Lice on a child's hair: what should be done? - briefly
Apply an FDA‑approved lice treatment to the child's scalp, following the label directions and repeating the dose after 7–10 days; then comb out nits with a fine‑toothed nit comb and launder all bedding, clothing, and personal items in hot water.
Lice on a child's hair: what should be done? - in detail
Head‑lice infestation in children requires prompt identification, effective eradication, and preventive measures to avoid recurrence.
Detection begins with a thorough scalp examination. Use a fine‑toothed lice comb on damp, conditioned hair, starting at the scalp and moving toward the ends. Look for live insects, which are gray‑brown and about the size of a sesame seed, and for nits—oval, white or yellowish eggs attached firmly to hair shafts within a few millimeters of the scalp. A single live louse confirms an active infestation; multiple nits indicate a developing problem.
Treatment options fall into two categories: chemical and non‑chemical.
-
Over‑the‑counter pediculicides
- Permethrin 1 % lotion applied to dry hair, left for 10 minutes, then rinsed.
- Pyrethrin‑based products combined with a piperonyl‑butoxide enhancer, applied similarly.
Follow label instructions precisely; repeat the application after 7–10 days to eliminate newly hatched lice.
-
Prescription agents
- Malathion 0.5 % lotion for resistant cases; apply to dry hair, leave for 8–12 hours, then wash.
- Ivermectin oral tablets (200 µg/kg) for severe or refractory infestations, administered as a single dose.
-
Mechanical removal
- Wet‑comb method using a fine‑toothed comb, performed every 2–3 days for two weeks.
- Systematic sectioning of hair to ensure complete coverage.
Non‑chemical approaches—such as dimethicone‑based lotions that coat and suffocate lice—provide alternatives for children with sensitivities to neurotoxic agents.
After treatment, verify success by re‑examining the scalp 24 hours later and again one week later. Absence of live lice and a significant reduction in nits indicate effective control.
Preventive actions reduce the likelihood of reinfestation.
- Wash bedding, hats, scarves, and hair accessories in hot water (≥ 60 °C) and dry on high heat.
- Seal non‑washable items in sealed plastic bags for two weeks to starve any remaining lice.
- Educate caregivers and school personnel about avoiding head‑to‑head contact and sharing personal items.
- Conduct weekly scalp checks for at least one month after treatment, especially during school outbreaks.
If an infestation persists despite correct application of a pediculicide, consider resistance testing or switch to an alternative class of medication. Persistent cases may require combined chemical and mechanical strategies under medical supervision.
Overall, timely detection, adherence to treatment protocols, and diligent follow‑up constitute the most reliable method to eradicate head‑lice infestations in children and prevent their return.