Head Lice

Dr Ira Shah
Consultant Pediatrician, B.J.Wadia Hospital for Children, Mumbai, India
First Created: 02/20/2001  Last Updated: 08/01/2015

Patient Education

My child has head lice. How should I treat it?

Lice infestation is suspected in a child who has excessive itching on the scalp. The presence of nits (eggs) and lice in the hair confirms the diagnosis.

Treatment of head lice includes not only treatment of the infected person but also the treatment of infested family members and by cleaning the house.

Treatment of infected person:
Apply lice medication called pediculicide according to instructions on the bottle. Before applying on the hair, remove all the clothing. (Remember not to use shampoo before using lice medicine and also do not wash the hair for 1-2 days after treatment). After 8-10 hours after treatment, comb the remaining dead and live lice out of the hair. Nits are often removed with a special nit comb. The hair and the comb should be checked every 2-3 days for 2-3 weeks till you are sure that all lice and nits have disappeared.

Some lice medications like pyrethrins, permethrin, and lindane may require retreatment after 7-10 days.

Warning signs:

  • Do not use more medications than what is necessary as these drugs may be dangerous when overused.

  • Do not treat with the same medication more than 3 times if it does not work. See your doctor for alternative medicine.

  • Do not mix the various lice medications.

Cleaning of house:
To kill all nits and lice, wash all washable clothes & bed linen that the infested person touched during the 2 days before treatment with hot water. Dry-clean other clothes. Stuffed animals, comforters, etc. that can not be washed or dry-cleaned have to be sealed in a plastic bag for 2 weeks.

Combs and brushes are washed with soap and hot water. The house is swept & dusted properly.

How do I prevent my child from getting lice infestation again?

Lice usually occur in children during school and play activities. Head-to-head contact is the most common mode of transmission. By avoiding head-to-head contact, not sharing infested combs, brushes, towels, hats, etc, can minimize the contact.

Is it necessary to treat everyone in the house if my child has head lice?

Although everyone has a risk of lice infestation, treatment to all is not necessary. Check household people for lice and nits every 2-3 days and treat only if crawling lice or nits are found within 1 cm of the scalp.

Can lice infestation occur in younger children?

Lice infestation can occur even in children less than 2 years. Instead of using over the counter medicines, remove the nits and lice manually by hand. If this does not work, consult your doctor for further treatment.

Which are the medications used to treat lice infestation?

Products containing pyrethrins, permethrin, Malathion, and lindane are commonly used to treat a lice infestation. They are available either as shampoo or as an oil-based solution.

Head Lice Head Lice https://www.pediatriconcall.com/show_article/default.aspx?main_cat=infectious-diseases&sub_cat=head-lice&url=head-lice-patient-education 2015-08-01
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