How to treat head lice? - briefly
Effective treatment uses an FDA‑approved lice medication applied to dry hair, then a meticulous wet‑combing with a fine‑toothed nit comb. Repeat the process after 7–10 days to eradicate any newly hatched insects.
How to treat head lice? - in detail
Effective management of a head‑lice infestation requires accurate identification, appropriate therapeutic agents, and thorough environmental control.
First, confirm the presence of live lice or viable nits within ¼ inch of the scalp. Use a fine‑tooth comb on wet hair, inspecting the comb after each pass for moving insects or brownish shells attached firmly to the shaft.
Second, select a treatment modality based on age, resistance patterns, and tolerance. Options include:
- Over‑the‑counter pediculicides containing 1 % permethrin or 0.5 % pyrethrin with piperonyl‑butoxide; apply to dry hair, leave for the recommended duration (usually 10 minutes), then rinse.
- Prescription‑only products such as 0.5 % malathion, 0.05 % ivermectin lotion, or 0.025 % spinosad; these are useful when resistance to pyrethroids is documented. Follow the manufacturer’s instructions precisely, noting any required pre‑treatment washing.
- Physical removal using a metal nit comb soaked in warm water; repeat combing every 2–3 days for at least two weeks to capture newly hatched nymphs.
- Dimethicone‑based lotions that coat and immobilize insects without neurotoxic action; apply to dry hair, leave for 10 minutes, then rinse.
Third, repeat the chosen regimen after 7–10 days to eliminate any lice that survived the first application and to target eggs that hatched after the initial treatment.
Fourth, decontaminate personal items. Wash clothing, bedding, and towels used within the previous 48 hours in hot water (≥ 130 °F/54 °C) and tumble‑dry on high heat. Items that cannot be laundered should be sealed in a plastic bag for two weeks or exposed to a dryer cycle on high heat for 30 minutes.
Fifth, educate all household members and close contacts about the need for simultaneous treatment and regular comb checks. Encourage avoidance of sharing hats, combs, or hair accessories during the outbreak.
Finally, schedule a follow‑up examination 2–3 weeks after the final treatment to verify eradication. Persistent itching may continue for several days due to allergic reactions to saliva; symptomatic relief can be provided with antihistamine creams or oral antihistamines as needed.
Adhering to this systematic approach maximizes the likelihood of complete elimination and minimizes the risk of reinfestation.