What is best to use against lice? - briefly
A 1 % permethrin rinse applied to the hair and scalp for the recommended duration is the most effective first‑line remedy; if lice persist, a prescription ivermectin lotion or oral medication should be used.
What is best to use against lice? - in detail
Effective control of head‑lice infestations relies on a combination of chemical, physical, and preventive measures.
First‑line pharmacologic agents include topical pediculicides such as permethrin 1 % lotion, pyrethrins combined with piperonyl‑butoxide, and dimethicone‑based silicone oils. Permethrin and pyrethrins act on the nervous system of the insect, causing paralysis and death. Dimethicone suffocates lice by coating their exoskeleton, and it retains activity against resistant strains. Application follows manufacturer instructions: apply to dry hair, leave for the recommended duration (usually 10 minutes), then rinse thoroughly. A second treatment 7–10 days later eliminates newly hatched nymphs.
When resistance to neurotoxic agents is documented, alternative compounds such as malathion 0.5 % or spinosad 0.9 % become appropriate. Malathion inhibits acetylcholinesterase, while spinosad disrupts nicotinic receptors. Both require careful handling to avoid skin irritation and must be applied in a well‑ventilated area.
Physical removal methods complement chemical treatment. Wet‑comb therapy uses a fine‑toothed nit comb on conditioner‑treated hair. Repeating the combing process every 2–3 days for two weeks removes live insects and eggs. High‑temperature devices—steam hoods or hair dryers set to ≥ 130 °C—kill lice on contact, provided the hair is not damaged.
Environmental decontamination reduces re‑infestation risk. Wash bedding, clothing, and towels in water ≥ 50 °C for at least 30 minutes, then tumble‑dry on high heat. Items that cannot be laundered should be sealed in plastic bags for a minimum of two weeks, exceeding the lice life cycle. Vacuuming upholstered furniture and car seats removes detached nits.
Preventive strategies limit spread. Advise regular head checks in schools and families, avoid sharing combs, hats, or hair accessories, and educate caregivers on early detection.
In summary, optimal management integrates an appropriate pediculicide (permethrin, dimethicone, or resistance‑based alternatives), systematic nit combing, targeted heat treatment, thorough laundering, and vigilant prevention. This multimodal approach maximizes eradication while minimizing recurrence.