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HEAD LICE - Coggle Diagram
HEAD LICE
Management
Wet Combing - The Bug Buster Kit, Nitty Gritty NitFree comb, Nitcomb-S1, Nitcimb-M2 and Portia head louse comb.
Physical Insecticide - Dimeticone 4% gel, lotion or spray. Dimeticon 92% spray/ < 95% lotion, Isopropyl Myristrate and Isopropyl alcohol aerosol: all available on NHS
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Choice of treatment depends on person/carer /parent. Wet Combing recommended first line for pregnant or breastfeeding women/young children aged 6 months to 2 years and people with Asthma/Eczema. Shampoos not recommended
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Wet Combing - recommended regimen is four sessions spaced over 2 weeks.
Detailed information on community hygiene concern www.chc.org).
Insecticides - recommended applied twice at least 7 days apart treating lice hatching from eggs before laying eggs. Detection combing should be done to ensure treatment successful
Advantages Wet Combing - Contact with clinician is not necessary. No contraindications or precautions for its use. It is expensive.
Disadvantages - Time consuming/labour intensive and cure rates lower than other methods.
Advantages Physical Insecticides - Well established safety profile and well tolerated. Suitable for people with Asthma, pregnant women and children.
Disadvantages - minor adverse effects e.g. skin irritation, a single case of hair loss
Advantages Traditional Insecticides - Cure rates 75%, suitable for people with Asthma or skin conditions, pregnant and breastfeeding women, no alcohol content.
Disadvantages - Unpleasant smell, skin irritation/hypersensitivity reactions ( anaphylaxis/angioedema and swollen eyes).
Background
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Life cycle of head house are three stages - Egg (ova), nymph and adult head lice.
Transmission - head to head contact, not transmitted via pets. Life span short once detached from human head (1-2 days).
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Complications - Pruritic rash on back of neck/behind ears as a result of reaction to louse faeces, erythema. Anxiety/distress/stigma.
Excoriation /secondary skin infection e.g. impetigo caused by scratching.
Diagnosis
Detection combing on wet /dry hair. Live louse must be found. Itching scalp insufficient to diagnose active infestation. Presence of louse eggs alone not an indicaiton
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Dry detection combing - Combing of dry hair with a fine-toothed head lice detection comb to confirm the presence of head lice.
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