May 23 2022

Recommendations to help remove lice

It is not a tragedy     

Lice infestation happens even in the best families, including your and our. Neither you nor your family members has worse health than others, nor are more dirty and neglected, so you should abandon any sense of guilt or shame if they have this parasitosis. Unlike other arthropods, lice do not transmit any known disease, including AIDS or Hepatitis. they are only responsible for possible injuries caused by scratching of the head and in the worst cases, a local infection caused by this mechanism. Avoid taking drastic measures to resolve a trivial nature.

Understanding the essential of the louse     

The louse is an arthropod that lives exclusively on the scalp of humans, feeding on the blood sucking. Outside its habitat can not withstand more than 48 hours. Therefore, it does not infect or lives on pets.

The female louse adheres each egg to a hair, at a distance not exceeding 1.5 cm of the scalp by a chitinous substance that adheres strongly. Hair conditioners and vinegar tend to dissolve this substance.

The egg hatches in 7-10 days, leaving an immature form of lice, the nymph, smaller and more whitish, reaching adulthood in the next two weeks. Mature females lay between 90 and 200 eggs over the remaining two weeks of their lives. Although they can live anywhere in the head and rarely in other parts of the body, usually it found mainly behind the ears, neck, crown and the area included between these points.

Lice only move walking, so the transmission is from person to person or by sharing some belongings (combs, hats, headphones, etc).

Find out on time     

Each year may have been visited by lice more than 12 million people. Soon may touch to your family. The usual presenting symptom of parasitized children is itching and its consequence, a frequent scratching head. It may take up to two or three weeks before the scratching becomes clear, so it can be considered a somewhat late symptom. At that time, the infestation has been shared by all members of your household.

To detect promptly, you can use the following method :

1. Wash your hair as usual, applying conditioner liberally, including the tips of the hair. Conditioner dissolves the substance that binds the nits to the hair.
2. Provide paper or towel in which to shake the comb for to discover the presence of nits.
3. Carefully comb all the hair from the root to the tip of each tuft. Better yet, use a metal nit comb to perform verification.
4. After each pass, observe the comb for if it had caught lice or nits. Shake the comb on the paper if nits are detected. Then wash your hair as usual.

It may be helpful to check directly also (better with a magnifying glass) the presence of lice, especially in places of their choice (behind the ears or neck). If not found, check if there are or not any nit. Usually, lice are more abundant than nits. If these are present, assume that your child also has lice and treat it properly. Do not confuse nits with dandruff; the latter falls quite easily.

Know the medicines available      

Permethrin (drug of choice) presented at varying concentrations, depending on the country and product. Often used at 1-3%, especially at 1.5%. Formulations at 5% are not recommended for the treatment of patients with permethrin-resistant lice. The forms available include cream, shampoo and lotion. In case of pregnancy, lactation and children under two years, avoid to treat yourself or your child and consult your doctor.

2. 1% Lindane. More toxic and worse choice than permethrin. It should be applied for 6-24 hours. Not recommended in pregnancy, lactation and young children. Nor if there are numerous injuries by scratching.

3. Trimethoprim-sulfamethoxazole. It is a chemotherapeutic agent with similar effects as antibiotics (septrin, abactrim and other brands). The effect is limited to adults and nymphs lice because it produces the death of intestinal bacteria of the louse. It does not attack nits, so it is mandatory repeatedly administer the drug to each new generation of lice. Less effective than permethrin.

4. Malathion: It have been approved for this use by the FDA. It is used as an alternative to permethrin in US.

5. Other therapeutic resources: Although they are used uncommonly, can be used when we are in front to resistant lice to permethrin and lindane. These alternative resources include ivermectin, decametrine and electric combs with microbursts.

How to treat the child     

The most recommended form of treatment is to wash the head with a regular shampoo and then rinse and remove the remains of this, apply the cream or permethrin shampoo (1-1.5%) for a period of about 20 minutes. Do not use hair conditioner at this stage, since they can inactivate the effect of the product. You can apply vinegar (two parts water to one part vinegar) after treatment, as it helps to loose the nits. Also follow the advice given in the next section.

Put to the child clean clothes after applying the treatment.

Do not treat children under two years. There is no conclusive evidence to ensure that this drug is harmless at these ages. Limit yourself to remove lice, nymphs, and nits manually and consult your doctor.

Nits must be removed mechanically by means of an appropriate comb for nits, a metal fine-toothed comb, shaking it on a plain surface after each pass on the hair, so check that the nits are released from its adherence to hair. The reason for not to trust completely on the insecticidal action of the drug is that it can not ensure that all the nits die after an application since there is the possibility that some survive. Mechanical removal of nits reduces the risk of treatment failure and is mandatory for the eradication of lice.

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Use the medication correctly     

The medication must be in contact with all the hair long enough and at sufficient concentration. Coated with the anti-lice product every hair, from the roots up to the tips. You can get it by re-combing all the hairs with a normal comb impregnated with the product. Keep at least twenty minutes.

Check those lice are not resistant to the drug

The lice may be resistant to the insecticide, so there is no way to know in advance. It may be suspected resistance if, after twenty minutes of treatment, the lice normally move. You can check it by combing hair repeatedly after application of the drug and shaking after each pass on a paper. If, after 8-10 hours, lice move but do it slowly, the drug has been effective. If the treatment results ineffective, insecticide must be changed. Note that you should not change the brand of product but of the active ingredient.

Kill them well dead     

It is unlikely that after the treatment session all nits die, and you should not expect your child is free of the parasite before a week. Since the female louse lays the egg (nit) until this hatches spend 7-10 days. From time to apply the product continue to be born new lice (nymphs) from the surviving eggs. The sum of the initial effect of the insecticide, its residual effect and the manual removal of nits not fully guarantee the resolution of the problem, so you need to resort to a second treatment session after seven days. If all went well, you will find nymphs but no lice. Those are smaller and lighter in color. Depending on your opinion or another circumstances, you can repeat the last operation seven days after or simply verifying that there are no survivors. Nits located over 1.5 cm of the hair root are unable to hatch.

Watch for if they return     

Your child may again suffer a new invasion by lice in the same way that become infected. It is estimated that nearly 20% of the population suffer a new infestation after 2 months so that people who have close contact with the child should also be treated.

After one week of treatment, you only can find nymphs; If, after properly treating the child and checking the absence of adult lice, you detect lice again, you should suspect that he suffers a new infestation. You should check each week if he or she has parasites, either by using a hair conditioner or a metal fine-tooth comb for nits.

With regard to patient's belongings (clothes, scarves, hats, towels, etc.) can proceed as follows:

Combs, brushes and other tools that can be boiled, should be subjected to the action of hot water (65 ° C) for 60 minutes or dip in the lice shampoo for five minutes. The clothes washable in hot water should be washed in a hot wash program cycle. Non-washable clothes in hot water should be stored in plastic bags for two weeks. Vacuum the floor and furniture, carpets and cushions. Do nothing with pets because the lice do not dwell on them. Do not apply insecticides by spraying, because they are not needed.

Better to prevent     

The child should not attend school or daycare until 24 hours after completion of treatment. In addition, it is recommended:

- Avoid using caps, hats, balaclavas, scarves, combs etc from people who have recently had pediculosis.
- Avoid direct head contact.
- Wash your child's hair regularly and check for lice.