Shampooing alone is not a remedy for head lice infestation

Introduction and Symptoms

A head lice infestation occurs when the minuscule insects find their way onto a person’s scalp and begin to multiply by reproduction. This brings about symptoms such as intense itching, pimples that are reddish on the scalp and back of the neck, and the appearance of very tiny eggs (“nits”).

Risk factors or causes

The most common means of infestation is when the lice are transferred directly through person-to-person contact. This is why members of groups which interact often are at highest risk. These groups can include children at play or close family members. Other means of transfer include shared combs, hats, pillows, etc.


Two things necessary for effective treatment of head lice are (a) Medication (either over-the-counter or prescribed) and (b) A specialized nit comb. “Nits” are the unhatched eggs attached by the female at the base of hair shafts. OTC medications include Pyrethrins (in combination with piperonyl butoxide), which are derived from chrysanthemum flowers. They kill the living, crawling lice, but not the eggs. Retreatment is advisable after about 9 days to kill any newly hatched lice before they themselves can grow and lay eggs. Anyone that has allergic reactions to chrysanthemum should use alternatives to pyrethrins; they are also not recommended for children under 2 years old. Permethrin lotion (1%) performs the same function as the natural pyrethrins, but with the advantage of approved and safe use with infants 2 months and older. Prescription medications like ivermectin lotion (0.5%) only kill living lice, while others like malathion lotion (0.5%) destroys both lice and eggs. All prescription meds vary according to age limits and any current medical conditions, along with re-treatment options and effectiveness. Use nit combs (which usually come in the box with the medication) to comb away any residual nits, and thoroughly follow ALL instructions from your pharmacist for best results.

Self care

Instead of seeing a professional, a few things can be done at home for treatment. The first step is the use of lice shampoo, which is lathered into hair and left for some minutes then rinsed off. This is not for baths and should be used carefully concerning skin-contact. Wait for some days before washing your hair so that the chemicals continue killing the insects, and use a nit comb daily to continually remove residuals. In addition, relevant items in the home should be treated. Combs and brushes should be soaked in hot water (over 130 degrees Fahrenheit) for about 10 minutes. Beddings can be washed and dried in laundry machines at high-heat temperatures. Miscellaneous items should be sealed in a plastic bag and kept in a freezer overnight or room temperature for 2 weeks. Infested hairs that might have fallen on the floor or furniture can be easily vacuumed.  

Drugs used in treating

Drugs used in treating are grouped into pesticides, occlusive, and oral agents. Pesticides/insecticides like malathion lotion are used to directly kill both lice and their eggs. Occlusive like benzyl alcohol block and clog breathing mechanisms to kill the insects. Oral agents like levamisole have also proven effective in treatment.

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