Lice in pregnant women – what should be done? - briefly
Treat with a single application of 1 % permethrin lotion, which is regarded as safe for pregnant patients, and wash all clothing, bedding, and towels in hot water (≥130 °F) followed by a dryer cycle. Repeat the treatment after 7–10 days to eradicate any newly hatched lice.
Lice in pregnant women – what should be done? - in detail
Lice infestation during pregnancy requires prompt, safe management to protect both the mother and the developing fetus. Diagnosis is clinical; live insects or nits attached to hair shafts confirm the problem. Immediate treatment is advisable because prolonged contact can cause itching, secondary skin infection, and increased discomfort.
Pharmacologic options
- Permethrin 1 % shampoo or lotion applied to dry hair, left for 10 minutes, then rinsed; repeat after 7 days. Permethrin has extensive safety data and is classified as pregnancy‑compatible.
- Pyrethrin‑based products combined with piperonyl butoxide may be used once, following label instructions; avoid repeated applications.
- Malathion 0.5 % is contraindicated because systemic absorption can affect fetal development.
- Oral ivermectin is not recommended; limited safety evidence and FDA classification as “Category C” discourage use in gestation.
Non‑chemical measures
- Fine‑tooth combing of wet hair after applying a conditioner; comb each section from scalp to tip, repeating every 2–3 days for two weeks.
- Washing all clothing, bedding, and towels used within the previous 48 hours in hot water (≥ 60 °C) and drying on high heat.
- Sealing non‑washable items in plastic bags for at least two weeks to starve lice.
- Vacuuming carpets, upholstery, and car seats to remove fallen nits.
Follow‑up
- Re‑examine the scalp 7–10 days after the first treatment; persistent live insects require a second application of the same pediculicide.
- If symptoms persist despite correct use, consult a dermatologist or obstetrician for alternative strategies.
- Document all treatments in the prenatal record to ensure coordinated care.
Precautions
- Do not apply any pediculicide to the scalp of a woman with known hypersensitivity to the active ingredient.
- Avoid simultaneous use of multiple insecticides; combine only with mechanical removal.
- Do not use products containing high concentrations of organophosphates or carbamates, as these pose teratogenic risks.
- Ensure proper ventilation during application to reduce inhalation exposure.
Effective control combines a pregnancy‑compatible topical insecticide with diligent mechanical removal and environmental sanitation. Early intervention, adherence to recommended dosing intervals, and thorough follow‑up minimize health risks for both mother and fetus.