How should lice be removed in pregnant women? - briefly
Use a fine‑toothed nit comb on wet hair after applying a pregnancy‑safe conditioner or diluted vinegar, repeating the process every 2–3 days until all nits are removed. Avoid over‑the‑counter insecticidal shampoos and consult a healthcare provider before using prescription pediculicides.
How should lice be removed in pregnant women? - in detail
Lice infestations during pregnancy require a treatment plan that minimizes fetal exposure while effectively eliminating the parasite.
Wet‑combing with a fine‑toothed nit comb is the safest first‑line method. The procedure involves applying a generous amount of conditioner to damp hair, separating sections, and pulling the comb from scalp to tip in a steady motion. Each pass should be followed by rinsing the comb and repeating until no live lice or nits are detected. Sessions are performed every 2–3 days for at least two weeks to break the life cycle.
Topical pediculicides that are considered low‑risk can be used when mechanical removal alone is insufficient. A 4% dimethicone lotion, applied according to manufacturer instructions, coats lice and blocks their respiratory openings without systemic absorption. Permethrin 1% cream rinse may be employed after thorough consultation; it is classified as pregnancy category C but has a long record of safe topical use. Application should be limited to the scalp, left for the recommended duration, and washed off completely.
Oral ivermectin is contraindicated in pregnancy and must be avoided. Topical ivermectin formulations, such as a 0.5% lotion, can be prescribed only under specialist supervision, with the understanding that data on fetal safety are limited.
Environmental control prevents re‑infestation. All clothing, bedding, and towels used within the previous 48 hours must be washed in hot water (≥ 60 °C) and dried on high heat. Items that cannot be laundered should be sealed in plastic bags for two weeks. Vacuuming carpets, upholstered furniture, and car seats removes detached nits. Personal items such as hairbrushes and combs should be immersed in hot, soapy water for at least 10 minutes.
Follow‑up examinations are scheduled 7–10 days after the initial treatment to verify eradication. If live lice persist, repeat the chosen pediculicide or continue wet‑combing until clearance is confirmed. Counseling the patient on hygiene practices and avoidance of shared personal items reduces the risk of recurrence.