What to apply for lice? - briefly
Apply a medicated shampoo, lotion, or cream containing permethrin, pyrethrin, or dimethicone, then comb out nits with a fine-toothed lice comb after each treatment. For resistant infestations, consult a healthcare provider for prescription options such as oral ivermectin.
What to apply for lice? - in detail
Effective lice treatment begins with a thorough assessment of the infestation. Identify the species (head, body, or pubic lice) and the extent of spread by examining hair shafts, clothing, and bedding. This determines the appropriate topical or systemic agent.
Topical insecticides
- Permethrin 1% lotion: applied to dry hair, left for 10 minutes, then rinsed. Re‑treatment after 7–10 days eliminates newly hatched nymphs.
- Pyrethrin combined with piperonyl butoxide: sprayed onto hair, left for 10 minutes, then washed out. Suitable for mild to moderate cases.
- Dimethicone 4% cream: oil‑based formulation that suffocates lice. Applied to dry hair, covered with a shower cap for 8 hours, then washed. Safe for children and pregnant individuals.
Oral medications
- Ivermectin 200 µg/kg single dose: effective for resistant head lice. May be repeated after 7 days if live lice persist.
- Azithromycin 500 mg daily for three days: alternative for body lice when topical options fail.
Adjunctive measures
- Nit combing: metal fine‑tooth comb used on wet, conditioned hair for 10 minutes per session, repeated every 2–3 days for two weeks. Removes live lice and eggs.
- Laundering: wash clothing, bedding, and personal items in water ≥ 60 °C or seal in plastic bags for 14 days to kill dormant lice.
- Environmental decontamination: vacuum carpets and upholstered furniture; discard items that cannot be cleaned.
Safety considerations
- Verify allergy history before applying synthetic pyrethroids; adverse reactions include skin irritation and itching.
- Avoid excessive use of insecticide shampoos; resistance develops with repeated exposure.
- For infants under two months, limit treatment to nit combing and thorough cleaning of personal items; pharmacologic options are contraindicated.
Follow‑up protocol
- Re‑examine hair 7 days after initial application. Presence of live lice warrants a second treatment with the same or an alternative agent.
- Continue nit combing for at least 14 days to ensure eradication of any surviving eggs.
- Document treatment outcomes and any adverse effects to guide future management.
By integrating a validated topical agent, appropriate oral therapy when indicated, and rigorous mechanical removal, complete eradication of lice can be achieved with minimal risk of recurrence.