No-Panic Guide to Head Lice Treatment (2024)

It’s easy to get upset if you discover that your child has head lice. The thought of tiny parasites in your child’s hair can lead to panic and rushed decisions. Would you be less stressed if you knew that head lice aren’t known to transmit diseases, and itching is the only major health issue they cause?

Parents can follow these tips for on how to get rid of head lice the right way. Let’s start with some head lice facts:

  • Head lice are common in children between the ages of 3 and 11 years old.
  • These pests are more prevalent in Caucasian children.
  • They are more frequently found in girls than boys.
  • Head lice live in all types of hair, whether it’s curly, straight, dyed or natural.

    Step 1: Know How Head Lice Spread

    Before you start treatment, understand how your child could have gotten head lice. Head lice don’t jump, they don’t live on pets and they have nothing to do with personal hygiene. The most common way head lice spread is by head-to-head contact. This means your child must have been touching heads with someone who has head lice. This may happen during sports, slumber parties or play time in or outside of school.

    A less likely way to get head lice is by sharing personal items that touch the head, such as hats, hair brushes and hair accessories. Head lice need to have a blood meal every 12 to 24 hours, so they can’t survive away from a human head for longer than a day.

    Step 2: Contain the Problem

    Once your child comes home with a confirmed case of head lice, take steps to prevent lice from spreading to other family members.

    • Avoid hugging or other close contact.
    • Check other kids and adults in your household for head lice.
    • Often, by the time you get a call from a school nurse, your child has had head lice for a while. Your whole family may need to be treated to prevent reinfestation.

    Washing hats, pillow cases and similar items that touch the head in hot water may help contain head lice. However, disinfecting your house is not necessary because the transmission of head lice from inanimate objects is rare.

    Step 3: Understand the Life Cycle of a Head Louse

    To properly treat head lice, you need to understand your enemy. Head lice can be found in one or more of these forms:

    • Head lice eggs (nits) are firmly attached to the base of the hair. They may look like dandruff, but if you examine them with a magnifying glass, you can see that nits are oval-shaped and not flat.
    • The egg produces a nymph, which has a greyish-white color and goes through three stages before becoming an adult.
    • Adult head lice are tan-colored and can be seen moving quickly along the hair or across the scalp.

    All three generations of head lice need to be nonviable, or dead, to get rid of head lice for good.

    Step 4: Consider ‘Destruction of Habitat’

    Head lice need a human host to survive. If the hair is gone, so are head lice. While cutting a child’s hair may seem like an extreme solution, it may be a viable course of action for some parents. If your child already gets short haircuts, it may make sense for you to deal with head lice by destroying their habitat.

    Step 5: Learn How Over-the-Counter Head Lice Treatments Work

    Your first line of defense against head lice is an over-the-counter (OTC) head lice treatment that typically comes in the form of shampoo. The main difference between various products is the active ingredient and which stages of head lice it kills. Most OTC head lice treatments don’t kill nits, so a second application may be necessary to kill the nymphs once they hatch.

    Some OTC head lice treatments use pyrethrins as the active ingredient. Pyrethrins naturally occur in flowers of the Compositae (Asteraceae) family like chrysanthemums, also known as mums or chrysanths. If your child is allergic to these flowers, he or she may also be allergic to the head lice treatment that uses pyrethrins.

    Step 6: Apply the Treatment as Directed

    One of the reasons over-the-counter head lice treatments don’t work is because they are not used as directed. Parents may split one dose into several applications or otherwise deviate from the directions. You shouldn’t see any crawling head lice after the first treatment if you applied it correctly. If you are still seeing live crawlers, then you may have missed a step or the treatment is not effective against the type of lice your child has.

    Additional Tips for Getting Rid of Head Lice

    Seek Professional Help

    Some parents turn to home remedies for head lice, such as tea tree oil, mayonnaise, neem oil, vinegar, saline spray and many others. These treatments are messy, time consuming and not supported by scientific evidence. If you tried an OTC head lice treatment that didn’t work and you are certain that your child didn’t get reinfested, seek professional help.

    It’s possible that you are dealing with head lice that are resistant to the active ingredient in your treatment product. Consult with your pediatrician or contact a pediatric dermatologistfor a prescription head lice treatment.

    Don’t Obsess Over Nits

    Generally, if no live crawling insects are seen three weeks after the treatment, it’s safe to assume that they are gone. Nits would have hatched by that time if they were alive. Nits and their shells may remain in the hair for some time but won’t be viable.

    Many prescription head lice treatments target nits along with adult head lice. If you used a product like this, no combing is necessary unless you can’t wait to get rid of the dead shells.

    Keep an Eye on Head Scratching

    Unfortunately, there is no proven head lice deterrent that will prevent your child from getting head lice again. The best you can do is stay alert for suspicious head scratching. Itching is an allergic reaction to chemicals in a head louse’s saliva. Not all kids will experience itching right away, but if they have had head lice before, they are more likely to start itching sooner. Catching this behavior early and treating it will help you stop a head lice problem at its roots.

    No-Panic Guide to Head Lice Treatment (2024)


    Why won't my lice treatment work? ›

    If you tried an OTC head lice treatment that didn't work and you are certain that your child didn't get reinfested, seek professional help. It's possible that you are dealing with head lice that are resistant to the active ingredient in your treatment product.

    How do you get rid of lice if you have tried everything? ›

    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. 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.

    How do you treat stubborn head lice? ›

    Medicated lotions and sprays

    These kill head lice in all types of hair, and you can buy them from pharmacies, supermarkets or online. Head lice should die within a day. Some lotions and sprays come with a comb to remove dead lice and eggs. Some treatments need to be repeated after a week to kill any newly hatched lice.

    What is the very best lice treatment? ›

    Best Overall

    Malathion Ovide Lotion is a prescription-strength lotion that comes highly recommended by experts for treating lice. It's suitable for treating live adult lice and their eggs, known as nits. Malathion is applied directly to the scalp and dry hair.

    How do you get rid of lice when nothing works? ›

    If a head lice treatment that you can buy without a prescription fails to work, the CDC recommends that you see a health care provider. Highly effective prescription treatments that you apply to the scalp are available.

    What to do if lice is not gone after treatment? ›

    After Treating with Lice Medicine

    If some are still present but moving slowly, do not shampoo again. If lice are still active and no dead lice are found, call your health care provider.

    What kills 100% of lice? ›

    Tea Tree Oil. Though many people are sensitive to tea tree oil, it has been shown to be effective at killing lice. One study showed a 100% mortality rate after 30 minutes of treatment. A tea tree oil-scented spray or shampoo may be useful in preventing reinfestation.

    Why can't some people get rid of lice? ›

    Over the years, some lice (called “super lice”) evolved so that the over-the-counter treatments don't effectively kill the lice. Powerful prescription drugs are available that can eliminate super lice with one dose.

    What kills lice immediately? ›

    Washing, soaking, or drying items at a temperature greater than 130°F can kill both head lice and nits. Dry cleaning also kills head lice and nits.

    What does head lice hate the most? ›

    What repels head lice? Coconut, tea tree oil, lavender, eucalyptus, rosemary, lemon grass, and peppermint are scents popularly believed to repel lice. Using any coconut scented shampoo and conditioner is an easy way to increase your defense. At 1% concentration, tea tree oil killed 100% of head lice after 30 minutes.

    What is the best treatment for resistant head lice? ›

    Traditional treatment for lice involves products containing pyrethrin and permethrin insecticides. Since super lice have become more resistant, doctors recommend stronger medications. Common drugs prescribed to treat resistant lice infestations include: Natroba.

    How do you treat extreme lice? ›

    1. Nonprescription products. Shampoos containing permethrin (Nix) are usually the first option used to combat lice. ...
    2. Oral prescription drug. Ivermectin (Stromectol) is available by prescription as a tablet taken by mouth. ...
    3. Topical prescription drugs.
    Jun 30, 2022

    What treats super lice? ›

    Nix® Ultra is highly effective for killing lice, superlice and their eggs.

    Is Rid or Nix more effective? ›

    The medicine in Nix® is recognized as the most effective over-the-counter treatment for killing lice and their eggs according to the Academy of Pediatrics.

    What is the number one way to get rid of lice? ›

    Permethrin is safe and effective when used as directed. Permethrin kills live lice but not unhatched eggs. Permethrin may continue to kill newly hatched lice for several days after treatment. A second treatment often is necessary on day 9 to kill any newly hatched lice before they can produce new eggs.

    Why are lice still alive after treatment? ›

    (If they are still alive this probably means that they are resistant to the insecticide.) Care should be taken when using head lice treatment products: if you are pregnant or breastfeeding. in children less than 12 months old.

    Why do I still have lice after 2 treatments? ›

    Treatments might not work for a couple of reasons. First, studies have shown that lice can be resistant to pesticide treatments that have been used in some geographical areas. Second, female adult lice lay up to eight eggs a day.

    Why do I still feel lice after treatment? ›

    Even after using lice treatments like shampoos or medications, you may still feel as if you have lice due to increased skin sensitivity or because the treatment wasn't effective. Lice are tiny insects that feed on your blood. They're commonly spread by sharing objects that touch your hair, such as hairbrushes or hats.

    Can lice be resistant to treatment? ›

    The head lice may have become resistant to the treatment. If the treatment used does not kill the head lice, your health care provider and pharmacist can help you be sure the treatment was used correctly and may recommend a completely different product if they think the head lice are resistant to the first treatment.

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