What should you do if you cannot remove lice from a child? - briefly
Seek medical advice for prescription‑strength lice medication and use a fine‑toothed comb to remove remaining insects and nits. Treat all close contacts and clean bedding and clothing to stop re‑infestation.
What should you do if you cannot remove lice from a child? - in detail
If a child’s head still harbors lice after initial treatment, follow these precise actions.
First, verify that live insects remain. Use a fine‑toothed nit comb on wet, conditioned hair under bright light. Separate each strand and inspect the comb after each pass. Live lice or viable nits indicate treatment failure.
Second, assess the product used. Confirm that the pediculicide was applied according to label instructions: correct dosage, thorough coverage, and required waiting time before rinsing. Some formulations require a second application 7–10 days after the first to target newly hatched nits. If the initial product was a single‑dose lotion, repeat with a second dose at the recommended interval.
Third, eliminate resistance as a factor. In areas with known resistance to permethrin or pyrethrins, switch to an alternative class such as malathion, spinosad, or ivermectin, following pediatric dosage guidelines. Consult a pharmacist or pediatrician before changing agents.
Fourth, remove eggs mechanically. After chemical treatment, comb the hair at least twice daily for a week, using the same nit comb. Each pass should be from scalp to tip, wiping the comb on a white surface to detect remaining nits. Discard or sterilize the comb after each session.
Fifth, decontaminate the environment. Wash clothing, bedding, and towels used within the previous 48 hours in hot water (≥ 130 °F/54 °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 the vacuum bag or clean the canister afterward.
Sixth, prevent re‑infestation. Instruct the child to avoid head‑to‑head contact and sharing of hats, hairbrushes, or headphones. Inform caregivers, teachers, and close contacts so they can inspect and treat if necessary.
Seventh, seek professional assistance if any of the following occur: persistent lice after two full treatment cycles, allergic reaction to medication, scalp irritation, or uncertainty about product use. A healthcare provider can prescribe prescription‑strength treatments, perform a thorough examination, and rule out secondary infections.
Finally, document the process. Keep a log of treatment dates, products used, and combing sessions. This record aids healthcare professionals in evaluating effectiveness and adjusting the regimen if needed.