.nasn.org. Accessed March 28, 2013.
23
The School Nurse: Advocate
• School district policies on head lice
management vary widely1-3
– Not always based on science
• School nurses can be instrumental
in championing evidence-based
policies in their school districts
and communities1-5
Getty Images/Ariel Skelley.
“The school nurse is the key health professional to
provide education and anticipatory guidance to the
school community regarding best practice guidance in
the management of pediculosis.”4
References: 1. Weisberg L. Nasnewsletter. 2009;24(4):165-166. 2. Sciscione P, et al. J Sch Nurs. 2007;23(1):13-20. 3. Pontius DJ.
NASN Sch Nurse. 2011;36(6):356-362. 4. Pontius D, Teskey C. Pediculosis management in the school setting. NASN position statement,
2011. http://www.nasn.org. Accessed March 28, 2013. 5. Schoessler SZ. Am J Manag Care. 2004;10(9 Suppl):S273-S276.
24
The School Nurse:
First Responder, Educator, Advocate
• The school nurse thus has a vital role to play in:
 Facilitating an accurate assessment of the problem1,2
 Containing head lice infestations1,2
 Safeguarding family privacy and confidentiality1,2
 Advising affected students and families to contact their
physician or other health care provider to discuss available
treatment options3
 Preventing overexposure to potentially hazardous
chemicals1,2
 Minimizing school absences1,2
References: 1. Pontius D, Teskey C. Pediculosis management in the school setting. NASN position
statement, 2011. http://www.nasn.org. Accessed March 28, 2013. 2. Schoessler SZ. Am J Manag Care.
2004;10(9 Suppl):S273-S276. 3. Burkhart CG. Mayo Clin Proc. 2004;79(5):661-666.
25
Strategies for School:
When Lice
Go to the Head of the Class
Managing Infestations in the School:
NASN Guidance
 If a child in school has live head lice, he or she should
remain in class but be discouraged from close direct head contact with
others
 The school nurse should contact the parents to discuss treating the
child at the end of the school day
 It is vital to prevent stigmatizing and maintain the student’s privacy
and the family’s right to confidentiality
 It may be appropriate to screen others who have had close
head-to-head contact with a student who has an active infestation
– Classroom-wide or school-wide screening is not merited
 Students with nits only should not be excluded from school;
however, it is appropriate to monitor for signs of active
re-infestation
Reference: 1. Pontius D, Teskey C. Pediculosis management in the school setting. NASN position statement, 2011.
http://www.nasn.org. Accessed March 26, 2013.
27
Helping Kids Stay in School
• The AAP and NASN state:
No healthy child should be allowed to
miss school time because of head lice1,2
• “No-nit” policies for return to school
should be abandoned1,2
• School-based head lice screening
programs have not had a significant
effect on incidence of head lice in
schools and are not cost-effective2
iStockphoto.
References: 1. Pontius D, Teskey C. Pediculosis management in the school setting. NASN position statement, 2011.
http://www.nasn.org. Accessed January 13, 2013. 2. Frankowski BL, et al. Pediatrics. 2010;126(2):392-403.
28
Easing the Stigma
• Head lice infestations can take a high emotional and
psychological toll on some children and parents1-3
People with head lice may feel:
– Disgust, horror, panic, anger;
feelings of being dirty or contaminated
– Excluded from school and social activities
• Head lice infestations can be an emotional issue
in schools
– Parents may panic when they are told their child has head lice
– Students may feel isolated
• Parents should rely on the experience and judgment of school
nurses and other health professionals who are equipped to
provide accurate information and recommend or prescribe
treatment options
References: 1. Gordon SC. J School Nurs. 2007;23(5):283-292. 2. Parison J, et al. Int J Dermatol. 2013;52(2):169-171. 3. Parison J, Canyon
DV. Head lice and the impact of knowledge, attitudes and practices—a social science overview. In: Heukelbach J, ed. Management and
Control of Head Lice Infestations. UNI-MED, Bremen, Germany; 2010:103-109.
29
Supporting Families
•
•
The school nurse can help students and families cope with the anxiety
and stress of head lice episodes1,2
The nurse has an opportunity to establish ongoing relationships with
students and families
– Often perceived as an ally
•
Offer support and encouragement through:
– Fact-to-face conversations with families
– Frequent phone contact
– Written materials sent home with the student
•
Nurse can serve as case manager
– Educating families and providing helpful resources for dealing with infestations
– Directing them to their physician or other health care provider to discuss
treatment options
– Following up with families
References: 1. Gordon SC. J School Nurs. 2007;23(5):283-292. 2. Schoessler SZ. Am J Manag Care. 2004;10(9 Suppl):S273-S276.
30
The School Nurse:
Champion for Evidence-Based Policies
“The school nurse, as a student advocate and nursing expert, should be
included in school district-community planning, implementation, and
evaluation of vector control programs for the school setting.”1 —NASN
•
School nurses can be successful in persuading school districts
to adopt evidence-based approaches:1-4
•
Case in point: Lovelock, Nevada2
–
School nurse used incremental approach to achieve change
• Individual conversations with teachers, administrators
• “Lice 101” presentation to school board
• Educational letters to parents; fact sheets on myths
Getty Images/joSon.
•
Case in point: 5 school districts in an Iowa county3
• School nurses were called upon to serve as “catalysts for change”
– Disseminated information on evidence-based approaches to key stakeholders
– Helped develop pediculosis toolkit—“best practice guideline” rather than “policy”
– Enlisted local public health department as a key partner
References: 1. Pontius D, Teskey C. Pediculosis management in the school setting. Position statement, NASN, 2011.
http://www.nasn.org. Accessed March 28, 2013. 2. Pontius DJ. NASN Sch Nurse. 2011;26(6):356-362. 3. Andresen K, McCarthy
AM. J Sch Nurs. 2009;25(6):407-416. 4. Weisberg L. Nasnewsletter. 2009;24(4):165-166.
31
Summary
• School nurses are important first responders to head
lice infestations
• They play a key strategic role in supporting children
and families, ensuring privacy, and combating myths
and stigma associated with head lice
• School nurses can work collaboratively with parents,
physicians, and other health care providers to help
manage head lice outbreaks in a calm and
professional manner
32
Summary (cont)
• School nurses can help their communities by advocating
for evidence-based policies and encouraging an end to
no-nit policies for school re-entry
• Professional associations such as the AAP are urging
pediatricians and other clinicians to become more
involved in head lice management and family education
• School nurses can support the AAP guidance by
directing students and families to first contact their
physician to discuss treatment options
33
For More Information …
Visit the Lice Lessons resources area at http://www.NASN.org
•
•
•
•
•
•
Selected References
NASN. Pediculosis management in the school setting, 2011 NASN
position statement. http://www.NASN.org
Pontius DJ. Hats off to success: changing head lice policy. NASN
Sch Nurse. 2011;26(6):356-362.
Frankowski BL, Bocchini JA Jr, AAP Council on School Health and
Committee on Infectious Diseases. Clinical report—head lice.
Pediatrics. 2010;126(2):392-403.
Weisberg L. The goal of evidence-based pediculosis guidelines.
Nasnewsletter. 2009;24(4):165-166.
Gordon SC. Shared vulnerability: a theory of caring for children with
persistent head lice. J School Nurs. 2007;23(5):283-292.
Andresen K, McCarthy AM. A policy change strategy for head lice
management. J Sch Nurs. 2009;25(6):407-416.
34
Background Information
on Approved
Head Lice Products
Treating Head Lice: Many Choices
OTC
Prescription
Nix®,a (permethrin, 1%)
Lindanec 1% shampoo
RID®,b et al (pyrethrins with
piperonyl butoxide)
Ovide®,d (malathion,
0.5% lotion)
Ulesfia®,e (benzyl alcohol,
5% lotion)
Natroba®,f (spinosad,
0.9% suspension)
Sklice®,g (ivermectin,
0.5% lotion)
Important Safety Information for Sklice Lotion
The most common adverse reactions for Sklice (<1%) are conjunctivitis, ocular hyperemia,
eye irritation, dandruff, dry skin, and skin burning sensation.
Please see Important Safety Information for Sklice Lotion at the end of this presentation.
Full Prescribing Information for Sklice Lotion will be provided at this session.
a
Nix® is a registered trademark of Insight Pharmaceuticals, LLC. b RID® is a registered trademark of Bayer HealthCare, LLC.
c Lindane is manufactured by Morton Grove Pharmaceuticals. d Ovide® is a registered trademark of Taro Pharmaceuticals, U.S.A., Inc.
e Ulesfia® is a registered trademark of Shionogi, Inc. f Natroba® is a registered trademark of ParaPRO LLC. g Sklice Lotion® is a registered
trademark of Sanofi Pasteur Inc.
36
Prescription Lice Products
Lindane, 1%1
Malathion, 0.5%
(Ovide)2
Benzyl
alcohol, 5%
(Ulesfia)3
Spinosad,
0.9%
(Natroba)4
Ivermectin,
0.5%
(Sklice Lotion)5
Age
indication
Use with caution
in those <110lb
Safety not shown
<6 y
≥6 mo
≥4 y
≥6 mo
Dosage
1-2oz depending
on hair length
and density
2-oz bottles; apply
enough to wet hair
and scalp
4-48oz
(varies with hair
length)
Up to 120mL
(1 bottle)
depending on
hair length
Up to 120mL
( 4-oz tube)
4 min;
do not
re-treat
8–12 hr; repeat
treatment in
7-9 d if lice present
10 min; repeat
treatment
after 7 d
10 min; repeat
treatment in
7 d if lice present
10 min; tube is
intended for single
use only; consult
health care
provider prior to
re-treatment
Time of
application
The comparison of product information has not been established in head-to-head trials.
The clinical significance of this information has not been established.
Please see Important Safety Information for Sklice Lotion at the end of this presentation.
Full Prescribing Information for Sklice Lotion will be provided at this session.
References: 1. Lindane [Prescribing Information]. Morton Grove, IL: Morton Grove Pharmaceuticals; 2005. 2. Ovide [Prescribing Information].
Hawthorne, NY: Taro Pharmaceuticals; 2011. 3. Ulesfia [Prescribing Information]. Florham Park, NJ: Shionogi Inc.; 2012. 4. Natroba
[Prescribing Information]. Carmel, IN:ParaPRO, 2011. 5. Sklice Lotion [Prescribing Information]. Swiftwater, PA: Sanofi Pasteur Inc.; 2012.
37
Important Safety Information
for Sklice Lotion
Indication
Sklice Lotion is a pediculicide indicated for the topical treatment of head lice
infestations in patients 6 months of age and older.
Adjunctive Measures
Sklice Lotion should be used in the context of an overall lice management program:
Wash (in hot water) or dry clean all recently worn clothing, hats, used bedding
and towels.
Wash personal care items such as combs, brushes and hair clips in hot water.
A fine tooth comb or special nit comb may be used to remove dead lice and nits.
Important Safety Information for Sklice Lotion
In order to prevent accidental ingestion, Sklice Lotion should only be administered to
pediatric patients under the direct supervision of an adult.
The most common adverse reactions (incidence <1%) were conjunctivitis, ocular
hyperemia, eye irritation, dandruff, dry skin, and skin burning sensation.
Before administering Sklice Lotion, please see the full Prescribing Information
provided at this session.
38