What to use to treat lice in the head? - briefly
Effective treatment involves applying an over‑the‑counter pediculicide such as 1 % permethrin or 0.5 % malathion and then combing the hair with a fine‑tooth nit comb. For resistant cases, prescription ivermectin lotion or oral ivermectin may be necessary.
What to use to treat lice in the head? - in detail
Effective treatment of head‑lice infestation relies on a combination of chemical agents, mechanical removal, and follow‑up procedures.
First‑line pharmacologic options include over‑the‑counter pediculicides containing 1 % permethrin or 0.5 % pyrethrins with piperonyl butoxide. These products are applied to dry hair, left for the recommended duration (usually 10 minutes), then rinsed thoroughly. Resistance to permethrin has become common; in such cases, a prescription‑only preparation of 0.5 % malathion or 0.05 % ivermectin lotion is indicated. Both are applied to damp hair, covered with a plastic cap for the specified time, and washed off.
Second‑line topical treatments use silicone‑based compounds such as 4 % dimethicone. Dimethicone coats lice and nits, causing desiccation without neurotoxic action, and is effective against resistant strains. Application follows the same protocol as other lotions, with a repeat dose after 7–10 days to eliminate newly hatched nits.
Mechanical removal complements chemical therapy. A fine‑toothed nit comb, used on wet, conditioned hair, extracts live lice and viable eggs. The comb should be passed through each section of hair at least three times, with the comb cleaned after each pass. Repeating the combing session every 2–3 days for two weeks ensures complete eradication.
Adjunctive measures reduce reinfestation risk. Wash bedding, clothing, and personal items in hot water (≥ 60 °C) or seal them in a plastic bag for two weeks. Vacuum carpets and upholstered furniture. Avoid sharing combs, hats, or hair accessories until treatment is complete.
Alternative remedies lacking robust clinical evidence—such as tea‑tree oil, neem oil, or vinegar rinses—should not replace approved agents. If a patient exhibits allergic reactions, skin irritation, or treatment failure after two attempts, refer to a healthcare professional for possible systemic therapy (e.g., oral ivermectin) or evaluation for secondary infection.
A treatment regimen typically follows this schedule:
- Apply a pediculicide or dimethicone product as directed.
- Perform nit combing within 30 minutes of application.
- Repeat the chemical treatment after 7–10 days.
- Conduct combing sessions every 2–3 days for the next two weeks.
- Implement environmental decontamination measures concurrently.
Adhering to this protocol maximizes eradication rates while minimizing the likelihood of resistance and recurrence.