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  • The Review Course in Family Medicine

Itching to Learn More About Treating Pediculosis Capitis?

Share the following treatment advice with your patients to help them get rid of their tiny problems causing big pruritis.


Option 1: Topical pharmacotherapy are first line (i.e. permethrin shampoo)

  • Dead nits will persist AFTER successful treatment, so are not evidence of active infection unless recently laid (within 0.6cm of the scalp)

  • Any living nits hatch after 8 days

  • May repeat treatment in 9-10 days if live lice observed

Option 2: Wet-combing

Wet hair, add lubricant such as conditioner, vinegar, or olive oil. Use a fine-toothed comb to remove adult lice. Repeat every 3-4 days for 2 weeks after finding the last adult louse.

Refractory: Oral therapy (i.e. ivermectin) is second line only cases after 2 trials of topical THE CONTACTS

  • Treat anyone who sleeps in the same bed even if no lice/nits

  • Assess everyone who shares the home

  • Pets don't need treatment (can't host pediculosis capitis)


  • Wash and dry textiles (clothes, sheets) on high temp. If items can't be washed, seal in plastic

  • Vacuum textiles (furniture, carpet, car)

  • No need to wash/vacuum/seal items not used in past 2 days (lice can't survive off the body > 48 hours)

  • Inform school if necessary (policies differ)

  • Instruct not to share hats/brushes to avoid re-infection

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