Lice

- Hair length, hair hygiene, socioeconomic status, and overall personal hygiene have little impact on risk of lice infestation.

- Shaving the head is not generally recommended.

- Children can attend school after their first shampoo treatment.

- Lindane has been discontinued from the Canadian market (Feb 2012) as it is a persistent organic pollutant.

- Wash clothes, bedding, toys that are slept with, and fomites in hot water (>50°C) and dry on hot cycle. If item can not be washed, store in plastic bags for 7 days. Only items that have been in contact with the head of the person with lice within 24-48 hours prior to treatment need to be cleaned. Vacuum mattresses.

- Empty nits are often mistaken for residual live lice. However, for true treatment failure, mechanical removal may be the only option.

 
Usual Pathogens

Pediculus humanus capitis

Alternative

Empiric Therapy Dose Duration
Permethrin 1% creme rinse (Nix®) Apply, wash off after 10 minutes Apply on day 1 and day 8
or    
Isopropyl myristate 50% (Resultz®) Apply, wash off after 10 minutes Apply on day 1 and day 8
or    
Dimeticone 50% (NYDA®) Apply, after 30 minutes, comb hair wtih lice comb and allow solution to dry on hair for at least 8 hours and then wash off. Apply on day 1 and day 8
or    
Pyrethrin 0.33% - piperonyl butoxide 3% shampoo (R&C®) Apply, wash off after 10 minutes Apply on day 1 and day 8

Treatment failure

Empiric Therapy    
Reapply shampoo treatment making sure to carefully follow product directions.