As a parent who has dutifully combed nits from my children’s hair, the promise of a no-comb treatment for head lice sounds mighty appealing. An article in today’s New England Journal of Medicine looks like a slam dunk for such a treatment, a medication called ivermectin (Sklice). In two trials, one dose of ivermectin and no nit-combing did vastly better than a placebo treatment. Side effects were also minimal. Keep in mind that the trials didn’t test ivermectin against the current standard treatment using lotions made with permethrin or pyrethrins. And they included under 800 people in carefully controlled situations. That means we don’t really know the true effectiveness, side effects, safety profile, and interactions with other drugs. Until more is known about side effects and how ivermectin stacks up against other treatments, it seems wise to follow the current guidelines from the American Academy of Pediatrics. They call for the use of an over-the-counter product containing permethrin or pyrethrins as a first salvo against head lice, along with combing wet hair with a fine-toothed comb to remove nits.