How and with what should I treat lice in children? - briefly
Apply a 1 % permethrin or 0.5 % malathion preparation as directed, then comb the hair with a fine-toothed lice comb to remove nits, and repeat the treatment after 7–10 days to catch any newly hatched lice.
How and with what should I treat lice in children? - in detail
Head lice infestations in children require prompt identification and a systematic treatment plan. Diagnosis involves visual inspection of the scalp and hair shafts for live insects, nymphs, or viable eggs (nits) attached within 1 cm of the scalp. Confirmation should be made before any intervention.
The first line of treatment consists of topical pediculicides approved for pediatric use. Permethrin 1 % lotion applied to dry hair for ten minutes, then rinsed, is effective for children older than two years. Pyrethrin formulations combined with piperonyl‑butoxide are suitable for children over six months but demand careful adherence to instructions to avoid resistance. Benzyl alcohol 5 % lotion, safe for infants six months and older, kills lice but does not affect eggs; a second application seven days later eliminates newly hatched nymphs. Spinosad 0.9 % suspension, approved for children six months and older, offers a single‑dose solution with residual activity against emerging lice. Ivermectin 0.5 % lotion, prescribed for children over fifteen kilograms, provides an alternative when resistance to other agents is suspected.
Prescription options include malathion 0.5 % oil for children older than six years, applied for eight to twelve hours before washing. Benzyl benzoate 25 % emulsion, used for children over twelve months, requires multiple applications at 48‑hour intervals. Oral ivermectin, administered as a single dose of 200 µg/kg, may be considered for refractory cases under medical supervision.
Non‑chemical measures complement pharmacologic therapy. Wet combing with a fine‑toothed nit comb, performed on damp, conditioned hair, removes live lice and nits. Sessions should occur every two to three days for two weeks. Manual removal of visible nits with fine tweezers is advisable after chemical treatment to reduce re‑infestation risk. Cutting hair short does not eradicate lice but facilitates combing.
Environmental control focuses on items that may harbor viable lice for up to 48 hours. Wash bedding, clothing, and towels used within the previous two days in hot water (≥ 50 °C) and tumble‑dry on high heat. Items that cannot be laundered should be sealed in plastic bags for at least 72 hours. Vacuum carpets, upholstery, and car seats; discard hair accessories and combs, or soak them in hot water (≥ 60 °C) for ten minutes. Pets do not serve as reservoirs for head lice and require no treatment.
A repeat application of the chosen pediculicide is mandatory 7–10 days after the first dose to eliminate newly emerged nymphs that survived the initial exposure. Follow‑up inspection one week after the second treatment confirms eradication; any remaining live lice demand retreatment or a switch to an alternative agent.
Safety considerations include avoiding products containing neurotoxic compounds in infants under two months, monitoring for skin irritation, and adhering to age‑specific dosage instructions. Parents should be instructed to read product labels, use protective gloves when applying chemicals, and keep treated children away from swimming pools for 24 hours to prevent dilution of the active ingredient.
Effective management combines an appropriate topical agent, diligent nit removal, and strict hygiene of personal items. Consistent application of these steps eliminates infestations while minimizing recurrence.