How to Get Rid of Lice: Treatment Options That Work

Head lice are tiny insects that live on the scalp and feed on blood. While they do not spread disease, they cause itching and are easily passed between people. The good news is that lice are treatable with over-the-counter products and proper combing techniques.

How Can You Check for Lice on Yourself?

Before treating lice, confirm you have them. Use two mirrors so you can see your scalp. Wet your hair, apply conditioner, and use a fine-tooth lice comb. Work through small sections, wiping the comb on a white paper towel after each pass.

Focus behind your ears and at the nape of your neck. Look for tan or grayish bugs about the size of a sesame seed, and oval-shaped eggs attached firmly to hair shafts near the scalp.

Over-the-Counter Treatments

Permethrin 1% (Nix) is the most common treatment. Apply to clean, towel-dried hair and leave on for 10 minutes before rinsing. It kills live lice and keeps working for several days. A second treatment 9 to 10 days later kills newly hatched lice.

Pyrethrin products (Rid, Pronto) are made from chrysanthemum flowers. They kill live lice but not eggs, so a second treatment is required. Avoid pyrethrin if you are allergic to chrysanthemums or ragweed. Both treatments are safe for children 2 months and older.

Prescription Treatments

If over-the-counter products fail, see a doctor. Prescription options include ivermectin lotion (Sklice) and spinosad (Natroba). Spinosad kills both lice and eggs, so retreatment is usually not needed. These are approved for children 6 months and older.

Combing Out Lice and Nits

Combing is key. Use a metal fine-tooth lice comb on wet hair. Work in small sections under bright light. Dip the comb in soapy water after each pass. Repeat every 2 to 3 days for 2 weeks to remove lice that hatch after treatment.

Cleaning Your Home

Lice die within 1 to 2 days without a human host. Wash bedding, clothes, and towels used in the past 2 days in hot water and dry on high heat. Items that cannot be washed can be sealed in a plastic bag for 2 weeks. Vacuum furniture and floors, but do not use fumigant sprays.

When to See a Doctor

See a doctor if over-the-counter treatment fails after two tries, if you develop sores from scratching, or if treating a child under 2 months old. A doctor can prescribe stronger treatments and check for skin infections.