What should be done for lice in a pregnant woman? - briefly
Use a pregnancy‑compatible pediculicide, such as 1 % permethrin shampoo, applied according to the product instructions, and comb out all nits with a fine‑tooth comb; repeat the treatment after 7–10 days. Wash bedding, clothing, and personal items in hot water and dry on high heat to eliminate any remaining lice or eggs.
What should be done for lice in a pregnant woman? - in detail
Pregnant patients who discover head‑lice infestation need a treatment plan that protects both the mother and the developing fetus. The first step is to confirm the presence of live lice or viable nits by examining the hair close to the scalp. Once confirmed, an integrated approach combining mechanical removal and safe topical agents is recommended.
Mechanical removal
- Use a fine‑toothed nit comb on damp, conditioned hair.
- Comb from the scalp outward, cleaning the comb after each pass with hot water.
- Perform the process every 2–3 days for at least two weeks to capture newly hatched insects.
Topical agents
- Permethrin 1 % cream rinse is classified as pregnancy category B and is the preferred first‑line medication. Apply to dry hair, leave for 10 minutes, then rinse thoroughly; repeat after 7 days.
- If permethrin is unavailable or ineffective, a 0.5 % malathion lotion may be considered, but only under physician supervision due to limited safety data.
- Over‑the‑counter shampoos containing dimethicone are non‑neurotoxic and can be used safely; they work by coating and immobilizing lice. Apply according to package directions, typically a 10‑minute exposure, followed by a repeat application after 7 days.
Prescription options
- Benzyl alcohol 5 % lotion is another category B alternative; it suffocates lice. Apply for 10 minutes, then rinse; repeat in one week.
- Oral ivermectin is generally avoided during pregnancy because of insufficient safety evidence; it should be reserved for severe cases after specialist consultation.
Environmental control
- Wash all bedding, towels, and clothing used within the previous 48 hours in hot water (≥60 °C) and dry on high heat.
- Seal non‑washable items in airtight plastic bags for two weeks.
- Vacuum carpets, upholstered furniture, and car seats; discard vacuum bags promptly.
Medical supervision
- Schedule a prenatal visit to discuss treatment choice and confirm gestational age.
- Document any adverse skin reactions; discontinue the product and seek alternative measures if irritation occurs.
By combining diligent combing, pregnancy‑compatible topical treatments, and thorough decontamination of personal items, the infestation can be eliminated while maintaining fetal safety.