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Itching and eczematous dermatitis. In long-standing, neglected cases, scratching may result in marked inflammation. Secondary infection by bacteria may occur, with formation of pustules, crusts, and suppuration. Hair may become matted and malodorous.
Therapies for lice infestations are modified frequently, to match the resistance of lice to current therapies and to minimize the toxicities of medications. Manual removal of lice always is appropriate and is strongly recommended by lice specialists. Others recommend the use of insecticides (pediculocides).
The patient and family are taught how to apply medication (lindane, permethrin, pyrethrins, piperonyl butoxide, malathion) to dry hair for lice and are warned that the eyes should be immediately flushed with copious amounts of water if the medication accidentally contacts them. They are informed about minimizing the spread of infection by washing or dry cleaning all clothing and linen used in the home, delousing of rugs and upholstered furniture with sprays or vacuuming, keeping combs and brushes separate, and using medicinal shampoos if there has been contact with the patient.