What should be done if lice appear? - briefly
Apply a pediculicide (e.g., permethrin 1 % shampoo or lotion) and comb out all nits with a fine‑toothed nit comb; then wash clothing, bedding, and personal items in hot water and dry on high heat to prevent re‑infestation.
What should be done if lice appear? - in detail
When an infestation of head lice is confirmed, immediate action is required to eliminate the parasites and prevent re‑infestation. The following protocol outlines each stage of treatment and post‑treatment management.
First, verify the presence of lice by examining the scalp and hair with a fine‑toothed comb under bright light. Look for live insects, nymphs, or viable eggs (nits) attached to hair shafts within a half‑inch of the scalp.
Next, select an appropriate pediculicide. Options include:
- Permethrin 1 % lotion, applied to dry hair, left for 10 minutes, then rinsed.
- Pyrethrin‑based products combined with a piperonyl‑butoxide synergist, applied according to manufacturer instructions.
- Dimethicone or silicone‑based lotions, which coat and suffocate lice without neurotoxic chemicals.
- Prescription oral ivermectin, reserved for cases resistant to topical agents.
Apply the chosen product precisely as directed, ensuring thorough coverage from scalp to hair tips. After the recommended exposure time, rinse hair with warm water and remove excess product with a mild shampoo if advised.
After treatment, comb the hair with a fine metal nit comb while it is still damp. Perform this step at least twice daily for seven days, removing each caught insect or egg. Dispose of combed material by sealing it in a plastic bag and discarding it.
Concurrent environmental measures reduce the risk of recurrence:
- Wash all bedding, clothing, and personal items used within the previous 48 hours in hot water (≥ 130 °F/54 °C) and dry on high heat.
- Seal non‑washable items (e.g., stuffed toys) in sealed plastic bags for two weeks.
- Vacuum carpets, upholstery, and vehicle seats to remove stray hairs that may harbor nits.
- Advise all close contacts—family members, classmates, caregivers—to conduct parallel examinations and, if necessary, receive prophylactic treatment.
Follow‑up inspection should occur 7–10 days after the initial application. Re‑treat only if live lice are still observed; otherwise, continue daily combing for an additional week to ensure all nits have been eliminated.
Document the treatment dates, products used, and any adverse reactions. Communicate the outcome to relevant authorities (e.g., school health officials) to facilitate broader monitoring and prevent further spread.