According to the American Academy of Pediatrics guidelines, the gold standard for diagnosing an active head lice infestation is the identification of a live nymph or adult louse. These guidelines recommend an examination of wet hair lubricated with such products as a standard hair conditioner. Your doctor will carefully comb your child's hair with a fine-toothed comb (nit comb) from the scalp to the end of the hair. If no live louse is found, he or she will likely repeat the entire exam at a second appointment. this study details all about head lice management please comment thank you

1. PREPARED BY
MARTIN SHAJI
PHARM D
HEAD
LICE
diagnosis & several
ways of management

2. Diagnosis
According to the American Academy of Pediatrics guidelines, the gold
standard for diagnosing an active head lice infestation is the
identification of a live nymph or adult louse.
These guidelines recommend an examination of wet hair lubricated with
such products as a standard hair conditioner. Your doctor will carefully
comb your child's hair with a fine-toothed comb (nit comb) from the
scalp to the end of the hair. If no live louse is found, he or she will likely
repeat the entire exam at a second appointment.

3. Identifying nits
Your doctor will also look for nits in your child's hair. To find nits, he or she
may use a specialized light called a Wood's light, which causes nits to appear
bluish. But the identification of nits does not necessarily confirm the
diagnosis of an active lice infestation.
A live nit needs to be near the scalp to #survive. Nits found more than about
1/4 inch (6 millimeters) from the scalp are likely #dead or empty. Suspect
nits can be examined under a #microscope to determine if they're living —
#evidence of a likely #active lice infestation.
If no live nits are found, they're probably left from a previous infestation and
do not need to be treated.

4. Treatment
Your doctor will likely recommend an over-the-counter (#OTC)
#medication that kills lice and some of the nits. These medications may
not kill recently laid #eggs. Therefore, an appropriately timed second
treatment is usually necessary to kill nymphs after they hatch but before
they become #adult lice.
Some studies suggest that retreating seven to nine days after the first
treatment is the ideal time for a second treatment, but other
retreatment schedules exist. Ask your doctor for written instructions for
a recommended treatment schedule.

5. Over-the-counter (OTC) products
OTC medications are based on pyrethrin, a chemical compound
extracted from the chrysanthemum flower that is toxic to lice.
Wash your child's hair with shampoo with no conditioner before
using one of these treatments. Rinsing the hair with white
vinegar before washing may help dissolve the glue that holds the
nits to the hair shafts. Follow directions on the package for how
long to leave the medication in the hair, and rinse your child's
hair over a sink with warm water.

6. OTC medications include the following:
Permethrin (Nix).
Permethrin is a synthetic version of pyrethrin. Permethrin does not kill nits,
and treatment needs to be repeated nine to 10 days after first application.
Side effects may include redness and itching of the scalp.
Pyrethrin with additives (Rid)
In this OTC medication, pyrethrin is combined with another chemical that
enhances its effectiveness. This product only kills lice, not nits, and needs to
be reapplied nine to 10 days after first treatment. Side effects may include
itching and redness of the scalp. Pyrethrin shouldn't be used if your child is
allergic to chrysanthemum or ragweed.

7. Prescription medications
In some geographic regions, lice have developed resistance to OTC
medications. Also, OTC treatment may fail because of incorrect use, such as
not repeating the treatment at an appropriate time.
If the correct use of an OTC treatment has failed, your doctor may
recommend a prescription treatment. These include:
Benzyl alcohol (Ulesfia).
This product is not toxic to lice but kills them by depriving them of air. Side
effects may include redness and itching of the scalp. Benzyl alcohol is not
approved for use in children younger than 6 months of age.

8. Ivermectin (Sklice).
Ivermectin is toxic to lice. It is approved for use with people age 6 months or
older. It can be applied once to dry hair and then rinsed with water after 10
minutes. Ivermectin is also available as a tablet to be taken by mouth to
children weighing more than 33 lbs. if other topical treatments do not
effectively eliminate a lice infestation.
Spinosad (Natroba).
Spinosad is approved for use with people age 4 years or older. It can be
applied to dry hair and rinsed with warm water after 10 minutes. It kills lice
and nits and usually doesn't need repeated treatment.

9. Malathion.
Malathion is approved for use with people age 6 or older. The lotion is
applied, left to dry naturally and rinsed out after eight to 12 hours. The
drug has a high alcohol content, so it can't be used with a hair dryer or
near an open flame. Malathion can be reapplied seven to nine days after
the first treatment if necessary

10. Lifestyle and home remedies
If you prefer not to use a medication for treating a head-lice infestation, you
may consider an alternative home treatment. There is little to no clinical
evidence of the effectiveness of such treatments.
Wet-combing
Combing wet hair with a fine-toothed nit comb may remove lice and some
nits. Studies show that wet-combing results vary.
The hair should be wet, and you should add something to lubricate the hair,
such as a hair conditioner or olive oil. Comb the entire head from the scalp
to the end of the hair at least twice during a session. The process should be
repeated every three to four days for several weeks — at least two weeks
after no more lice are found.

11. Essential oils
Small clinical studies have suggested that some natural plant oils may
kill lice by suffocation, but effectiveness is uncertain. These products
include:
Tea tree oil
Anise oil
Ylang-ylang oil
These products are not required to meet safety, efficacy and
manufacturing standards used for drugs approved by the Food and
Drug Administration (FDA), and can sometimes cause allergic
reactions.

12. Smothering agents
A number of household products are used to treat head-lice infestations.
These products are thought to deprive the lice of air when generous
amounts are applied to the hair, covered with a shower cap and left on
overnight. Products used for this purpose include:
Mayonnaise
Olive oil
Margarine or butter
Petroleum jelly
However, the effectiveness of these treatments is unclear.

13. Dehydration
Another option is a machine that uses one application of hot air in an
attempt to kill head lice and their eggs through dehydration. The machine
requires special training and is currently available only at professional lice
treatment centers.
The machine uses air that is cooler than most hair dryers and at a much
higher flow rate to kill the lice by drying them out. A regular hair dryer
should not be used to accomplish this result as it's too hot and could burn
the scalp.
Dangerous products to avoid
Flammable products, such as kerosene or gasoline, should never be used
to kill lice or to remove nits.

14. Household cleaning
Lice usually don't live past one day without feeding from a human scalp,
and eggs do not survive if they aren't incubated at the temperature near
the scalp. Therefore, the chance of lice surviving on household items is
small.
As a precaution, you may clean items that the affected person has used in
the previous two days. Cleaning recommendations include the following:
Wash items in hot water.
Wash bedding, stuffed animals and clothing in hot, soapy water — at least
130 F (54.4 C) — and dry at high heat.

15. Clean hair care items.
Clean combs, brushes and hair accessories by soaking them in
hot, soapy water for five to 10 minutes.
Seal items in plastic bags.
Seal items that can’t be washed in plastic bags for two weeks.
Vacuum.
Give the floor and upholstered furniture a good vacuuming.