How should lice and nits be treated in children? - briefly
Apply a 1 % permethrin shampoo or lotion to the child’s hair, follow the label’s timing, rinse, and repeat after 7–10 days; then remove nits with a fine‑tooth comb and launder bedding, clothing, and personal items in hot water. If resistance is suspected, a prescription‑strength agent such as 0.5 % ivermectin lotion may be used under medical supervision.
How should lice and nits be treated in children? - in detail
Effective management of head‑lice infestations in children requires a combination of chemical treatment, mechanical removal, and environmental control.
Initial assessment should confirm the presence of live insects and viable eggs by visual inspection of the scalp and hair shafts. Adult lice are mobile and visible; nits attached close to the scalp appear creamy‑white, while empty shells are tan and located farther from the scalp.
Chemical options include:
- Permethrin 1 % lotion, applied to dry hair, left for 10 minutes, then rinsed; repeat after 7–10 days to eliminate newly hatched lice.
- Dimethicone 4 % lotion, a silicone‑based product that suffocates insects without neurotoxic activity; left on hair for 8 hours before washing.
- Pyrethrin‑based sprays combined with piperonyl‑butoxide, used according to label instructions; resistance patterns may reduce efficacy.
- Prescription agents such as malathion 0.5 % lotion (single 8‑hour application), benzyl alcohol 5 % lotion (applied twice daily for 10 days), or oral ivermectin (single dose of 200 µg/kg) for cases unresponsive to over‑the‑counter products.
Mechanical removal complements chemical therapy. A fine‑toothed nit comb should be used on wet, conditioned hair, section by section, beginning at the scalp and moving toward the ends. Repeating combing every 2–3 days for at least two weeks ensures removal of any surviving eggs.
Environmental measures focus on reducing re‑infestation risk:
- Wash clothing, bedding, and towels used within the preceding 48 hours in hot water (≥ 60 °C) and dry on high heat.
- Seal non‑washable items in sealed plastic bags for two weeks.
- Vacuum carpets, upholstered furniture, and car seats; discard vacuum bags immediately.
- Avoid sharing hats, hairbrushes, or hair accessories during treatment.
Follow‑up examination should occur 7–10 days after the initial application to verify eradication. Persistent live lice or newly emerged nits warrant a second treatment cycle with the same or an alternative agent, considering potential resistance.
Safety considerations emphasize age‑appropriate product selection. Permethrin and dimethicone are approved for children over 2 months; malathion is contraindicated in children under 6 years. Oral ivermectin requires physician oversight, especially in children weighing less than 15 kg.
A structured approach—accurate diagnosis, appropriate pharmacologic choice, diligent nit combing, and thorough environmental decontamination—provides reliable resolution of lice and egg infestations in pediatric patients.