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Head lice - Management
How should I treat a confirmed head louse infestation?

  • Treat the person only if a live head louse is found.
  • Advise all household members to check for head lice using wet or dry detection combing.
  • Ensure all affected individuals in a household are treated simultaneously.
  • Choice of treatment depends on the preference of the individual or parent and what has been previously tried.
    • Treatment has most chance of success if it is applied or undertaken correctly and if all affected individuals in the household are treated simultaneously.
  • There is no need to wash clothing or bedding that has been in contact with lice.
  • Treatment options include:
    • Dimeticone 4% lotion (Hedrin® lotion), a physical insecticide.
      • Suitable for all ages, those with skin conditions, and those with asthma. It cannot be purchased over-the-counter for children younger than 6 months of age.
      • It should be applied twice, with 7 days between applications. Dimeticone is left on the hair and scalp for 8 hours or overnight, and is then washed out using shampoo.
    • Wet combing using the Bug Buster® comb and method.
      • Suitable for all ages, those with skin conditions, and those with asthma.
      • Unlike other treatment options, the Bug Buster® comb is reusable; one comb can be used to treat the whole family.
      • Treatment involves methodically combing wet hair with the fine-toothed Bug Buster® comb to remove lice. This is undertaken for four sessions over 2 weeks. Wet combing should be continued until no full-grown lice have been seen for three consecutive sessions.
    • Isopropyl myristate and cyclomethicone (Full Marks Solution®), a physical insecticide.
      • Suitable for those with asthma.
      • Not suitable for children younger than 2 years of age or people with skin conditions.
      • It should be applied twice, with 7 days between applications. It is left in place for 10 minutes. The hair is then systematically combed with a fine-toothed comb to remove lice and is then washed using shampoo to remove the solution.
    • Coconut, anise, and ylang ylang spray (Lyclear SprayAway®), a physical insecticide.
      • Not suitable for children younger than 2 years of age, people with skin conditions, or those with asthma.
      • It should be applied twice, with 7 days between applications. The spray is left in place for 15 minutes. The hair is then washed using shampoo to remove the spray, and then systematically combed with a fine-toothed comb to remove lice.
    • Malathion 0.5% aqueous liquid, a traditional insecticide.
      • Suitable for all ages and those with skin conditions. It cannot be purchased over-the-counter for children younger than 6 months of age.
      • It should be applied twice, with 7 days between applications. The insecticide is applied to the hair from the roots to the tips, left on the hair and scalp for 12 hours or overnight, and then washed out using shampoo.
  • For further information to assist with the choice of treatment, see Treatment options: advantages and disadvantages.

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