Lice

Question 1

When treating lice, what’s the first thing that should be investigated?

Answer 1

The presence of a LIVE infestation (i.e. live lice) [the presence of nits doesn’t prove live infestation]

Question 2

How should a live infestation be confirmed (i.e. using what method?)

Answer 2

“Wet combing method”

1. Put white conditioner into hair
2. Use a lice fine to trap any possible live lice

Question 3

If the child is > or = 2 mths old, what lice insecticide products can be used?

Answer 3

1. pyrethrins w/ piperonyl butoxide (R and C product)

2. permethrin 1% (Nix, Kwellada-P)

Question 4

How to use pyrethrins w/ piperonyl butoxide (R and C product)?

Answer 4

1. Apply to DRY hair
2. Leave in for 10 mins
3. Work into hair to create a lather
4. Rinse
5. Repeat in 7-10 days

Question 5

How to use permethrin 1% (Nix, Kwellada-P)?

Answer 5

1. Wash hair w/ conditioner-free shampoo, rinse, and towel dry
2. Saturate hair and scalp w/ product
3. Leave in for 10 mins
4. Rinse
5. Repeat in 7 days

Question 6

Side effects associated w/ insecticides used to kill lice?

Answer 6

1. Mild burning
2. Itching
3. Redness

Question 7

When would anti-lice PHYSICAL agents be used (as opposed to chemical insecticides)

Answer 7

1. When insecticides weren’t successful

2. When parents don’t want to use insecticides on their children

Question 8

Name two physical agents used to treat lice:

Answer 8

1. isopropyl myristate (Resultz)

2. dimeticone (NYDA)

Question 9

How to use isopropyl myristate?

Answer 9

1. Protect eyes and clothes w/ towel
2. Apply to DRY hair and scalp
3. Leave in for 10 mins
4. Rinse
5. Repeat in 7 days

Question 10

How to use dimeticone?

Answer 10

1. Spray dimeticone (NYDA) all over DRY hair
2. Massage product into hair and scalp
3. Leave for 30 mins
4. Comb hair w/ NYDA’s lice comb
5. Sleep
6. Morning: Wash w/ reg. shampoo
7. Repeat in 8-10 days

Question 11

What age is recommended for isopropyl myristate (Resultz)?

Answer 11

> 4 yrs

Question 12

What age is recommended for dimeticone (NYDA)?

Answer 12

> or = 2 years

Question 13

What should always be done after the first application of either an insecticide or physical agent?

Answer 13

Nitpicking w/ lice comb

Question 14

What can be done at home to prevent spread of lice?

Answer 14

1. Minimize direct contact w/ infested ind
2. Don’t share personal items
3. Wash clothes/linens in washer on HOT cycle
4. Soak combs and brushes in very hot water for 10 mins or w/ pediculicide shampoo
5. Examine all other family members

Question 15

What should be done if family members are found to have live infestations of lice?

Answer 15

Treat them ASAP

Question 16

Should family members be treated prophylactically?

Answer 16

No! (except maybe for children who share a bed w/ child who has lice)

Question 17

When can a child be sent back to school?

Answer 17

ASAP:

1. Lice infestations = low contagion
2. little risk for others in classroom
3. Child should remain in school, but avoid close direct head contact w/ others

Question 18

What 8 things should be mentioned to pt/pt’s parents regarding treatment of lice?

Answer 18

1. Is this for yourself or for someone else?
2. Have you seen a doctor?
3. Any other relevant medical conditions (e.g. allergies)? Currently on any Rx/OTC/Herbal meds?
4. Have you tried any lice products before?
5. Select suitable product based on case aspects and patient preferences (consider age of child and other products used)
6. Tells patient how to use product (including to use lice comb everyday for 7 days until re-application)
7. Side effects
8. Tells patient how to monitor for treatment success/when pt should start seeing effects

Question 19

Side effects associated w/ isopropyl myristate and dimeticone (physical agents) used for lice therapy?

Answer 19

1. irritation
2. mild itching
3. staining