Accurate diagnosis is essential for developing an appropriate treatment strategy. Treatment should only be given if living lice are found. Too often children are exposed to insecticides unnecessarily because a parent finds a few empty louse eggshells in the hair. However, if a child has never had head lice before, an infection may run for several weeks before it is discovered by chance, simply because there is no overt sign of the infestation.12 Prescribers should, therefore, always ask for evidence of active infection, in the form of a louse stuck to a piece of paper, before deciding on treatment.
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