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Head lice - Management
Basis for recommendation
These recommendations are based on the following:
- There is evidence that none of the treatment options for head lice can guarantee success.
- Since no treatment for head lice is completely ovicidal (it is not known whether physical insecticides have any ovicidal activity), it is possible that an egg laid on the morning of either treatment session could survive treatment and hatch a live head louse after the completion of a course of treatment [Lebwohl et al, 2007]. The average time from lay to hatch is 7 days, but longer intervals of up to 12 days between lay and hatch have been observed in laboratory studies.
- Opinion from CKS expert reviewers was divided regarding the length of time itch may persist after successful treatment. Some reviewers suggest it is a few days, whilst others suggest that itch may persist for 2–3 weeks after successful eradication.
- Some CKS expert reviewers advise that people using a traditional or physical insecticide should use an additional detection combing session on day 5 after the first application of treatment. The additional check on day 5 allows removal of nymphs that have hatched from eggs which survived the first treatment session before they can become mature adults.
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