Dawaa Reference

infectious

Head Lice (pediculosis capitis)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources4 sources

AAP Clinical Report: Head Lice 2022 for the indication, with the product from Egyptian National Drug Formulary - Antimicrobial 2023, Permethrin monograph (printed page 414): "Head lice: Topical: Cream rinse/lotion 1%: Prior to application, wash hair with conditioner-free shampoo; rinse with water and towel dry. Apply a sufficient amount of lotion or cream rinse to saturate the hair and scalp ... Leave on hair for 10 minutes (but no longer), then rinse off with warm water; remove remaining nits with a nit comb. A single application is generally sufficient; however, may repeat 7 days after first treatment if lice or nits are still present." The formulary's head lice strength is 1% against the 2.5% given here, and it puts 5% at scabies. · AAP Clinical Report: Head Lice 2022 · CDC Parasites: Lice: Head Lice Treatment 2020 · Ovide (malathion) Lotion 0.5% US prescribing information (DailyMed, Taro)

Verified against3 documents
  • AAP Clinical Report: Head Lice 2022 for the indication, with the product from Egyptian National Drug Formulary - Antimicrobial 2023, Permethrin monograph (printed page 414): "Head lice: Topical: Cream rinse/lotion 1%: Prior to application, wash hair with conditioner-free shampoo; rinse with water and towel dry. Apply a sufficient amount of lotion or cream rinse to saturate the hair and scalp ... Leave on hair for 10 minutes (but no longer), then rinse off with warm water; remove remaining nits with a nit comb. A single application is generally sufficient; however, may repeat 7 days after first treatment if lice or nits are still present." The formulary's head lice strength is 1% against the 2.5% given here, and it puts 5% at scabies.
  • AAP Clinical Report: Head Lice 2022
  • Ovide (malathion) Lotion 0.5% US prescribing information (DailyMed, Taro)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (2)

  • Itching is the main presenting complaint of a lice infestation [itching]
  • Itching in someone living in crowded or unhygienic conditions raises suspicion for body lice [itching]

Signs — what you find (4)

  • Diagnosis is confirmed by seeing at least one live louse on examination
  • Nits alone do not confirm active infestation, since they can persist on hair for months after treatment
  • Dandruff, hairspray residue, and dirt can look like nits and cause false positives
  • Pubic lice are diagnosed by finding lice in the pubic hair itself

Tests (4)

  • Sticky tape can collect adult lice from the scalp for microscopic examination
  • Nits look oval and are firmly attached to the hair shaft
  • A Wood lamp makes nits fluoresce greenish-yellow
  • Skin scrapings can rule out a fungal infection when the diagnosis is uncertain

If not this — what else fits (6)

  • Scalp lice must be differentiated from dandruff
  • Scalp lice must be differentiated from seborrhea
  • Scalp lice must be differentiated from superficial fungal infection
  • Scalp lice must be differentiated from eczema
  • Scalp lice must be differentiated from folliculitis
  • Scalp lice must be differentiated from scabies

SourceStatPearls "Pediculosis" - disease-level clinical article

Presentation findings are traced to the source above.

1

PERMETHRIN

1st line

Formtopical

Adult dose and duration

Apply 2.5% lotion or cream to clean, towel-dried hair and scalp, leave on for 10 minutes, then rinse thoroughly with warm water. Repeat application in 7-10 days. x 2 applications 7-10 days apart

Paediatric dose

Suitable for infants and children >=2 months old. Apply to scalp/hair, leave on for 10 minutes, rinse. Repeat in 7-10 days.

Dose source

AAP Clinical Report: Head Lice 2022 for the indication, with the product from Egyptian National Drug Formulary - Antimicrobial 2023, Permethrin monograph (printed page 414): "Head lice: Topical: Cream rinse/lotion 1%: Prior to application, wash hair with conditioner-free shampoo; rinse with water and towel dry. Apply a sufficient amount of lotion or cream rinse to saturate the hair and scalp ... Leave on hair for 10 minutes (but no longer), then rinse off with warm water; remove remaining nits with a nit comb. A single application is generally sufficient; however, may repeat 7 days after first treatment if lice or nits are still present." The formulary's head lice strength is 1% against the 2.5% given here, and it puts 5% at scabies.

Why

AAP/CDC guidelines specify 1% permethrin baseline; Ectomethrin 2.5% lotion/cream is the registered formulation available in Egyptian retail pharmacies.

Cautions
  • Avoid contact with eyes and mucous membranes; rinse thoroughly with water if contact occurs.
  • Re-treatment on day 7-10 is essential to kill newly hatched nits, as topical pediculicides are not completely ovicidal.
  • Examine and treat all household members with active infestation simultaneously to prevent re-infestation.
Egyptian brands
Egyptian brandManufacturerIndicative price
ECTOMETHRIN 2.5 % CREAM 20 GMMISR > APC (ARAB PERFUMES CHEMICALS AND PHARMACEUTICAL CO.)12.00 EGP
ECTOMETHRIN 5 % CREAM. 20 GMMISR > APC (ARAB PERFUMES CHEMICALS AND PHARMACEUTICAL CO.)21.00 EGP
ECTOMETHRIN 5% OINT. 20 GMMISR > APC (ARAB PERFUMES CHEMICALS AND PHARMACEUTICAL CO.)21.00 EGP
NEWCID 1% 60ML SHAMPOOCID9.00 EGP
NEWCID 1% 80ML SHAMPOOCID11.00 EGP
2

MALATHION

2nd line

Formtopical

Adult dose and duration

Apply 0.5% lotion to dry hair and scalp, allow to air dry naturally, leave on for 8-12 hours (or overnight), then wash out with shampoo. Repeat in 7-9 days if live lice persist. x 1-2 applications 7-9 days apart

Paediatric dose

Approved for children >=6 months (BNFC 2024) or >=6 years (CDC 2020 / FDA). Apply to dry hair, leave for 8-12 hours, then shampoo out. Repeat in 7-9 days.

Dose source

Ovide (malathion) Lotion 0.5% US prescribing information (DailyMed, Taro)

Why

Second-line organophosphate pediculicide registered in Egypt (Prioderm / Lice Clean 0.5% lotion) used when permethrin treatment failure or resistance occurs

Cautions
  • Flammable due to isopropyl alcohol base; keep away from open flames, heat sources, and electric hair dryers while applied.
  • Do not use in infants under 6 months of age without specialist advice.
  • May cause temporary scalp irritation or stinging.
  • Leave the hair uncovered while it dries, and comb it through with a fine nit comb after rinsing - the lotion kills, the comb removes.
  • It is an organophosphate. If a child swallows any, that is an immediate hospital trip, not a wait.
Egyptian brands
Egyptian brandManufacturerIndicative price
PRIODERM 0.5 % LOTION 60 ML? different route - not topicalPHARCO > MUNDIPHARMA8.00 EGP
LICE CLEAN 0.5GM/100ML TOPICAL LOTION? different route - not topicalWESTERN PHARMACEUTICALS INDUSTRIES > WESTERN PHARMA8.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.