Chemical/Pesticide Shampoos and Cream Rinses can also be used with some cautions:
• Refer the child and family to their healthcare provider for instructions for treatment. If the student has no healthcare provider, he may be referred to the local health department for treatment. Several medicated shampoo and cream rinse preparations are available without a prescription. All of these products are toxic medications that need to be used with care, and only when necessary. Lice treatment should be performed by an adult, not by the child. Educate families to seek the advice and counsel of the healthcare provider or pharmacist and read all insert materials before using these products. People with chrysanthemum or ragweed allergies may be sensitive to some of these products.
• Before using the treatment, shampoo the hair vigorously with regular shampoo to soften and loosen the nits in the hair. Follow this by thoroughly combing the hair with a special fine-tooth comb. These activities can weaken and damage the nit capsules and help the medicated shampoo work. Use the shampoo or rinse as directed by healthcare provider or pharmacist, or as outlined on the product information (Nix® Crème Rinse should be put on towel-dried hair).
– Do not get any medicated shampoo into the eyes—cover the child’s eyes with a towel and instruct child to keep eyes tightly closed. Any product that does get into the eyes should be rinsed immediately with large amounts of tap water.
– Keep these products out of reach of young children.
– Use the products over the sink, not in the tub or shower to avoid exposure of the skin to chemicals. All topical pediculicides should be rinsed from the hair over a sink, using cool water, to minimize product absorption due to vasodilation.
– Medicated shampoos and cream rinses should not be left on the head longer than directed on the product label (usually 10 minutes). The medicated shampoos and rinses are not preventive and should never be used unless live lice or nits are present.
– Wash hands well after using these products.
• Using a vinegar rinse (1:1 solution of water and white vinegar) after shampooing (except with Nix Crème Rinse) may make it easier to remove nits. No known preparation kills all of the nits so some must be manually removed.
• After using the product as directed and rinsing, nits must be removed by combing the hair with a special fine-tooth comb made for this purpose. This process is easier with a very bright light, and sometimes a magnifying glass is helpful.
• Have the child put on clean clothing immediately after the treatment.
• A student should not miss more than one to two days from school because of head lice. On days two to six after initial treatment, wash the hair with regular shampoo and remove any nits that are still present.
• Re-treatment after nine days may be necessary to eradicate any lice that may have hatched from nits that were not killed or removed. Do not retreat before seven days. Follow the healthcare provider’s recommendations.
• Some people have had success using oil, such as mineral or olive oil, to cover the hair, wrapping the head with a towel (not a shower cap), and leaving it on overnight. The oil is then washed out with regular shampoo. Manual removal of lice and/or nits is still necessary after this treatment. Vaseline applied to the eyebrows/eyelashes for 24 hours can treat lice in this area.
• The entire household should be checked and all infected individuals treated. If the first treatment in a family fails, then all members should be treated.
• In resistant cases, since lice can only live independent of a human host for approximately 24 hours and some objects in the environment cannot be easily cleaned, families may want to consider moving the child from his environment for 24-36 hours (i.e., stay at another relative’s house for one to two days).
• Machine-washing in hot water and/or drying on the hot cycle of the dryer can disinfect many personal articles, such as bed linens, clothing and headgear. Eggs can be killed in 10-15 minutes at 130º F, and live lice at slightly lower temperatures. Allow time between loads of laundry for the water to regain its maximum water temperature. If only the dryer is available, dry articles for at least 20 minutes at the high heat setting.
• Articles that are not washable may be effectively disinfected in the dryer if the heat will not harm them.
• Dry cleaning or storing items in a tightly sealed plastic bag for 10-14 days is also effective.
• Vacuum mattresses, pillows, upholstered furniture, car seats and carpeting. Discard contents of vacuum bag immediately in plastic trash bags.
• Combs and brushes should be soaked in hot water for one hour.
• To control the spread of head lice, infested persons should not share items that come into contact with the head, neck or shoulders (e.g., combs, brushes, hats, scarves, coats, towels, stuffed animals child sleeps with).
• Handwashing and cleaning under fingernails is also important since nits could get under the nails when scratching and easily be spread to others.
• Animals in the home do not carry lice.
• Do not use dog shampoo, kerosene or other unapproved products. They do not kill lice and can be dangerous.
• Treatment should focus on the infested person and his/her personal articles. The U.S. Public Health Service does not recommend fumigation or use of insecticides in the home, school or on school buses.
Cautions from the National Pediculosis Association:
• Don’t use shower caps during treatment and never leave the product on longer than directed.
• Don’t use a prescription product containing the pesticide LINDANE.
• Don’t use a chemical treatment on or near the eyes.
• Don’t use a chemical head lice treatment on a baby.
• Don’t use lice sprays. • Don’t treat individuals who are not infested.
• Don’t use chemical treatments to prevent head lice