Removing lice from your head: Duration and additional details
Head lice are a common nuisance, particularly among children aged 3-11 years old. These tiny parasites live on the scalp and feed on blood, causing symptoms such as a tickling feeling in the hair, itching, irritability, difficulty sleeping, and sores on the head from scratching.
Understanding Head Lice
Head lice have three main life stages: eggs (nits), nymphs, and adults. They do not hop or fly, instead, they spread through head-to-head contact or by sharing items that have contact with the head, such as combs or hats.
Identifying Head Lice
Identifying head lice involves wetting the hair, sitting under a bright light, separating the hair into sections, and slowly combing outward while looking for eggs, nymphs, and adult lice. A fine-toothed nit comb and a bright light are commonly used for this purpose.
Treating Head Lice
Treating head lice effectively requires addressing each life stage. Most treatments only kill live lice, leaving the eggs unaffected. Therefore, manual removal with a fine-toothed nit comb is essential. Combing should be done every 2–3 days for 2–3 weeks to ensure all nits are removed.
For adult lice and nymphs, medicated lice treatments such as Permethrin (Nix) or pyrethrin-based products can be used following package directions. Ivermectin lotion (Sklice) can also be applied once to dry hair and rinsed after 10 minutes; it kills lice but may not kill all eggs. Advanced treatments use FDA-cleared silicon-based gels combined with heated air and enzymes to kill both lice and eggs in one session effectively.
Repeating the medicated treatment 7 to 10 days after the first application is recommended to kill newly hatched nymphs before they mature and lay new eggs.
Environmental Cleaning
Head lice live on the scalp and typically survive about 25-35 days there but only around 24 hours away from a human host. Environmental cleaning, such as vacuuming mattresses and treating with alcohol-based sprays, can help remove lice from sleeping areas since they can survive up to 48 hours off the scalp but do not live long without a host.
Preventing Reinfestation
It is essential to notify close contacts to prevent reinfestation. Head lice are not a sign of poor hygiene or disease, so maintaining good personal hygiene will not prevent their spread.
In summary, expect about 2–3 weeks of combined treatment with medicated products and meticulous nit combing, with at least two medicated applications spaced about a week apart, to completely eradicate head lice and their eggs. Advanced single-visit treatments exist but are less common outside specialized clinics. Over-the-counter (OTC) medications for lice include pyrethrins combined with piperonyl butoxide, which only kill live lice and require multiple treatments, and permethrin lotion 1%, which also only kills live lice without affecting eggs.
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