What’s the Treatment for Lice?

If you or your child has lice, you want a treatment that works -- fast. Lice occurs in 6 million to 12 million school kids every year. 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.

Medications for Killing Lice

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.

Over-the-counter products only kill live lice, not their eggs (nits). You apply two treatments – about 7 to 9 days apart -- to prevent adult lice from laying new eggs.

Over-the-counter lice treatments have these active ingredients:

  • Piperonyl butoxide with pyrethrins (A-200, Pronto, R&C, Rid, Triple X): You can use this treatment in kids ages 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.

Don’t use more than the recommended amount or combine different products. If you still see lice moving after using an over-the-counter treatment, call a doctor. You may need a stronger product.

Prescription lice treatments include:

  • Benzyl alcohol (Ulesfia): This lotion kills active lice, not eggs. It can be used to treat head lice in children ages 6 months and older, and is safe for women who are pregnant or breastfeeding. You 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) and you don’t need to treat a second time. 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 ages 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 only need one treatment with this product. It kills nits and live lice. It’s safe for use on kids ages 4 years and older.

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Lidane shampoo is also FDA-approved to treat lice. But the American Academy of Pediatrics no longer recommends its use because it has been linked to nervous system damage.

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 of the skin.

Other Ways to Treat Head Lice

If you don’t wish to use chemical treatments, talk to your doctor about other options. Wet combing is one technique. You 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.

Some believe you can suffocate and kill lice using greasy substances like petroleum jelly, mayonnaise, or olive oil. But these may not work well.

Getting Rid of Lice at Home

Lice can crawl off your body onto nearby items, like bedding, towels, and hats. But they need human blood to survive, so they don’t live long after they fall off the body. Try these tips to treat lice in your house:

Wash any items used or worn by the person in hot water, and dry them on high heat. Lice and lice eggs (nits) die when exposed to temperatures greater than 128.3°F for more than 5 minutes. Wash jackets, hats, scarves, pillowcases, sheets, headbands -- any item that touched the skin or scalp.

If you can’t toss the items into the washer and dryer, seal them in a plastic bag for 2 weeks.

Vacuum rugs, sofas, upholstery, other furniture, and floors to remove hairs that may have active lice eggs still attached.

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.

WebMD Medical Reference Reviewed by Stephanie S. Gardner, MD on March 08, 2017

Sources

SOURCES:

American Academy of Dermatology: “Head Lice: Overview,” “Head Lice: Tips for Managing.”

CDC: “Frequently Asked Questions,” “Treatment.”   

KidsHeath: “If You Think You Have Lice.”

FDA: “Treating Head Lice.”

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