Which first line treatment for head lice includes a method to remove nits?

The first-line treatment for head lice that includes a method to remove nits is permethrin 1% shampoo. This treatment is effective not only in killing adult lice but also in loosening and helping to dislodge nits (lice eggs) from the hair shafts. The application process typically involves washing the hair with the shampoo, allowing it to sit for a set period, and then rinsing it out. After treatment, it's recommended to comb through the hair with a fine-toothed nit comb to physically remove any nits that may still be attached to the hair. This combing step is crucial for achieving effective lice management because it ensures that both the lice and their eggs are eliminated, thus preventing a re-infestation.

Other treatments like dimeticone lotion mainly work by suffocating lice but do not specifically address nit removal; oral ivermectin is a systemic treatment that may not provide immediate nit removal, and hydrocortisone cream is used for reducing inflammation or itching associated with lice but does not treat the infestation itself.