ABSTRACT
Recently, head lice have appeared to become more resistant to standard over-thecounter (OTC) treatment and initial treatment failures are exceedingly common. The first line of treatment remains OTC 1% permethrin cream rinse (NIX) or A-200 pyrinate liquid (RID). They should be applied to wet towel-dried hair and left on at least 10 minutes. After treatment, hair should be combed meticulously with a special fine-toothed nit removing comb to remove any viable nonhatched nits. All personal headgear, scarves, coats, and bed linen should be disinfected by machine washing in hot water and drying on the hot cycle of a dryer for at least 20 minutes. Combs and brushes should be soaked in hot water (above 130F) for 5 to 10 minutes. Thorough vacuuming of rooms is also recommended.
