How are lice treated in a hospital? - briefly
In a hospital, lice are eradicated with a single application of a topical pediculicide such as 1 % permethrin or 0.5 % malathion, left on the scalp for the specified duration and then washed off. All personal items, bedding, and clothing are laundered in hot water or isolated for at least 48 hours to prevent re‑infestation.
How are lice treated in a hospital? - in detail
Lice infestations are identified through visual inspection of the scalp, hair shafts, and body hair. Confirmation requires finding live insects, nits attached within 1 cm of the scalp, or recent bite marks. Once diagnosed, patients are placed in a private room or cohort with other affected individuals to prevent cross‑contamination.
The therapeutic protocol includes three components: pharmacologic treatment, mechanical removal, and environmental decontamination.
Pharmacologic agents
- Permethrin 1 % cream rinse: applied to dry hair, left for 10 minutes, then rinsed; repeat after 7 days.
- Pyrethrins with piperonyl butoxide: sprayed on hair, left for 10 minutes, then washed off; repeat after 7 days.
- Malathion 0.5 % lotion: applied to dry hair, left for 8–12 hours, then washed; single application.
- Ivermectin 0.5 % lotion: applied to dry hair, left for 10 minutes, then rinsed; repeat after 7 days.
- Benzyl alcohol 5 % lotion: applied to dry hair, left for 10 minutes, then rinsed; repeat after 7 days.
- Spinosad 0.9 % suspension: applied to dry hair, left for 10 minutes, then rinsed; repeat after 7 days.
Selection depends on patient age, allergy history, and previous treatment failures. Pediatric dosing follows manufacturer guidelines; infants under 2 months are generally excluded from permethrin and malathion.
Mechanical removal
- Fine-toothed lice combs used on wet, conditioned hair for 10 minutes per session.
- Sessions repeated every 2–3 days for two weeks.
- Comb cleaning after each pass with hot water and detergent.
Environmental control
- All bedding, clothing, and personal items laundered at ≥60 °C or sealed in plastic bags for 72 hours.
- Non‑washable items (e.g., helmets, wigs) treated with a 0.5 % permethrin spray, then isolated for 48 hours.
- Room surfaces cleaned with a hospital‑approved disinfectant; vacuuming of carpets and upholstery performed.
Nursing staff monitor treatment adherence, assess for adverse reactions (e.g., skin irritation, neurotoxicity), and document clearance of live lice. Follow‑up examinations occur on day 7 and day 14 to verify eradication. Persistent infestation prompts a switch to an alternative pediculicide or combination therapy.
The comprehensive approach—targeted medication, systematic combing, and strict environmental measures—ensures effective elimination of lice within the clinical environment.