Provider Alert! Guidance for first-line treatment of pediculosis capitis (head lice)

Provider Alert!

Provider Alert! Guidance for first-line treatment of pediculosis capitis (head lice)

Attention: Primary Care Providers
Effective Date: July 16, 2020

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.

Call to action: Head lice infestations affect millions of children and their families every year.  These incidents result in direct and indirect social and economic burdens as infestations spread among household members and peers.  Permethrin 5% and Natroba (spinosad) 0.9% are currently the only agents with preferred designation on the Texas Medicaid drug formulary for STAR, STAR Kids, and CHIP members.

Permethrin is the preferred first line agent in the absence of known permethrin resistance in the community per the American Academy of Pediatrics (AAP) guidelines.  Natroba should be considered only if there is known permethrin resistance, or if the member has failed permethrin treatment.

How this impacts providers: Providers should continue to attempt initial treatment of head lice with permethrin.

Next steps for providers: Providers should continue to follow AAP guidelines when prescribing.


American Academy of Pediatrics Clinical Report on Head Lice

The Texas Managed Medicaid STAR/CHIP/STAR Kids formularies are available here:

If you have any questions, please email Provider Network Management at:
For access to all provider alerts, log into: or

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