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Treating Head Lice


On April 9, 2009, FDA approved a new prescription medication for the treatment of head lice. Ulesfia (benzyl alcohol) Lotion, 5%, is approved for use in children 6 months of age and older. This new drug is the first FDA-approved head lice product with benzyl alcohol as the active ingredient.

The safety and effectiveness of Ulesfia Lotion, 5%, were shown in two studies of more than 600 people with active head lice infestation. The study participants received two, 10-minute treatments with either Ulesfia Lotion or a topical inactive substance (placebo), one week apart. More than 75 percent of the participants who received Ulesfia Lotion were lice-free 14 days after the final treatment, compared to 26 percent who received the placebo. The lotion kills lice but not nits, so the second treatment is needed to kill lice that have hatched since the first treatment.

“Benzyl alcohol lotion is considered to be a safe treatment for head lice,” says Walker. “However, it is not without risks.” Common side effects of the medication include irritation of the skin, scalp, and eyes, and numbness of the scalp where the product is applied. The product is not approved for use in children younger than 6 months, and premature infants could be at risk for developing serious side effects such as seizure, coma, and death.

Ulesfia Lotion, 5%, is distributed by Sciele Pharma Inc., a subsidiary of Atlanta-based Shionogi Company.

Steps for Safe Use

Follow these steps to use any head lice treatment safely and appropriately:

  • After rinsing the product from the hair and scalp, use a fine-toothed comb or special “nit comb” to remove dead lice and nits.
  • Apply the product only to the scalp and the hair attached to the scalp—not to other body hair.
  • Before treating young children, talk with the child's doctor or your pharmacist for recommended treatments based on a child’s age and weight.
  • Use medication exactly as directed on the label and never more often than directed unless advised by your health care professional.
  • Use treatments on children only under the direct supervision of an adult.

Heading Off Head Lice

  • Teach children to avoid head-to-head contact during play and other activities at home, school, and elsewhere (sports activities, playgrounds, slumber parties, and camps).
  • Teach children not to share clothing and supplies, such as hats, scarves, helmets, sports uniforms, towels, combs, brushes, bandanas, hair ties, and headphones.
  • Disinfest combs and brushes used by a person with head lice by soaking them in hot water (at least 130°F) for 5–10 minutes.
  • Do not lie on beds, couches, pillows, carpets, or stuffed animals that have recently been in contact with a person with head lice.
  • Clean items that have been in contact with the head of a person with lice in the 48 hours before treatment. Machine wash and dry clothing, bed linens, and other items using hot water (130°F) and a high heat drying cycle. Clothing and items that are not washable can be dry-cleaned or sealed in a plastic bag and stored for two weeks.
  • Vacuum the floor and furniture, particularly where the person with lice sat or lay. Head lice survive less than one or two days if they fall off the scalp and cannot feed.
  • Do not use insecticide sprays or fogs; they are not necessary to control head lice and can be toxic if inhaled or absorbed through the skin.