Children should not be kept home from school because they have Head Lice. Although many schools still have "no-nits" policies, they have not been shown to be effective for reducing the spread of head lice because head lice are primarily transmitted through direct head-to-head contact, which is more likely to occur at sleepovers and sleep-away camps than in schools. First-line treatment should still be 1% permethrin lotion, which is available over the counter, or pyrethrins when resistance to these products is not suspected. In cases where resistance is confirmed or treatment fails, prescription malathion 0.5% can be used in children 2 years of age or older. Benzyl alcohol 5% is another option.