Lice during pregnancy – what should be done? - briefly
Treat head‑lice infestation during pregnancy with a doctor‑recommended topical pediculicide—commonly 1 % permethrin or 0.5 % malathion—and follow with meticulous combing, laundering of clothing and bedding, and environmental cleaning to prevent re‑infestation.
Lice during pregnancy – what should be done? - in detail
Lice infestations in pregnant individuals require prompt and safe management because the parasites can cause itching, secondary skin infection, and discomfort that may affect sleep and overall well‑being. Diagnosis is straightforward: adult lice and nits are visible on the scalp, particularly behind the ears and at the hairline. A careful visual inspection with a fine-toothed comb confirms the presence and extent of the problem.
Treatment options must balance efficacy with fetal safety. The first‑line approach is mechanical removal. Wet combing with a fine-toothed comb, performed on damp hair after applying a mild conditioner, eliminates adult lice and most nits. Repeating the combing every 2–3 days for two weeks ensures that newly hatched lice are captured before they mature.
If chemical agents are needed, only products classified as safe for use during pregnancy should be considered. Permethrin 1 % lotion, approved for topical use, is regarded as low risk because systemic absorption is minimal. Application follows the manufacturer’s instructions: apply to dry hair, leave for 10 minutes, then rinse thoroughly. A second treatment after 7–10 days targets any survivors. Dimethicone‑based products, which act by coating and suffocating lice, are also acceptable; they contain no neurotoxic insecticides and have no documented teratogenic effects.
Oral medications are generally avoided. Ivermectin, although effective, is not recommended for routine use in pregnancy due to limited safety data. In severe cases where oral therapy becomes unavoidable, consultation with an obstetrician and a dermatologist is mandatory.
Environmental control reduces reinfestation risk. Wash all bedding, towels, and clothing used within the previous 48 hours in hot water (≥ 60 °C) and tumble‑dry on high heat. Items that cannot be laundered should be sealed in plastic bags for two weeks, the typical lifespan of a louse. Vacuum carpets, upholstered furniture, and car seats to remove stray hairs that may harbor nits. Avoid sharing personal items such as combs, hats, or hair accessories.
Pregnant individuals should inform close contacts—partners, family members, and childcare providers—so that simultaneous treatment can be implemented, preventing cross‑contamination. Follow‑up examinations after the final treatment confirm eradication; absence of live lice and nits after two weeks indicates success.
Postpartum care mirrors the prenatal strategy. Breastfeeding does not contraindicate the use of permethrin or dimethicone, as topical application poses no risk to the infant. Nevertheless, maintaining strict hygiene and regular scalp inspections remains essential to avoid recurrence during the early weeks after delivery.