A client has lice, what to do? - briefly
Apply a licensed pediculicide shampoo as directed, then comb out nits with a fine‑tooth comb and launder clothing, bedding, and personal items in hot water. Advise the client to repeat the treatment after seven days and to avoid head‑to‑head contact until the infestation is cleared.
A client has lice, what to do? - in detail
When a client presents with head‑lice infestation, immediate action is required to prevent spread and alleviate discomfort.
First, confirm the diagnosis by inspecting the scalp and hair for live lice and viable nits within 2 mm of the scalp. Use a fine‑toothed comb on wet hair under adequate lighting.
Next, select an appropriate pediculicide. Preferred options include:
- Permethrin 1 % lotion, applied to dry hair, left for 10 minutes, then rinsed.
- Dimethicone‑based products, which immobilise insects without neurotoxic effects.
- Malathion 0.5 % for resistant cases, applied for 8‑12 hours under medical supervision.
Apply the chosen treatment according to manufacturer instructions, ensuring full coverage of the scalp and hair length. After rinsing, repeat the application after 7‑10 days to eliminate newly hatched lice.
Simultaneously, address the environment:
- Wash all clothing, bedding, and towels used within the previous 48 hours in hot water (≥ 60 °C) and dry on high heat.
- Seal non‑washable items in a sealed plastic bag for 2 weeks.
- Vacuum carpets, upholstered furniture, and vehicle seats; discard vacuum bags promptly.
Provide the client with a detailed care plan, including:
- Instructions for combing with a nit‑comb every 2‑3 days for 2 weeks.
- Guidance on avoiding head‑to‑head contact and sharing personal items.
- Schedule for follow‑up examination to verify eradication.
Document the incident in the client’s record, noting the type of product used, dosage, and any adverse reactions. Notify relevant supervisory personnel if the client is part of a group setting (e.g., school, daycare) to coordinate broader preventive measures.
Continual monitoring for re‑infestation is essential; repeat scalp inspection at 1‑week and 4‑week intervals. Prompt detection of any recurrence permits immediate retreatment, minimizing further transmission.