Severe Larval Infestation
Infants and ticks
The use of some pesticides is contraindicated with infants. In severe infestation of microscopic larval ticks, a 30 minute bath with 1 cup of bicarbonate of soda can help to dislodge ticks. Larval ticks may contain microorganisms for transmission.
Creams or Lotions
To remove ticks use a paralyzing topical cream or lotion such as:
i) Permethrin 5%, cream or lotion (usually for scabies ) (Lyclear 30g or Quellada Scabies Treatment 100ml)and is suitable for use for children. Apply from the chin down and wash off with warm, soapy water 8–14 hours later. Rinse thoroughly. Can also apply to the scalp, neck, face and ears in children
For a single attached tick, dab Lyclear to the tick and leave alone for 1/2 hr. If the tick is still attached after 1/2 hr apply more Lyclear. After another 1/2 hr the tick should be dead and safe to remove with tweezers if it hasn’t already fallen off.
Note: The likelihood of transmitting micro-organisms into the skin with these methods has not been studied and is unknown.
ii) Benzyl benzoate 25%, lotion (Ascabiol 200ml or Benzemul 200ml) is an alternative to permethrin though it is usually more irritant and use is unsuitable in children. Apply from the chin down and wash off with warm, soapy water 24 hours later. Traditionally applied after a hot bath, but this is unnecessary (Hadani et al, 1977, Gouck, 1966).
Removing multiple nymph infestation of the head can be addressed with, anti-lice shampoo containing 1% permethrin e.g., Quellada Head Lice Treatment, 100ml, or dab permethrin 5% cream or lotion as in i) above.