OTC - headlice

Question 1

Symptoms?

Answer 1

• live lice: grey-brown insects, detected by fine-tooth combing
• nits: empty cream coloured egg shells stuck to hair, do not necessarily indicate current infestation
• itchy scalp may not always be present

Question 2

Referral criteria?

Answer 2

no specific refereal criteria

Question 3

OTC products?

Answer 3

• DIMETICONE (hedrin): traps and suffocates lice
• PERMETHRIN (lyclear)/ MALATHION (derbac-M): insecticide

2 applications 7 days apart to treat hatched lice

Question 4

Choice of OTC formulation?

Answer 4

• alcoholic preparations (more effective): avoid in asthma and eczema; aqueous is safe
• lotions or liquifds for 8-12 hours/overnight: avoid shampoo; diluted too much during use; ineffective

Question 5

Advice?

Answer 5

• Wet-combing method (alternative): wash hair with usual shampoo and apply plenty of conditioner. Use a 0.2-0.3mm fine comb for the whole head every 4 days for at least 2 weeks until no lice are found on 3 consecutive sessions
• do not use insecticides for prevention; accelerates resistance
• treat all affected at same time
• detection combing; to see if treatment was effective