20 Best Lice Treatments, According to Experts

First Things First: Chill Out

Honestly, just take a deep breath and don't freak out if you or your child has head lice. Sure, they're gross (just talking about them can make your head itch), but they're not actually harmful to your health or known to carry or spread disease.

It's best to steel yourself for weeks or months of vigilance since lice can reappear due to repeated exposure or a missed nit. What doesn't help is panic.

Buy a Fine-Toothed Comb

Fine-toothed combs are the gold standard for head lice removal. And you'll need to use them in conjunction with almost all other treatments.

First, comb hair section-by-section with a special comb, like the Nit Free Terminator Comb ($11; amazon.com), to remove lice and nits. After a comb-through, you may also want to use a magnification light to find and pick out any strays.

Use an OTC Product With Pyrethrins or Pyrethrum

Pyrethrum, the active ingredient in Rid shampoo ($13; amazon.com) and similar OTC (A-200 and Pronto, for example), comes from chrysanthemum flowers that harbor natural insecticides called pyrethrins.

Pyrethrins attack the nervous systems of live lice but don't always work. That's because research has found that some lice have become resistant to the toxin.

Apply product to dry hair, wait 10 minutes, add water to form a lather, and rinse. Then, comb for nits. A second application is recommended after seven to 10 days to kill any remaining live bugs. Keep an eye out for allergic reactions.

Try Some Olive Oil

The kitchen staple may be a decent smothering agent.

Lice supposedly suffocate and die when olive oil plugs their breathing holes, but 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.

Also, try following a "5-Step Lice Elimination Plan," which involves applying olive oil on specific days over the course of a 21-day period. All in all, this method isn't the most practical and may not be the most efficient way to get rid of lice.

Opt for an OTC Product With Permethrin

Permethrin, the active ingredient in OTC products, like Nix ($15; amazon.com), is a synthetic version of pyrethrins.

Permethrin works in the same way as pyrethrins to attack live lice. Although, there are reports of lice becoming resistant to the medicine. Allergic reactions are possible, too.

On damp, shampooed (but not conditioned) hair, saturate the head with the lotion. Leave for 10 minutes, rinse, and comb out nits. Repeat if live lice appear seven or more days after the initial treatment.

Blast Your Hair With a Blow Dryer

Studies have shown that hot-air methods prove highly effective in killing nits but less so in eradicating live lice. An old-fashioned bonnet dryer kiss nearly 89% of nits but just 10% of lice. On the other hand, a blow dryer using direct heat gets rid of nearly 98% of nits and 55% of lice.

So, try using a hair dryer on freshly washed hair to eradicate those little buggers. However, never use hot air after applying a chemical lice treatment. Some of those treatments may contain flammable ingredients.

See Your Healthcare Provider for a Spinosad Prescription

Natroba (spinosad), a prescription lotion, is a natural insecticide derived from soil bacteria.

The Food and Drug Administration approved the Natroba in January 2011 for patients aged four years and older. In two clinical trials, 84.6% and 86.7% of patients were lice-free 14 days following treatment, compared to 44.9% and 42.9% of patients who used permethrin.

Coat the scalp and work the liquid through dry hair from roots to ends. Leave on for 10 minutes, rinse, and comb for nits. The most common side effects of the Natroba are eye and skin irritation.

Get a Prescription for Ivermectin From Your Healthcare Provider

The Food and Drug Administration approved Sklice (ivermectin), a prescription lotion, in February 2012. Like Natroba, Sklice also derives from soil bacteria. It works by paralyzing and killing lice and their eggs.

You can use Sklice on kids aged older than six months. In clinical trials, roughly three-quarters of patients were lice-free after a single application (without nit combing) two weeks after treatment. Fewer than 1% of patients experienced side effects, such as eye and skin irritation.

Apply the lotion to dry hair and scalp, and rinse after 10 minutes.

Try Some Petroleum Jelly

Not much research proves that petroleum jelly, such as Vaseline, kills head lice. Although, like olive oil, the goo supposedly suffocates the bugs by clogging their breathing holes.

Research has suggested that petroleum jelly works better than other home remedies. Here's one approach: Coat the hair and scalp, cover it overnight or all day with a shower cap, and wash it out. Comb for nits. Repeat the treatment one week later.

However, Vaseline may not work and is difficult to remove.

Try a Prescription With Benzyl Alcohol Lotion

The Food and Drug Administration approved Ulsefia (benzyl alcohol), a prescription lotion, in 2009. It works by stunning a louse's breathing apparatus, causing asphyxiation. But it doesn't kill nits.

You should apply Ulesfia at least twice. In two clinical trials, 75% and 76.2% of participants were lice-free 14 days after the second treatment. You can use Ulesfia on patients aged six months and older. As far as side effects go, it may cause eye and skin irritation.

Saturate dry hair and scalp with the lotion, wait 10 minutes, and rinse out in a sink. Shampooing is okay afterward; a nit comb will help remove nits and dead lice.

Do the Laundry on Hot

To prevent reinfection, clean items that have been in recent contact with infected family members' heads. Wash bedding, caps, scarves, and towels in hot water. Dry on a hot setting.

In addition, you'll also want to wash any clothing worn within two days in hot water.

Give the "Shrinkwrap" Method a Try

Despite its name, the "shrinkwrap" technique does not involve plastic wrap.

Some healthcare providers recommend the lice-killing protocol involves applying a non-toxic product—like Cetaphil Gentle Skin Cleanser ($15; amazon.com)—to dry hair. Then, comb out as much of the product as possible, and blow the hair dry. Repeat three times per week.

Hover, in two trials, an average of 97% and 95% of patients were cured at the end of treatment, and 94% were lice-free after six months. This method may not be the best approach if it takes as long as six months to get rid of head lice.

For in-depth instructions, visit Nuvo for Head Lice.

Pair Another Home Remedy With Dishwashing Liquid

Dish soap, like Dawn, does not kill lice. But it may help remove the bug-suffocating glop—olive oil or Vaseline—that parents slather into their kids' hair by cutting through the greasy mess left behind.

Some dish soaps supposedly also help break down the glue-like substance attaching nits to the hair shaft.

Soak Combs and Brushes

To avoid transferring lice back onto your hair every time you brush it, soak all combs and brushes in hot water for five to 10 minutes.

Another option: Soak combs and brushes for one hour in a solution that contains some anti-lice shampoo.

Also, visually inspect all of your hair tools before using them again.

Give Your House a Deep Clean

The good news is that lice can only live for a day or two off the scalp, and they can't hop or fly. Plus, their eggs typically cannot hatch off the scalp since they need hot and humid conditions similar to that of the scalp. So, you don't need to sterilize the entire house.

But you should vacuum floors, pillows, upholstered furniture, and car seats. Stow non-washables—a treasured stuffed animal, for example—in a sealed bag for two weeks.

Prevent Head-to-Head Contact

Lice are just as happy to invade a squeaky clean head as a dirty one, so frequent washing is no guarantee of preventing an infestation.

The best advice is to avoid head-to-head contact. Don't share combs, brushes, towels, hats, scarves, or coats. Although, spread from shared clothing or personal items is uncommon.

And don't make it easy for them to crawl from one head to the next by keeping long hair in a tight ponytail or braid.

Try This Vacuum-Like Device

The LouseBuster is a device that looks like a vacuum cleaner with a brush-like nozzle. It blasts hot air toward the hair roots and scalp to dry out lice and their eggs. Research has found that the LouseBuster kills 94.8% of nits and live lice.

LouseBuster treatments are only available through certified operators. It's relatively safe and quick. The typical treatment takes only 30 minutes.

Try a Prescription With Malathion Lotion

Ovide (malathion) is a prescription insecticide that kills live lice and some eggs. But it's flammable and can cause stinging and second-degree burns. Safety and effectiveness have not been established in children younger than six.

Apply to dry hair, leave on for eight to 12 hours, and air dry. Never blow dry hair or expose lotion to heat sources. Before combing, wash your hair in a sink, not the shower or tub. Treat again after seven to nine days if live bugs remain.

Only Use Lindane-Containing Shampoos as a Last Resort

Lindane-containing shampoos, like Kwell and Thionex, are neurotoxins that kill lice and their eggs.

However, lindane is a suspected human carcinogen. Overuse or misuse of lindane can cause serious side effects—including seizures and death. And even when used as directed, it can cause seizures and death in some people.

The American Academy of Pediatrics no longer recommends lindane-containing shampoos to kill lice, especially on children, the elderly, or anyone who weighs less than 110 pounds. Only people who failed or cannot tolerate other treatments may try lindane-containing shampoos as a last resort. But only use the products as directed by your healthcare provider.

Hire a De-Lousing Service

Need a nit-picking hand? Hire a de-lousing service to handle the job.

The need for effective, non-toxic treatment options sprouted a whole industry of people who specialize in removing head lice. The National Association of Lice Treatment Professionals launched in 2012 to bring some standards to the industry (and in response to complaints from consumers about some of those businesses.)

It's probably best to ask friends, neighbors, or the school nurse for recommendations for reliable service.