What should be used against lice? - briefly
Effective treatment involves applying a pediculicide such as 1 % permethrin or a dimethicone‑based lotion, then combing the hair thoroughly with a fine‑tooth nit comb to remove nits.
What should be used against lice? - in detail
Effective countermeasures against head lice involve chemical, mechanical, and environmental strategies. Chemical agents are the primary option for rapid eradication. Permethrin 1 % lotion, applied for ten minutes and rinsed, eliminates most infestations; resistance can reduce efficacy, so alternative pediculicides may be required. Pyrethrin formulations combined with piperonyl‑butoxide act similarly but share resistance patterns. Malathion 0.5 % liquid, left on the scalp for eight to twelve hours, provides a non‑neurotoxic option for resistant cases. Spinosad 0.9 % suspension, applied for ten minutes, targets lice and nits with a novel mode of action, reducing cross‑resistance risk. Ivermectin 0.5 % lotion, applied for ten minutes, offers a prescription‑only alternative with systemic absorption minimal for topical use.
Mechanical removal supplements chemicals. Fine‑toothed nit combs, used on wet, conditioned hair, physically extract live lice and viable nits. Repeating combing every two to three days for ten days ensures removal of newly hatched insects. Comb‑only regimens avoid toxic exposure but require meticulous technique and consistent effort.
Environmental control reduces reinfestation. Wash clothing, bedding, and towels used within the previous 48 hours in water ≥ 30 °C, then tumble dry on high heat. Items that cannot be laundered should be sealed in plastic bags for two weeks or exposed to a freezer at –20 °C for 24 hours. Vacuum carpets and upholstered furniture to remove stray lice and nits; discard vacuum bags promptly.
Treatment protocol typically follows these steps: (1) apply an approved pediculicide according to label instructions; (2) rinse and dry hair; (3) comb out nits with a nit comb; (4) repeat the chemical application after seven to ten days to target any survivors; (5) conduct a second combing session 24 hours after the repeat treatment. Monitoring continues for four weeks, with additional combing if live lice are detected.
Safety considerations include age restrictions, allergy history, and potential skin irritation. Permethrin and pyrethrin are contraindicated for children under two months; malathion should not be used on infants. Pregnant or nursing individuals should consult healthcare providers before using systemic agents such as ivermectin.
In cases of confirmed resistance, rotating to a different class of pediculicide, combining chemical treatment with thorough nit combing, and ensuring environmental decontamination provide the highest likelihood of eradication. Continuous follow‑up and adherence to the outlined schedule are essential for lasting success.