Lice in a child: what should be done, shampoos? - briefly
Apply a 1 % «permethrin» or «pyrethrin» shampoo as directed, comb out live lice and nits with a fine‑tooth comb, and repeat the treatment after 7–10 days; for resistant infestations, use a second‑generation pediculicide such as «dimethicone» spray.
Lice in a child: what should be done, shampoos? - in detail
Head lice infestations in children require prompt, systematic action to eliminate the insects and prevent re‑infestation. The process consists of three essential phases: detection, treatment, and follow‑up.
Detection begins with a thorough visual examination of the scalp, especially behind the ears and at the nape of the neck. Use a fine‑tooth lice comb on wet hair; each pass should be inspected for live lice or viable nits attached within 1 cm of the scalp. If any are found, the infestation is confirmed and treatment must commence immediately.
Treatment options fall into two categories: chemical agents and mechanical removal. Chemical preparations include pediculicidal shampoos, lotions, and mousse formulations containing either pyrethrins, permethrin (1 % concentration), or dimethicone. These products work by either neurotoxic action or by coating the insects, causing immobilisation. Application instructions are critical: apply to dry hair, massage into the scalp, leave for the specified duration (usually 10 minutes), then rinse thoroughly. Repeat the treatment after 7–10 days to target newly hatched nits that survived the first application.
Mechanical removal relies on a fine‑tooth nit comb, preferably made of stainless steel. The recommended procedure is:
- Wet hair with conditioner to reduce tangling.
- Comb from scalp outward in sections, cleaning the comb after each pass.
- Repeat the combing session daily for at least 10 days, extending to two weeks if live lice persist.
Adjunct measures support the primary treatment:
- Wash all bedding, clothing, and hats used within the previous 48 hours in hot water (≥ 60 °C) and tumble‑dry on high heat.
- Seal non‑washable items in airtight plastic bags for two weeks.
- Vacuum carpets and upholstered furniture to remove stray nits.
- Avoid sharing combs, hair accessories, or hats until the infestation is cleared.
When selecting a shampoo, prioritize products with dimethicone for families seeking a non‑neurotoxic option; dimethicone acts by suffocating the insects and has a low risk of resistance. Permethrin‑based shampoos remain effective in many regions but may encounter resistance in areas with documented pyrethroid‑resistant lice populations. Verify the product’s expiration date and confirm that it is approved by relevant health authorities.
If chemical treatment fails after two complete cycles, consider prescription‑strength options such as malathion (0.5 %) or ivermectin lotion (0.5 %). These should be administered under medical supervision due to potential side‑effects and contraindications.
Continuous monitoring after treatment is essential. Inspect the child’s hair every 2–3 days for three weeks; any reappearance of live lice necessitates immediate retreatment. Documentation of treatment dates, product used, and observed outcomes assists healthcare providers in managing persistent cases.
In summary, successful eradication of head lice in children relies on accurate detection, appropriate choice of pediculicidal shampoo or thorough combing, rigorous hygiene of personal items, and diligent post‑treatment surveillance.