20 Best Lice Treatments, According to Experts

Natural remedies, prescription medications, OTC treatments—they're all here.

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Six to 12 million kids in the U.S. get head lice each year, according to the Centers for Disease Control and Prevention (CDC), and just as many tears are shed by kids—and adults—trying to get rid of those tiny parasitic insects.

But before you dive into all the different remedies to get rid of lice, it's important to know what they actually are first. Head lice (and, actually, body and pubic lice) have three forms: Nits, which are lice eggs; nymphs, which are immature lice; and adult lice, which are fully-grown and about the size of a sesame seed, per the CDC. And to fully treat a lice infestation, you have to go after all three forms. Most of the time, that results is a topical over-the-counter (OTC) or prescription medication applied twice: Once to kill any adult lice, and the next, a few days later to kill any nits that have since hatched, per the CDC.

But sometimes, a standard medication doesn't work or parents may prefer to try home remedies first. Here, a variety of treatments—prescription, OTC, and natural remedies—used to help stop lice in their tracks.

01 of 20

First Things First: Chill Out

Honestly, just take a deep breath and don't freak out if 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 health or known to carry or spread disease, per the CDC.

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.

02 of 20

Buy a Fine-Toothed Comb

Fine-toothed combs are the gold standard for head lice removal, per the CDC, and you'll need to do this in conjunction with almost all other treatments. First you 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.

03 of 20

Use an Over-the-Counter Product with Pyrethrins or Pyrethrum

Pyrethrum, the active ingredient in Rid shampoo ($13; amazon.com) and similar over-the-counter products (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 because some lice may have become resistant to the toxin, according to a 2015 clinical report published in the journal Pediatrics.

Apply product to dry hair, wait 10 minutes, add water to form a lather and rinse. Comb for nits. A second application is recommended 7 to 10 days later to kill any live bugs that remain. Watch for allergic reactions.

04 of 20

Try Some Olive Oil

This kitchen staple is thought to be a decent smothering agent. Lice supposedly suffocate and die when the ooze plugs their breathing holes, but it needs to be applied for six to eight hours under a shower cap because lice can survive without breathing for hours, according to lice removal information from the Gibson County Health Department in Indiana. However, the National Pediculosis Association warns against putting a shower cap on a child at night. You'll also have to comb to remove nits, but the olive oil should help loosen them from the hair shafts.

Joan Sawyer, co-author of the book Head Lice to Dead Lice, promotes a "5-Step Battle Plan" that involves applying olive oil on specific days over the course of a 21-day period.

05 of 20

Opt for an Over-the-Counter Product With Permethrin

Permethrin, the active ingredient in over-the-counter products like Nix ($15; amazon.com) is a synthetic version of pyrethrins. Permethrin works in much the same way as pyrethrins to attack live lice, although there are reports of lice becoming resistant to this medicine published in 2017 in Clinical Case Reports. Allergic reactions are possible.

On damp, shampooed (but not conditioned) hair, saturate 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.

06 of 20

Blast Your Hair With a Blow Dryer

In a 2006 study published in the journal Pediatrics, hot-air methods proved highly effective in killing nits, but less so in eradicating live lice. An old-fashioned bonnet dryer killed nearly 89% of nits but just 10% of lice, while a blow dryer using direct heat got rid of nearly 98% of nits and 55% of lice. So use a hair dryer on freshly washed hair to increase your chance of eradicating the little buggers. But never use hot air after applying a chemical lice treatment. Some may contain flammable ingredients.

07 of 20

See Your Healthcare Provider for a Spinosad Prescription

This prescription lotion (brand name Natroba) contains spinosad, a natural insecticide derived from bacteria found in soil. It was approved by the Food and Drug Administration (FDA) in January 2011 for patients 4 years of age and older. In two clinical trials, 84.6% and 86.7% of patients were lice-free 14 days after treatment, versus 44.9% and 42.9% with 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 common side effects are eye and skin irritation.

08 of 20

Get a Prescription for Ivermectin From Your Healthcare Provider

Approved by the FDA in February 2012, ivermectin lotion 0.5% (brand name Sklice) comes from bacteria found in soil. It paralyzes and kills lice and their eggs and can be used with kids over 6 months of age. 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% experienced side effects, such as eye and skin irritation.

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

09 of 20

Try Some Petroleum Jelly

There's not a lot of research that proves that petroleum jelly (Vaseline) kills head lice, although like olive oil, many people swear by it. The goo supposedly suffocates the bugs by clogging their breathing holes.

A 2004 study published in the Journal of Pediatric Nursing suggested petroleum jelly worked better than other home remedies. However, the National Pediculosis Association cautions that Vaseline may not work and is difficult to remove.

Here's one approach: Coat the hair and scalp, cover it overnight or all day with a shower cap, and then wash it out (shower caps not recommended overnight for children). Comb for nits. Repeat the treatment one week later.

10 of 20

Try a Prescription With Benzyl Alcohol Lotion

This prescription lotion (brand name Ulesfia) approved by the FDA in 2009. It works by stunning a louse's breathing apparatus, causing asphyxiation (it doesn't kill nits).

At least two applications are needed. In two clinical trials, per the FDA, 75% and 76.2% of participants were lice-free 14 days after the second treatment. Ulesfia can be prescribed for patients 6 months of age and older. It can cause eye and skin irritation.

Saturate dry hair and scalp with the lotion, wait 10 minutes and rinse out in a sink. It's okay to shampoo afterward, and using a nit comb will help remove nits and dead lice.

11 of 20

Do the Laundry on Hot

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

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

12 of 20

Give the "Shrinkwrap" Method a Try

Despite its name, this technique doesn't involve plastic wrap of any kind. What it does involve is the application of a non-toxic product to dry hair (Cetaphil-brand gentle skin cleanser), combing out as much as possible, and blowing the hair dry. This is repeated 3 times at one-week intervals.

A 2004 study in Pediatrics described the lice-killing protocol and some healthcare providers recommend it.

In two trials, an average of 96% of patients were cured at the end of treatment, and 94% were lice-free at a 6-month follow-up.

For how-to instructions, visit Nuvo for Head Lice.

13 of 20

Pair Another Home Remedy With Dishwashing Liquid

Dish soap doesn't kill lice. But it does help remove the bug-suffocating glop—salad oil or Vaseline—that parents slather into kids' hair.

Dawn dishwashing liquid is said to be good for cutting through the greasy mess left behind. Some dish soaps supposedly help break down the glue-like substance attaching nits to the hair shaft.

14 of 20

Soak Combs and Brushes

To ensure you aren't transferring lice back onto your hair each time you brush it, soak all combs and brushes in hot water for five to 10 minutes, according to the CDC.

Another option: Soak combs and brushes for one hour in a solution that contains some anti-lice shampoo, per Seattle Children's Hospital.

Also do a visual inspection of all hair tools before using them again.

15 of 20

Give Your House a Deep Clean

The good news is thaat head lice can only live a day or two off the scalp, and they can't hop or fly. Plus, their eggs cannot typically hatch off the scalp since they need ideal heat and humidity similar to the scalp, per the CDC. So you don't need to sterilize the entire house.

Vacuum floors, pillows, upholstered furniture and car seats. Stow non-washables—a treasured stuffed animal, for example—in a sealed bag for 2 weeks, per the CDC.

16 of 20

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 per the CDC. And don't make it easy for them to crawl from one head to the next. Keep long hair in a tight ponytail or braid. Other tips: Don't share combs, brushes, towels, hats, scarves or coats. Although, spread from shared clothing or personal items is uncommon, per the CDC.

17 of 20

Try This Vacuum-Like Device

This device looks like a vacuum cleaner with a brush-like nozzle. It blasts heated air toward the hair roots and scalp to dry out lice and their eggs. In a 2014 study published in the Journal of Medical Entomology, the LouseBuster killed 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.

18 of 20

Try a Prescription With Malathion Lotion

This prescription insecticide (brand name Ovide) kills live lice and some eggs. But it's flammable and can cause stinging and second-degree burns. Safety and effectiveness has not been established in children younger than 6, according to the CDC.

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

19 of 20

Only Use Lindane-Containing Shampoos as a Last Resort

This neurotoxin kills lice and their eggs. But it's a suspected human carcinogen. Overuse or misuse of Lindane (brand names Kwell and Thionex) can causes serious side effects, including seizures and death. And even when used as directed, it can cause seizures and death in some people, according to the FDA.

It's no longer recommended by the American Academy of Pediatrics to kill lice, and is not recommended for children, the elderly, or anyone who weighs less than 110 pounds. It is only prescribed to people who have failed or cannot tolerate other treatments, per the FDA. Use only as directed by your healthcare provider.

20 of 20

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 has sprouted a whole industry of people who specialize in removing head lice. The National Association of Lice Treatment Professionals was launched in 2012 to bring some standards to the industry (and in response to complaints from consumers about some of these businesses.) It's probably best to ask friends, neighbors, or the school nurse for recommendations for a reliable service.

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