Management

Mechanical removal of head lice and their eggs with special fine-toothed combs or other implements is an established technique. Non-prescription pyrethrins can be applied twice with an interval of 10 days between doses. Pyrethrins kill adults and immatures, but not live nits, which must be combed out. Lindane and malathion can also be prescribed. As with all infectious diseases, resistance is increasing (19), and local information as to the most effective pediculucide must be obtained.

For body lice, the principal therapy lies in more frequent washing and changing of clothes and linens, which should be placed loosely in a clothes dryer for at least one-half hour at a temperature of at least 65° C. If lice or louse eggs lie amid body hair, head to foot treatment with pediculucides, either pyrethrin or lindane, is recommended.

Pubic lice are best eliminated by pyrethroid-containing shampoo, mechanical removal of lice and eggs, and shaving the affected region. Eyelid infestations have been treated by 1% yellow mercuric acid ointment, four times daily for two weeks (24), but, as this infestation is rare, no definite therapeutic recommendations can be made, and no specific FDA approval is now available. For all forms of louse infestation, ivermectin may soon become an important adjunct.

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