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Pediculosis Capitis

 

THE PATIENT

Option 1: Topical pharmacotherapy are first line (i.e. permethrin shampoo)

  • Dead nits will persist AFTER successful treatment, so are not evidence of active infection unless recently laid (within 0.6cm of the scalp)

  • Any living nits hatch after 8 days

  • May repeat treatment in 9-10 days if live lice observed

Option 2: Wet-combing

Wet hair, add lubricant such as conditioner, vinegar, or olive oil. Use a fine-toothed comb to remove adult lice. Repeat every 3-4 days for 2 weeks after finding the last adult louse.

Refractory: Oral therapy (i.e. ivermectin) is second line only cases after 2 trials of topical THE CONTACTS

  • Treat anyone who sleeps in the same bed even if no lice/nits

  • Assess everyone who shares the home

  • Pets don't need treatment (can't host pediculosis capitis)

THE ENVIRONMENT

  • Wash and dry textiles (clothes, sheets) on high temp. If items can't be washed, seal in plastic

  • Vacuum textiles (furniture, carpet, car)

  • No need to wash/vacuum/seal items not used in past 2 days (lice can't survive off the body > 48 hours)

  • Inform school if necessary (policies differ)

  • Instruct not to share hats/brushes to avoid re-infection

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