How to remove lice if nothing works? - briefly
Apply a prescription pediculicide (e.g., permethrin 5% or ivermectin) and use a fine-toothed nit comb on wet hair, repeating the treatment after 7‑10 days to catch any newly hatched nits. Simultaneously launder all bedding, clothing, and personal items in hot water and vacuum the living area to eliminate residual eggs and lice.
How to remove lice if nothing works? - in detail
When conventional over‑the‑counter shampoos and combs do not eradicate an infestation, a systematic approach is required. Begin with a precise assessment: examine the scalp under bright light, using a fine‑toothed lice comb to confirm the presence of live insects and viable eggs. Record the number of nits attached within a ¼‑inch of the hair shaft, as this indicates treatment urgency.
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Prescription topical agents – Seek a dermatologist or pediatrician for medicated lotions or creams containing ingredients such as spinosad, ivermectin, or malathion. Apply exactly as directed, typically leaving the product on the scalp for a specified duration before rinsing. A second application 7–10 days later eliminates newly hatched lice that survived the first round.
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Oral systemic therapy – In resistant cases, a physician may prescribe oral ivermectin or other antiparasitic tablets. Dosage is weight‑based; follow the prescription schedule, usually a single dose repeated after one week.
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Mechanical removal – After chemical treatment, detangle hair and comb wet strands with a fine‑toothed nit comb every 2–3 days for two weeks. Divide the scalp into sections, pulling the comb from the scalp outward to capture both lice and eggs. Discard combed material in sealed bags.
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Environmental decontamination – Wash all clothing, bedding, and towels used within the previous 48 hours in water ≥ 130 °F (54 °C) for at least 10 minutes. Items that cannot be laundered should be sealed in plastic bags for a minimum of two weeks. Vacuum carpets, upholstered furniture, and car seats; discard vacuum bags immediately.
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Adjunctive measures – Consider dimethicone‑based lotions that suffocate insects without neurotoxic effects. Apply to dry hair, cover with a shower cap for 8–10 hours, then rinse thoroughly. Repeat after one week.
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Monitoring and retreatment – Perform a follow‑up scalp inspection 14 days after the final application. If any live lice or viable nits remain, repeat the prescribed regimen. Document each treatment session to track efficacy.
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Preventive education – Advise all household members to avoid head‑to‑head contact, refrain from sharing combs, hats, or hair accessories, and to inspect children’s hair weekly during the outbreak period.
By integrating prescription medication, rigorous mechanical combing, and thorough environmental control, even the most stubborn infestations can be eliminated without resorting to ineffective home remedies. Continuous monitoring ensures that resurgence is detected early and addressed promptly.