Lice Treatment

Medically Reviewed by Poonam Sachdev on January 30, 2024
7 min read

If you or your child has lice, you want a treatment that works fast. Lice affects 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, begin treatment right away.
  • 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.

Head lice aren't a sign of poor hygiene or dirty living conditions. However, if lice go untreated, the problem will continue.

Lice treatment shampoo

Lice treatment shampoos (called pediculicides) are available over the counter or with a prescription. 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 9-10 hours, they are probably dying. Check with your doctor about whether you should reapply.

OTC lice treatments with pesticides contain these active ingredients:

  • Permethrin lotion,1% (Nix). This lice shampoo is approved for use in babies and children aged 2 months and older.
  • Piperonyl butoxide with pyrethrins (A-200, Pronto, R&C, Rid, Triple X, Xeglyze). You can use this treatment in kids aged 2 years and older. It’s made from the chrysanthemum flower. Don’t use it if you have an allergy to chrysanthemums (mums) or ragweed.

OTC treatments without pesticides include:

  • Dimethicone. This is a non-pesticide, 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 OTC treatment, call a doctor. You may need a stronger product.

Prescription lice shampoos include:

  • Benzyl alcohol (Ulesfia). This lotion kills active lice, not eggs. It can treat head lice in children aged 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 after a week.
  • Lindane prescription shampoo is also FDA-approved to treat lice. However, the American Academy of Pediatrics no longer recommends it because it has been linked to nervous system damage.

Lice treatment medications 

Your doctor might prescribe one of these drugs to deal with lice.

  • Ivermectin (Sklice). This lotion kills most head lice, even newly hatched ones, with just one use. You don’t need to comb out lice eggs (nits). Children aged 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 aged 6 years and older. If you still see lice moving 7-9 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 kids aged 6 months and older.

If other treatments don't work, your doctor might recommend Ivermectin tablets to be taken orally. You should only take this if prescribed by your doctor. Don't use veterinary versions of the drug.

Body lice treatment

If you have body lice, the first step is to wash yourself with soap and hot water. You also need to wash any contaminated items, such as clothes or bedding, in hot water. Dry them in a clothes dryer on high heat. Any clothes that can't go in a washing machine should be dry-cleaned or ironed. 

If that doesn't get rid of the lice, try one of the OTC shampoos or lotions that contain 1% permethrin. If the problem continues, your doctor can give you a prescription lotion.

How to get rid of lice permanently

If you follow directions, you should be able to get rid of lice. But lice can always come back if you're exposed to them again. Some tips to lower the odds of that:

  • Avoid sharing hats, scarves, combs, and brushes.
  • Hang your kids' clothes on separate pegs.
  • Avoid beds, couches, pillows, and blankets that have been in contact with someone who has head lice.

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 sensation.

If you don’t want 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 their scalp, then covering it with a shower cap, and leaving it on while they sleep. You can try petroleum jelly, mayonnaise, or olive oil. But these may not work well.

Does dying your hair kill lice?

Hair dye can contain harsh chemicals such as ammonia and hydrogen peroxide, which could damage lice. But the most effective way to kill lice is with a treatment designed for that job.

Lice can crawl off your body onto nearby things, such as 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 might have 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 your rugs, sofas, upholstery, 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 5-10 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 being 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.

Head lice are a common problem, especially among children who come in close contact with each other. If you or someone in your family has lice, begin treatment right away with a product specifically designed to kill lice. You may have to do more than one treatment. Follow the directions carefully.

What kills lice immediately?

Various OTC and prescription shampoos and lotions are effective for killing lice, but you'll need to choose the formula that's right for you or your family member. Some are not recommended for children below a certain age. The first treatment may not kill all the lice and eggs (called nits).

Can head lice live on pillows and sheets?

Yes, they can, but not for very long. They need warmth and human blood to survive. Still, it's best to wash items that came in contact with lice using hot water.

What's the best treatment for lice in the head?

The best way to treat head lice is with an OTC or prescription medicine designed for the job. If you're not sure which one to use, check with your doctor.