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Head lice - Management
How should I manage confirmed unsuccessful treatment?
- Advise that household members, close family, and close friends (both adults and children) should be assessed using detection combing to identify possible sources of reinfestation.
- Check whether treatment was used correctly, as poor adherence increases the risk of treatment failure.
- For physical or traditional insecticides:
- Check that the following were used: two treatments, correct application technique, correct application time, and sufficient volume of product to cover hair adequately.
- Consider the possibility of resistance to a traditional insecticide, such as malathion or permethrin.
- For wet combing:
- Check that the following were used: the correct type of comb (for example a Bug Buster®), correct combing technique, sufficient duration of combing session, and sufficient combing sessions.
- Repeat the same treatment or switch to a different treatment. The choice of treatment will depend on:
- The preference of the person or child's parent.
- Whether resistance to a traditional insecticide is suspected.
- Whichever treatment strategy is chosen, ensure that all affected household contacts are again treated simultaneously. Other affected close contacts should also be treated without delay to reduce the risk of reinfestation.
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