What should be done if lice do not come out after treatment? - briefly
Apply a second treatment using a pediculicide with a different active ingredient, following the label’s timing guidelines (typically a repeat dose after 7–10 days). If live lice remain, seek professional medical advice for alternative therapies.
What should be done if lice do not come out after treatment? - in detail
If head‑lice survive an initial therapy, the first step is to confirm that live insects remain. Examine the scalp in bright light, using a fine‑toothed comb on wet hair. Look for nits attached within ¼ inch of the scalp and for adult or nymph lice moving between strands.
When live insects are detected, repeat the treatment according to the product’s instructions. Most over‑the‑counter pediculicides require a second application 7‑10 days after the first, targeting newly hatched lice that escaped the initial dose. Apply the second dose precisely as directed, ensuring thorough coverage of the entire scalp and hair length.
If the second application fails to eradicate the infestation, consider the following actions:
- Switch to a different class of insecticide (e.g., from a pyrethrin‑based formula to a dimethicone‑based product) to avoid resistance.
- Use a prescription‑only medication, such as ivermectin or malathion, after consulting a healthcare professional.
- Perform meticulous manual removal: comb the hair with a fine‑toothed nit comb every 2‑3 days for at least two weeks, removing each nymph and nit as it appears.
- Wash all personal items (hats, scarves, pillowcases, bedding) in hot water (≥ 130 °F/54 °C) or seal them in a plastic bag for two weeks to kill any dormant lice or eggs.
- Vacuum carpets, upholstered furniture, and car seats; discard or launder items that cannot be cleaned.
If lice persist after these measures, obtain a professional evaluation. A clinician can confirm correct diagnosis, rule out misidentification of other scalp conditions, and prescribe a stronger regimen if necessary. Continuous monitoring for at least three weeks will ensure that any remaining eggs hatch and are eliminated, preventing re‑infestation.