What’s the Treatment for Lice?
If you or your child has lice, you want a treatment that works — fast. Lice happens in 6 million to 12 million school kids every year. Many areas of the U.S. have lice that resist permethrin-based treatments, so you need to be aware of the best choices to get rid of lice.
Experts offer a few basic guidelines to help get these parasites under control:
- If you see lice on your child’s head or body, it needs to be treated.
- If you live with or are close to someone who has lice, you need to be checked for it.
- Anyone who shares a bed with someone who has lice should be treated at the same time.
Lice Treatment Medications
You can treat lice at home. Lice treatments (called pediculicides) are available over the counter or with a prescription. They include shampoos, lotions, and cream rinses. If you’re pregnant or breastfeeding, ask your doctor to recommend a product that’s safe to use.
Both over-the-counter (OTC) products and prescription treatments may kill live lice and their eggs (nits). Check the labels to be sure. If lice are moving slowly after 9 or 10 days, they are probably dying. Check with your doctor about whether you should reapply.
OTC medications for lice treatment
OTC lice treatments with pesticides contain these active ingredients:
- Piperonyl butoxide with pyrethrins (A-200, Pronto, R&C, Rid, Triple X, Xeglyze). You can use this treatment in kids 2 years old and older. It’s made from the chrysanthemum flower. Don’t use it if you have an allergy to chrysanthemums (mums) or ragweed.
- Permethrin lotion,1% (Nix). This lice shampoo is approved for use in babies and children ages 2 months and older.
OTC treatments without pesticides include:
- Dimethicone. This is a nonpesticide, silicone-based material that works by coating lice and interfering with their ability to manage water. Some studies have shown it to be more effective than products that contain pesticides.
Don’t use more than the recommended amount or combine products. If you still see lice moving after you use an over-the-counter treatment, call a doctor. You may need a stronger product.
Prescription medications for lice treatment
Prescription lice treatments include:
- Benzyl alcohol (Ulesfia). This lotion kills active lice, not eggs. It can treat head lice in children ages 6 months and older, and it’s safe for women who are pregnant or breastfeeding. Comb the hair first, shampoo the product into dry hair, and let it sit for about 10 minutes before rinsing. You need to repeat this treatment in a week.
- Ivermectin (Sklice). This lotion kills most head lice, even just-hatched lice, with just one use. You don’t need to comb out lice eggs (nits). Children ages 6 months and older can use this product.
- Malathion (Ovide). This very strong lotion paralyzes and kills lice and some lice eggs. It’s approved for use in kids 6 years and older. If you still see lice moving 7 to 9 days later, you’ll need a second treatment. Warning: The product is flammable. Avoid all cigarettes and heat sources, including blow dryers, curling irons, lighters, fireplaces, space heaters, and stoves. Using them at the same time can start a fire.
- Spinosad (Natroba). You usually need only one treatment with this product. It kills nits and live lice. It’s safe for use on kids 4 years and older.
Lidane shampoo is also FDA-approved to treat lice. But the American Academy of Pediatrics no longer recommends it because it has been linked to nervous system damage.
How to Use Lice Treatments
Keep these tips in mind when using lice treatments:
- Always follow the product instructions carefully.
- Use a fine-tooth comb or the lice comb that came with the product to comb out all nits. (Some prescription products don’t require combing.)
- If you’re using a lice shampoo, be sure to apply it over a sink or tub while you and your child are fully dressed. Don’t use the product while showering. You want to limit how much of it touches your body.
The most common side effect of lice treatments is skin irritation. They may cause a temporary burning or stinging.
Lice Treatment Home Remedies
If you don’t wish to use chemical treatments, talk to your doctor about other options. There are some treatments you can do yourself. These home remedies include:
- Wet combing. Simply wet the hair and use a fine-tooth comb to remove active lice and their eggs. You’ll need to do this every week for at least 3 weeks.
- Essential oils. Plant oils such as tea tree and anise may suffocate and kill lice, but it’s not clear how well this works. You can also have an allergic reaction to these and other essential oils
- Smothering agents. Some people try to suffocate and kill lice by putting large amounts of a greasy substance on your scalp, covering with a shower cap, and leaving it on while you sleep. You can try petroleum jelly, mayonnaise, or olive oil. But these may not work well.
How to Get Rid of Lice in Your Home
Lice can crawl off your body onto things nearby, like bedding, towels, and hats. But they need human blood to survive, so they don’t live long after they fall off your body. Try these tips to treat lice in your house:
- Use heat. Wash any items used or worn by the person in hot water, and dry them on high heat. Lice and nits die when exposed to temperatures higher than 130 F for more than 5 minutes. Wash anything that touched the person’s skin or scalp, including jackets, hats, scarves, pillowcases, sheets, and headbands.
- Bag items in plastic. If you can’t toss the items into the washer and dryer, seal them in a plastic bag for 2 weeks.
- Vacuum. Vacuum rugs, sofas, upholstery, other furniture, and floors to remove hairs that may have active lice eggs attached.
- Clean hair tools. Soak brushes, combs, and other hair accessories in hot, soapy water for 5 to 10 minutes.
- Don’t use insecticide fogs or sprays. These fumigating treatments can be toxic if you inhale them or absorb them through your skin.
If you have lice, try not to be embarrassed. It’s not a sign of disease or that you or your child is dirty. Even the cleanest people get it. Consider telling friends and teachers so they check their kids and classrooms and stop these pests from spreading.