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The treatment of human lice is the removal of head lice parasites from human hair. It has been debated and studied for centuries. However, the number of cases of human louse infestations (or pediculosis) has increased worldwide since the mid-1960s, reaching hundreds of millions annually. There is no product or method that assures 100% destruction of the eggs and hatched lice after a single treatment. However, there are a number of treatment modalities that can be employed with varying degrees of success. These methods include chemical treatments, natural products, combs, shaving, hot air, and silicone-based lotions.
Treatment is recommended only after a clear diagnosis since all treatments have potential side effects. Louse eggs hatch 6–9 days after oviposition. Therefore, a common recommendation is to repeat treatment with a pediculicide at least once after 10 days, when all lice have hatched. Between the two treatments (Days 2–9) the person will still be infested with lice that hatch from eggs not killed by the anti-louse product. Between the treatments, it is advised to wet the hair and comb daily with a louse-comb to remove the hatching lice. If no living lice are found, the treatment was successful, even if nits (eggs) are visible on the hair. If living lice are still present, the treatment is repeated using an anti-louse product with a different active ingredient. This is kept in the hair for 2 hours and then rinsed out, with the head and hair cleaned before sleep. Prophylactic treatment with pediculicides is not recommended.
Many of the pediculicides in the market are either not fully effective or are ineffective when they are used according to the instructions. Pediculicides may rapidly lose their efficacy because of the development of resistance. Resistance of head lice to insecticides such as lindane, malathion, phenothrin and permethrin has been reported.
A 2021 systematic review and meta-analysis found that the mean frequency of pyrethroid resistance of lice was 77% globally, and even 100% in several countries (Australia, England, Israel, and Turkey). It concluded that treatment with current insecticides may not be effective and is likely the cause of increased levels of infestations.
Ivermectin by mouth has been shown to reduce levels of louse infestation. Ivermectin is approved by the U.S. Food and Drug Administration (FDA) for pediculosis.
Agents approved by the FDA for treatment of pediculosis include abametapir, topical ivermectin lotion, lindane, malathion, permethrin, and piperonyl butoxide with pyrethrins.
A number of commercial head lice treatment companies across the country offer a heated air treatment.
Electronic louse combs use a small electrical charge to kill lice. The metal teeth of the comb have alternating positively and negatively charged tines, which are powered by a small battery. When the comb is used on dry hair, lice make contact with multiple tines of the fine-toothed comb, thereby closing the circuit and receiving an electrical charge. A non-peer-reviewed letter has been published in a dermatology journal claiming effectiveness based on personal experience (total of 6 uses).
Infestation with lice is not a serious disease and the medical symptoms are normally minimal. In any case, health providers and parents should try not to create emotional problems for children during examination and treatment.
Shaving of the area above and behind the ears and the upper part of the neck while leaving the crown of the head with hair is commonly used to prevent lice among tribes in Africa, Asia, and America (in America – Mohawk hairstyle style).
A number of health researchers and organizations object to the no-nit policy. Opponents to the no-nit policy mention that visible nits may only be empty egg casings which pose no concern as transmission can only occur via live lice or eggs. This has led to the perception that the no-nit policy serves only to ease the workload of school nurses and punish the parents of infested children.
Proponents of the no-nit policy counter that only a consistently nit-free child can be reliably shown to be infestation-free.
That is, the presence of nits serves as an indirect proxy for infestation status. Proponents argue that such a proxy is necessary because lice screening is prone to false negative conclusions (i.e., failure to find lice present on actively infested children).National Health and Medical Research Council (2005). 9780642456311, Commonwealth of Australia. . ISBN 9780642456311
For example, a 1998 Israeli study found that 76% of live lice infestations were missed by visual inspection (as verified by subsequent combing methods).
Although lice cannot fly or jump, they are fast and agile in their native environment (i.e., clinging to hairs near the warmth of the scalp), and will try to avoid the light used during inspection.
Louse colonies are also sparse (often fewer than 10 lice), which can contribute to difficulty in finding live specimens. Further, lice populations consist predominantly of immature nymphs,
which are even smaller and harder to detect than adult lice.
Before gasoline was used as fuel, it was sold in small bottles as a treatment against lice and their eggs. At that time, the word Petrol was a trade name.
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