What to Buy Haircare Products The 9 Best Lice Treatments of 2023 Malathion Ovide Lotion is a prescription-strength treatment that quickly takes care of lice. By Michelle Pugle Michelle Pugle Facebook Instagram Website Michelle Pugle is a mental health writer and health news reporter featured in multiple digital publications. She also writes lived experience essays about anorexia, addiction and sobriety, and living well with fibromyalgia and CPTSD. She is the author of Ana, Mia & Me: An Eating Disorder Recovery Memoir, Space to Grow, Poems, and Disordered: You Are Not Crazy. Michelle holds a Master of Arts degree in Feminist Research, a double BA in Sociology and English, a diploma in Holistic Herbal Therapy, and training certifications in mental health first aid by the Mental Health Commission of Canada, Usui reiki, and suicide prevention. Her work translates the latest research into actionable tips that support people in making informed choices about their health. health's editorial guidelines and Karen Pallarito Karen Pallarito Twitter Karen is a senior editor at Health, where she produces health condition “explainers” backed by current science. health's editorial guidelines Updated on January 10, 2023 Medically reviewed by Susan Bard, MD Medically reviewed by Susan Bard, MD Susan Bard, MD, is a board-certified general and procedural dermatologist with the American Board of Dermatology and a Fellow of the American College of Mohs Surgery. learn more Fact checked by Richard Scherr Fact checked by Richard Scherr Rich Scherr is an updates strategist and fact checker for Dotdash Meredith brands, including Health and Verywell. He is a seasoned financial and technology journalist who served as editor-in-chief of the Potomac Tech Wire for nearly two decades, and is a regular contributor to the sports pages of The Baltimore Sun. He has also been a news editor for America Online and has contributed to the Associated Press and The Washington Post. health's fact checking process Share Tweet Pin Email In This Article Expand Jump to a Section Our top picks Reviews How We Selected What to Know About Best Lice Treatments Your Questions, Answered Who We Are We independently evaluate all recommended products and services. If you click on links we provide, we may receive compensation. Learn more. Amazon We all remember the dreaded head lice checks in grade school. And now, even as adults, we can be sure no one likes thinking about lice, and that’s why we may feel unprepared when someone in our household needs lice treatment. But with some estimated 6 to 12 million kids between 3 and 11 years old in the United States getting lice infestations each year, the day may come when we’re forced to face this little blood-sucking, wingless insects. Knowing the best way of handling this creepy-crawly situation can help ease the pain and discomfort that comes with lice for the whole family. But getting the right treatment is important not only for stopping the itch, but helping children and teens return to school and regain their confidence as quickly as possible. Lauren Penzi, MD, a board-certified dermatologist specializing in cosmetic and medical dermatology in Long Island, says treatment resistance to lice is increasing, meaning finding the best lice treatment is perhaps now more important than ever. Fortunately, you can find effective over-the-counter (OTC) lice treatments and prescriptions available. Average prices vary between $3 for home remedies and over $100 for expert-recommended prescription lice treatment. Our Top Picks Best Overall: Malathion Ovide Lotion at Amazon Jump to Review Best Comb: Nit Free Terminator Lice Comb at Amazon Jump to Review Best Spray: Tec Labs Head Lice Spray at Amazon Jump to Review Best Shampoo: RID Lice Killing Shampoo at Amazon Jump to Review Best Mousse: Fairy Tales Lice Good-Bye Mousse at Amazon Jump to Review Best All-Natural: Pompeian Extra Virgin Olive Oil at Amazon Jump to Review Best for Kids: Ladibugs One and Done Lice Treatment Kit at Amazon Jump to Review Best for Sensitive Skin: Cetaphil Gentle Skin Cleanser at Amazon Jump to Review Best for Prevention: Lice Shield Shampoo & Conditioner at Amazon Jump to Review Best Overall Malathion Ovide Lotion Amazon View On Amazon Why We Like It: This prescription-strength lotion is highly effective for lice treatment. It’s Worth Noting: While it may be prescribed for children as young as 6, the safety and effectiveness of malathion in children under that age has not been determined in controlled clinical trials. 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. This means it’s best not to shampoo or condition before applying the medication. Malathion should be left on the scalp and hair (uncovered) for 8-12 hours or by your healthcare provider’s recommendation. The CDC recommends avoiding washing your hair for 1-2 days after treatment and, if some lice remain, repeating treatment 5-7 days after the first treatment to kill remaining live lice or eggs. Price at time of publication: $180 Product Details: Key ingredient(s): Malathion Size/unit count: 1 bottle; 2 fl. oz. Best Comb Nit Free Terminator Lice Comb 4.6 Amazon View On Amazon View On Walmart View On Home Depot Why We Like It: This comb is made specifically for lifting lice eggs from the scalp for easier removal; its easy-grip handle means even shaky or nervous hands stay in control while removing lice and nits. It’s Worth Noting: No matter how well-designed this fine-tooth comb is, you’ll still likely need a magnifying glass to actually see the nits. The Nit Free Terminator Lice Comb has grooved-teeth designed specifically for targeting, lifting, and removing eggs and adult lice. The teeth ends are softly rounded, making for a gentle experience free of skin pricking, scraping, scratching, or hair pulling. Lice tends to stay close to the skin for warmth, so check within an inch or two of the scalp while combing out lice, says Brendan Camp, MD, FAAD, a double board-certified dermatologist at MDCS Dermatology in Manhattan. “Separate the hairs with your hands, a long wooden cotton tipped applicator, or chopsticks,” he suggests. Then, start combing out lice and nits in small sections of hair. The Nit Free Terminator Lice Comb’s stainless steel material is durable, rust-resistant, and also easy to sterilize so you can reuse the comb many times, if necessary. Price at time of publication: $14 Product Details: Key ingredient(s): Stainless steel material Size/unit count: One comb Best Spray Tec Labs Head Lice Spray Amazon View On Amazon View On Walmart View On CVS Why We Like It: This spray can be used for head lice treatment and be used to kill lice and their eggs on bedding and furniture. It’s Worth Noting: It does contain fragrance, which may be irritating to some with scent-sensitivities. The Licefreee Spray Head Lice Treatment spray uses a mineral-based formula with the addition of inactive ingredients such as benzyl alcohol to kill lice and their eggs. It’s best used on dry hair. While this product can be used for killing lice on surfaces, the CDC suggests this isn’t really a necessary step in lice treatment for your household. Therefore, you can save the spray scalp and hair lice treatments. “Head lice do not survive long if they fall off a person and cannot feed. You don’t need to spend a lot of time or money on house cleaning activities,” states the CDC. The spray method is also appealing because it kills lice and nits without the need for someone wearing gloves to apply a lotion or gel-type treatment to the scalp and hair. Price at time of publication: $15 Product Details: Key ingredient(s): Sodium chlorideSize/unit count: 6 fl. oz. The 15 Best Dandruff Shampoos of 2023 Best Shampoo RID Lice Killing Shampoo 4.9 Amazon View On Amazon View On Walmart View On CVS Why We Like It: It’s formulated to smell like everyday shampoo. It’s Worth Noting: You may not be able to find RID shampoo only and instead may need to use the RID shampoo and conditioner 2-in-1 formula or a RID Lice Treatment Complete Kit that comes with the shampoo. RID Lice Killing Shampoo is a type of OTC pediculicide, which works by repelling lice in a few ways. The gel formula helps to reduce the static charge in hair that attracts lice in the first place. It also prevents lice from attaching to the hair and laying eggs. All of this helps reduce live lice count and risk of lice reinfestation. The main active ingredient in RID Lice Killing Shampoo is pyrethrin, the natural insecticide found in chrysanthemum flowers. While highly effective, it’s still normal to require more than one application. This is becoming increasingly obvious as lice have become more resistant to this type of insecticide. Treatment applications should be a week apart depending on the medication, says Dr. Camp. This will help to treat lice that have emerged from eggs that may have been leftover from the first application and removal session. Price at time of publication: $21 Product Details: Key ingredient(s): Pyrethrin Size/unit count: 10 fl oz The 16 Best Anti-Itch Creams of 2023 Best Mousse Fairy Tales Lice Good-Bye Mousse Amazon View On Amazon View On Walmart Why We Like It: It’s a naturally derived formula safe for repeat use in children and adults. It’s Worth Noting: This product is also not suitable for people with an allergy to gluten. Fairy Tales Lice Good-Bye No-Drip Mousse is a clinically proven lice treatment that helps with lice removal and dissolving any residue leftover on the hair or scalp from nits. You’ll use it like a lotion or gel formula. The naturally derived formula is made from specific types of yeast and alcohol. Since lice are becoming more resistant to chemical pesticides, this non-toxic formula may be more effective against current lice outbreaks and future lice reinfestation (i.e., super lice). The Fairy Tales line of lice treatment products also uses essential oils. Several essential oils have also been reported as effective as lice therapy, says Dr. Penzi. These essential oils have been incorporated into OTC lice treatments like the Fairy Tales Lice Good-Bye No-Drip Mousse. Price at time of publication: $23 Product Details: Key ingredient(s): Brewer’s yeast, alcohol ethoxylate, essential oils Size/unit count: 4 fl. oz. Best All-Natural Pompeian Smooth Extra Virgin Olive Oil Amazon View On Amazon View On Walmart Why We Like It: It’s a common household pantry item, and if you don’t have olive oil, you can substitute for other plant-based oils. It’s Worth Noting: This can become greasy and messy quite quickly. Olive oil or coconut oil are an effective, albeit messy, way to smother lice and suffocate them, says Dr. Camp. “This treatment method usually requires more than one application and the use of a nit comb to remove dead lice and nits,” he adds. While lice supposedly suffocate and die when olive oil plugs their breathing holes, you need to apply it for six to eight hours under a shower cap because lice can survive without breathing for hours. You'll also have to comb to remove nits, but the olive oil should help loosen them from the hair shafts. Dr. Penzi seconds the choice of olive oil as a best all-natural lice treatment. She says the oil works by helping to slow the lice movements, enabling them to be more easily combed from the scalp and hair. Price at time of publication: $6 Product Details: Key ingredient(s): Olive oilSize/unit count: 16 fl. oz. Best for Kids Ladibugs One and Done Lice Treatment Kit Amazon View On Amazon Why We Like It: It’s a “one and done” lice treatment kit, meaning you don’t need to buy one product only to realize you need more supplies now or later. It’s Worth Noting: The key ingredient, menthol, in the mint serum may have a cooling effect on the scalp, which may not appeal to every child. Ladibugs One and Done Lice Treatment Kit have a touch of everything. It includes a double-working serum with lice-repelling menthol and lice-killing dimethicone. It also comes complete with a mousse that is naturally derived and a nit comb for removal of lice and eggs. Together, the two family-friendly lice treatment products work to lubricate the scalp. Dr. Camp explains that lubricating the hair works by suffocating the lice. Price at time of publication: $38 Product Details: Key ingredient(s): Menthol and Dimethicone Size/unit count: 1 kit containing mint serum, mousse, and a nit comb Best for Sensitive Skin Cetaphil Gentle Skin Cleanser 8 Fl Oz 4.9 Walmart View On Amazon View On Walmart View On Ulta Why We Like It: It’s scent-free so it won’t irritate even the most sensitive skin. It’s Worth Noting: This is not a medicated formula for treating lice, meaning it doesn’t actively kill lice and their eggs. Cetaphil Gentle Skin Cleanser is formulated to be extra gentle, making it an expert-recommended method of treating lice for people with sensitive skin. It can be applied to the scalp and allowed to dry so that the hair becomes brittle, which suffocates lice, says Dr. Camp. After about 10 hours, you rinse the product out and proceed to comb the lice and nits out. Cetaphil Cleanser often requires more than one treatment, adds Dr. Camp. Price at time of publication: $14 Product Details: Key ingredient(s): Cetearayl alcoholSize/unit count: 20 fl. oz. Best for Prevention Lice Shield Shampoo & Conditioner Amazon View On Amazon View On Walmart View On CVS Why We Like It: It includes a detangler for easier after-washing brushing or combing. It’s Worth Noting: This is a preventative method, not a treatment method. Lice Shield Shampoo and Conditioner contains botanical plant oils such as rosemary to help naturally deter lice. It also contains additional essential oils that have been shown to repel lice. A comparison study between the effectiveness of essential oils and synthetic chemicals commonly used to treat lice found that the essential oils did help in lice treatment, mostly due to their slippery nature rather than repelling lice properties. This Lice Shield Shampoo and Condition can be helpful to integrate into your child’s skincare routine during the school year or used, along with close inspection, when others in the family catch lice, says Dr. Camp. Price at time of publication: $14 Product Details: Key ingredient(s): Citronella, rosemary, lemongrass, cedar, and geraniolSize/unit count: 10 fl. oz. The 9 Best Scalp Massagers of 2023, Tested and Reviewed How We Selected To determine the best lice treatments and tools, we consulted several board-certified dermatologists to see their recommendations. We prioritized FDA-approved prescription lice treatments that come highly recommended by dermatologists, along with everyday items you may already have at home. Average prices range from $3 to over $100, largely depending on the ingredients. In reviewing the best lice treatments, we considered the key ingredients that either kill lice and their eggs or make removal from scalp and hair easier and the size of the product. We also noted precautions that should be taken into account before choosing the best lice treatment, such as potential common side effects and how long the product should be left on the scalp and hair. We offer a range of options so you can find something to stop the infestation and bring back peace of mind to the whole household, no matter your budget or age. What to Know About Best Lice Treatments How to Use Lice Treatments Lice treatments will come with instructions. Always read and follow all directions because some formulas may require a longer stay-on time than others. For example, some formulas are fast-acting while others take hours. In many cases, someone wearing gloves will apply the manual or chemical treatment to the scalp and hair. Then, depending on treatment type, you may need to rinse and start combing, just rinse, or just comb. Methods of Lice Treatments The best lice treatment method is prevention. You can reduce risk of infestation in the first place if you avoid close contact with others that have lice, do not share clothing, combs, or towels, and do not share the same bed, pillows, or stuffed animals, says Dr. Camp. “Make sure to wash clothing and linens used by someone with lice using hot water and heat. Vacuum heavy-trafficked areas and furniture,” he adds. Manual vs. Chemical Different methods for treating lice include manual or chemical methods. Manual methods include combing lice and nits from scalp and hair. Manual methods can also include home remedies that do not contain chemical insecticides that kill lice. Chemical methods include OTC and prescription options that contain insecticides. In some cases, chemical treatments come with a nit comb and combing after chemical treatment is recommended for the best treatment. Active Ingredients to Look for and to Avoid When looking for best lice treatments, experts say prescription and OTC options with pyrethrin are still the mainstay of therapy. Nix and Rid are two highly-recommended and common OTC lice treatments, says Dr. Camp. You will want to avoid any ingredients to which someone in the household is allergic. You may consider speaking with your pediatrician, dermatologist, or healthcare provider about best options for you or a family member if there are other health considerations to be mindful of, too. For example, some chemical formulas may contain ingredients that negatively interact with certain medications. This information is listed in the contraindications, warnings and precautions, or important information section of company websites and instruction inserts. Your Questions, Answered What ingredients are in lice treatments? Over-the-counter lice treatments typically contain insecticides or pediculicides known as pyrethrin or permethrin (synthetic pyrethroid). The insecticides are derived from the natural extract of Chrysanthemum cinerariaefolium (chrysanthemum) flower heads. These insecticides are FDA-approved for treating lice. These ingredients can be found in lice treatment lotions, shampoos, foam mousse, and cream rinses. Other ingredients for treating lice, according to Dr. Penzi, may include: Malathion, a topical insecticide that has a recommended treatment time of 8 to 12 hoursIvermectin, a topical lice treatment FDA-approved in 2012 for people 6 months and older. Dr. Penzi notes that there is also an oral application for treatment-resistant lice infection, but it is not recommended during pregnancy or in children under 33 pounds or 15k g. Benzyl alcohol lotion works by asphyxiation or preventing the lice respiratory system from workingDimethicone, is a silicone oil that blocks lice’s ability to excrete water (i.e., they can’t regulate fluid levels) Spinosad lotion is FDA-approved for lice treatment in children 4 years and older. This natural insecticide made from soil bacteria works by inducing muscle spasms and paralysis in lice.Lindane is an industrial-strength insecticide found in lice treatment shampoos. It’s also a neurotoxin, though, and as such, is reserved for treatment-resistant cases of lice (i.e., for people who have not responded to typical OTC treatments found in this article). Does lice treatment kill eggs? Not all lice treatments work the same way. Dr. Penzi explains certain treatments are ovicidal, meaning they eliminate nits, or lice eggs. Other lice treatments may work to kill both eggs and live lice, she says. For example, malathion is pediculicidal—meaning it kills live lice—and partially ovicidal—meaning it kills some eggs. “Pyrethrin, permethrin, and benzyl alcohol, for example, are only pediculicidal, but not ovicidal,” adds Dr. Penzi. And while some ingredients are effective in treating live lice and eggs in a single treatment, Dr. Camp warns that others may require a second treatment days later to treat lice that hatch later. How long does it take for a lice treatment to work? Lice treatments should take effect within a day, says experts. You can give it 24 to 48 hours before determining whether or not the lice treatment worked, says Dr. Penzi. Experts advise that people do a second treatment one week later, though, in order to kill any nits that may have survived the first treatment application. The second application also helps defend against growing resistance to many pediculicides and reduce risk of reinfestation, according to Dr. Penzi. Can home remedies get rid of lice? Home remedies can help with slowing down adult lice movement, which can make capturing the lice with the nit comb easier. However, home remedies don’t kill lice, says Dr. Penzi. Well, at least not in the way we may initially think. Dr. Camp explains home remedies can be used to treat lice, though they may have lower efficacy than OTC or prescription products or require multiple treatments. “Combing through wet hair to remove live lice and nits every couple of days, applying occluding products that suffocate lice such as mayonnaise, coconut oil, or petroleum jelly is another approach to treating lice at home,” says Dr. Camp. Who We Are Michelle Pugle is a medical and health writer and news reporter featured in Healthline, Verywell Health, and Everyday Health. She is the author of Ana, Mia & Me: An Eating Disorder Recovery Memoir and Space to Grow, Poems. Was this page helpful? Thanks for your feedback! Tell us why! Other Submit Sources Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. CDC. Head lice: Epidemiology & risk factors. CDC. Head lice: Treatment. Devore CD, Schutze GE; AAP, Council on School Health, Committee on Infectious Dises. Head lice. Pediatrics. 2015;135(5):e1355–e1365. doi:10.1542/peds.2015-2696 Greive KA, Barnes TM. The efficacy of Australian essential oils for the treatment of head lice infestation in children: A randomised controlled trial. Australas J Dermatol. 2018;59(2):e99-e105. doi:10.1111/ajd.12626 Haghighizadeh A, Mortezanejad SAF, Dadpour S, Rajabi O. Evaluation of anti-lice topical lotion of ozonated olive oil and comparison of its effect with permethrin shampoo. Rev Recent Clin Trials. 2022;17(1):58-67. doi:10.2174/1574887116666211202122132 Jahangiri F. Case report: a new method for treatment of permethrin - resistant head lice. Clin Case Rep. 2017;5(5):601-604. doi:10.1002/ccr3.899