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Head lice
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Counseling
Follow the product directions exactly, rinse over a sink with warm water, and wait a day or two before shampooing. Some products need a second treatment about 9 to 10 days later, after eggs have hatched. Combing out nits is optional; nits alone do not mean active lice. Recommended supportive care with an emphasis on washing recently used bedding, hats, and brushes in hot water or bagging items for 2 weeks. Return precautions given including live lice still seen after the second treatment, scalp sores or signs of skin infection, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
CounselingNot in the note with these choices
Nits alone, especially those more than a centimeter from the scalp, are usually empty shells and do not need treatment. Recommended supportive care with an emphasis on checking the hair for live lice over the next couple of weeks. Return precautions given including live lice seen, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
What the sources cover
- Live lice vs nits only (nits alone don't justify treatment)
- Permethrin 1% or pyrethrins first; Sklice, spinosad; malathion, oral ivermectin
- Retreatment interval
- Rinse over sink, no shampoo 24-48 h
- Household: check and treat; bedmates prophylaxis
- No exclusion; no-nit policies discouraged