What should I do if lice treatments don't work? - briefly
If over‑the‑counter products fail, consult a physician or dermatologist for prescription‑strength medication such as oral ivermectin or a stronger topical agent. Follow the professional’s regimen and use a fine‑tooth nit comb after each application to confirm eradication.
What should I do if lice treatments don't work? - in detail
When standard over‑the‑counter products fail to eliminate head lice, begin by confirming that the treatment was applied exactly as instructed. Check the dosage, timing, and thoroughness of combing; even a small amount of missed hair can preserve a surviving nymph.
Next, explore alternative chemical options. Prescription‑strength pediculicides containing 1% permethrin, 0.5% malathion, or 0.2% spinosad are available through a physician. These agents require a second application 7–10 days after the first to target newly hatched insects. Follow the label precisely, and avoid mixing products.
If chemical measures remain unsuccessful, consider non‑chemical strategies. Manual removal using a fine‑toothed lice comb on wet, conditioned hair can eradicate live insects and eggs when performed daily for at least a week. Heat‑based devices—such as specialized lice‑removal lamps or steam treatments—destroy lice and nits without chemicals, provided the manufacturer’s safety guidelines are observed.
Professional evaluation is essential when home methods do not work. A dermatologist or pediatrician can:
- Examine the scalp under magnification to verify infestation status.
- Prescribe oral ivermectin or other systemic agents for resistant cases.
- Offer in‑office lice removal services that combine chemicals with meticulous combing.
Environmental control reduces reinfestation risk. Wash all clothing, bedding, and towels used within the previous 48 hours in hot water (≥ 130 °F) and dry on high heat. Items that cannot be laundered should be sealed in a plastic bag for two weeks. Vacuum carpets, upholstery, and car seats; discard vacuum bags immediately after use.
Finally, schedule a follow‑up assessment 2–3 weeks after the last treatment to ensure complete eradication. Continue periodic comb checks for another month, and educate household members about avoiding shared personal items to prevent recurrence.