Lice Infestation

HEAD LICE

Treatment

• Pyrethrins 0.165% with piperonyl butoxide 2% foam or aerosol spray or shampoo or

• Permethrin 1% or malathion (Maldison) 1%

Method

• Massage well into wet shampooed hair

• Leave for a minimum of 20 mins except malathion—leave 8 h (usu. overnight)

• Wash off thoroughly (avoid eye contact)

• Comb with a fine-toothed comb after each treatment to remove eggs

• Repeat after 7 d and comb

Note:

• The hair does not have to be cut short

• Treat all household child contacts if lice or nits found on inspection

• Notify school when detected; no exclusion necessary for initial diagnosis

• Wash clothing and bedclothes after treatment (normal machine wash)

• If resistant, use permethrin + cotrimoxazole (o) for 10 d

Eyelash involvement

• Apply petrolatum (Vaseline) bd for 8 d, then pluck off remaining nits

Handy tips for removal of nits

• Use a hair conditioner on dry hair, comb with a fine-toothed comb

• Apply a 1:1 mixture of water and vinegar, leave 15 mins then comb

PUBIC LICE

Can use same topical agents as for head lice.

Method

• Apply to pubic hair

• Leave for a time according to manufacturer’s instructions (e.g. 10 mins for Lyban and permethrin 1%, 12 h for malathion)

• Wash off thoroughly

• Wash underwear and bedclothes after treatment

• Repeat after 7 d (maybe third treatment)

• Treat sexual partners

BODY LICE

Treat as for head lice but apply to entire body (with care). Discard clothing or wash in a hot cycle or seal in a plastic bag for 30 days.