What should be used to remove lice from adults and children? - briefly
A pediculicide shampoo or lotion—commonly 1 % permethrin or 0.5 % malathion—applied as directed eliminates head lice in both adults and children. After treatment, use a fine‑toothed nit comb to remove remaining nits.
What should be used to remove lice from adults and children? - in detail
Effective lice eradication for both adults and children relies on a combination of chemical agents, mechanical removal, and environmental control. Chemical products are the primary tool; they must be applied according to label instructions and repeated after seven to ten days to eliminate newly hatched nymphs.
- Permethrin 1 % lotion or cream rinse: FDA‑approved for individuals six months of age and older. Apply to dry hair, leave for ten minutes, then rinse. A second application after ten days is standard.
- Pyrethrin‑based shampoos with piperonyl‑butoxide: Suitable for children older than two years. Follow the same timing as permethrin.
- Malathion 0.5 % lotion: Reserved for cases where resistance to permethrin is suspected. Use for children six months and older; leave on scalp for eight to twelve hours before washing.
- Benzyl alcohol 5 % lotion: Non‑neurotoxic option for children two years and older. Apply for ten minutes, then rinse; repeat after seven days.
- Spinosad 0.9 % suspension: Effective against resistant strains; approved for children six months and older. Apply for ten minutes, then rinse; repeat after seven days.
- Oral ivermectin: Prescription‑only, dose 200 µg/kg as a single dose, repeat after seven days. Indicated for individuals twelve years and older or when topical therapy fails.
Mechanical removal complements chemical treatment and is essential for individuals who cannot use insecticides or when resistance is documented. A fine‑toothed nit comb (0.2 mm spacing) removes live lice and eggs when used on wet, conditioned hair. Comb from scalp to ends, cleaning the comb after each pass. Perform daily combing for at least ten days.
Environmental measures reduce re‑infestation risk:
- Wash clothing, bedding, and towels used within the previous 48 hours in hot water (≥60 °C) and dry on high heat.
- Seal non‑washable items in a sealed plastic bag for two weeks.
- Vacuum carpets, upholstered furniture, and car seats; discard vacuum bags immediately.
- Avoid sharing personal items such as hats, brushes, and hair accessories.
Safety considerations differ by age and health status. Permethrin and pyrethrin are contraindicated in individuals with known hypersensitivity to pyrethroids. Malathion should not be used on infants under six months or on pregnant women without medical supervision. Benzyl alcohol may cause scalp irritation; discontinue if severe redness occurs. Oral ivermectin requires liver function assessment in patients with hepatic disease.
Adhering to the outlined regimen—appropriate topical or oral agents, systematic combing, and thorough environmental decontamination—provides reliable elimination of head lice across all age groups.