Head lice

Receptionists

• Give wet combing method leaflet to parent.
• Instruct parent to either
  • bring affected child to practice nurse or
  • take child to health visitor at Tweedmouth Clinic at 9.00am or 3.30pm
• Prescriptions will not normally be given because of the concerns regarding the use of insecticides and the development of resistance.

Doctor

• Refer to practice nurse or health visitor for advice.

Practice nurse or health visitor

• If mild infestation, encourage the use of the wet combing method and provide leaflet .
• If heavy infestation use the recommended treatment in the practice formulary
• Check extended family - grannies are less likely to itch!

Treatment - mosaic approach

• 1st choice - permethrin + combing.
• 2nd choice - malathion + combing.
• 3rd choice - carbaryl (GP) + combing.

With each treatment choice

• Use 2 applications of insecticide, 7 days apart.
• 2-3 days after final application of insecticide check hair thoroughly with a plastic detector comb.
• If adult lice are still present, go on to next treatment choice. Always thoroughly investigate reason for treatment failure.