The treatment of choice for pediculosis (lice) is 1% permethrin (60 mL emulsion or lotion). It is recommended to wash the hair with normal shampoo (do not use conditioner) and dry with the help of a towel and also use lice treatment like lice treatment Tampa. Apply the product on almost dry hair until saturation and all over the scalp, not forgetting to apply it on the back of the neck and behind the ears. Leave to act for 10 minutes and rinse with warm water. Do not wash your hair for the next 24 to 48 hours after applying the product. The same treatment must be repeated on the 9th day. Permethrin can be used from 2 months of age and is safe to use during pregnancy.
Manual removal of nits is not mandatory for the resolution of the frame. However, in cases where removal is desired for aesthetic reasons or school requirements, it must be carried out every 2 to 3 days until all the nits are removed. The procedure must be done with the aid of a fine-tooth comb, with damp hair, and the use of a conditioner.
Other Important Guidelines:
Clothes used by the patient in the last 2 days, bed linen, and towels must be washed in hot water or ironed.
Combs and brushes used by the patient should be soaked in hot water for 5 to 10 minutes.
Accessories in contact with the hair and that cannot be washed should be cleaned and placed in a sealed plastic bag for 2 weeks.
Family members and close contacts should be examined and treated if they have live lice or nits within 1 cm of the scalp. Preferably, carry out the treatment at the same time as the patient. Individuals who share a bed with the patient should always be treated prophylactically, even if they do not have lice or nits.
The main causes of treatment failure are poor adhesion, incorrect use of the product (for example: using the product on very damp hair), insufficient product quantity, failure to remove viable nits, and reinfection.
If the patient does not respond to an adequate course of permethrin treatment and the other causes of failure have been ruled out, permethrin resistance should be considered. The presence of viable lice 24 hours after treatment favors the resistance hypothesis, while late recurrences are usually due to reinfestation. In cases of suspected resistance, the alternatives are:
Oral ivermectin (200 to 400 mcg/kg/day) in a single dose and repeat after 7 days. It can be used by children weighing over 15 kg.
Associate trimethoprim-sulfamethoxazole (10 mg/kg/day of trimethoprim, twice a day, for 10 days) using 1% permethrin, increasing the effectiveness from 72% to 95%.
Ivermectin 0.5% lotion 120g (under handling): apply to dry hair (full length of hair and scalp) in a single application and rinse after 10 minutes. No need to repeat the application. Only suitable for children over 6 years old.
4% Dimethicone lotion 150 ml (under handling): apply to dry scalp and hair for 8 hours and repeat after 7 days. Remove the nits with the aid of a fine comb before removing the product.
Increasing the concentration of permethrin to 5% does not increase the effectiveness in cases of resistance.
- Measures to reduce the chance of developing resistance:
- Avoid applying the product to hair that is still very damp (dilutes the medication).
- Avoid preventive or unnecessary treatments (except in the cases mentioned above).
- Avoid very frequent treatments with the same pediculicide.
- Avoid using the product in insufficient quantities (use 2 bottles if your hair is too long).
When To Seek Medical Advice With Head Lice
You can usually treat the head lice yourself or use lice treatment like lice treatment tampa for instance. However, there are a few cases when you should seek medical advice first:
Not all products are suitable for very young children, infants, and toddlers. Your doctor can recommend or prescribe a suitable product for you.
For diseases of the scalp or scratched sores.
During pregnancy and breastfeeding.
With a chrysanthemum allergy or the rare MCS syndrome (multiple chemical sensitivity, multiple hypersensitivities to chemical substances). In this case, either exclusively use the wet combing method or ask your doctor whether there are lice remedies that you can safely use.