Skin Problems & Treatments Health Center

Understanding Lice and Scabies -- Treatment

What Is the Treatment for Lice?

To get rid of head lice, the most common treatment is to kill the adults with a pediculocide and to clear out the nits with a special fine-toothed comb. Pyrethrins are a common treatment that is available over the counter. Brand names include Rid, Triple X, Pronto, A-200. For best results, follow the directions exactly. Repeat treatment in nine to 10 days to kill any new lice that may have hatched since the first treatment. Permithrin lotion 1% (also known as Nix) is another over the counter product which also only kills lice, but not eggs, and will require repeat treatment in nine to 10 days.

Malathion lotion 0.5% (also known as Ovide) is a prescription medication that is approved for head lice and can kill some eggs. Directions and precautions for use must be strictly followed.

Lindane shampoo 1% is approved for lice treatment, but shouldn't be used as first line treatment. If used improperly, especially in young children, it can attack and damage the brain and other parts of the nervous system.

A new treatment for lice was approved by the FDA in early 2011 called spinosad (Natroba). The drug is topical and applied to the scalp. It is not approved for use in children under age 4. 

For those who prefer to avoid the use of insecticides, try a "combing only" technique. Wash the hair with ordinary shampoo and conditioner, and leave wet. With a fine-toothed comb, stroke slowly outward from the roots through one lock of hair at a time. Lice will land on the back of the comb, get caught between the teeth, or fall off. Space at least 30 strokes over the head. Repeat every three days. Because newborn lice do not lay eggs for the first week, all the lice should disappear after about two weeks of combing.

Pubic lice can be treated with over-the counter medications containing pyrethrins or permethrin lotion 1%. Your sexual partners will also have to be treated. Crabs are also sometimes found on eyelashes or eyebrows. A nit comb or fingernails may be used if there are only a few live and nits on them. Otherwise a special prescription eye ointment may be prescribed.

To treat body lice, wash the entire body with soap and water. If this is not effective, you may have to use pediculocide preparation -- either over-the-counter or prescription. As with a head lice infestation, you'll have to wash all clothing, towels, and bedding in hot water and dry in a hot dryer.

What Is the Treatment for Scabies?

Scabicides that kill mites -- and some also kill eggs -- are available by prescription only. Permethrin cream 5% (also known as Elimite) is a common treatment that kills mites and eggs. It is approved for use in adults and children at least two months old.

Crotamiton lotion or cream 10% (also known as Eurax or Crotan) is approved for scabies treatment in adults only. However, it is not very effective.

Lindane lotion is approved for use as scabies treatment, but should not be used as first-line therapy. If used improperly, it can attack and damage the brain and other parts of the nervous system.

A prescription oral drug, ivermectin, is also very effective in eradicating scabies. Two doses taken one week apart are needed.