How to Get Rid of Head Lice

Head lice are spread from one person to another by close head-to-head contact, or by sharing certain things that might carry lice, such as hairbrushes or clothing. The first sign of lice is often intense itching. However, head lice rarely survive more than a few days if they fall off a person, because they can’t feed. Nits, or small eggs that will eventually hatch into lice, usually die within a week if they are removed from the scalp area. Getting rid of the head lice on heads and in the environment is the first step to eradicating and preventing the problem.

How to Get Rid of Head Lice

Getting lice off the heads of those who are infected is the first step. Then you must remove it from other places in the home or surrounding environment. This usually takes a good deal of patience and repeated treatments.

1. Treat the Infested People

  • Start by removing clothing that could be stained during treatment.
  • Apply the chosen medication to the scalp, following the directions on the box.
  • Be sure to follow every direction, as cutting corners might allow the lice to remain. When the treatment is finished, use fine-tooth combs to remove any dead lice and nits from the hair.
  • If the lice are still moving around 8-12 hours after treatment, that particular treatment might not be working; in this case, you will need to try something else.
  • After the treatment is deemed to be working, check for lice and nits every 2-3 days, removing nits when you find them. Check for up to three weeks.

2. Take Supplemental Measures

In addition to removing lice and nits from people, you should also remove them from the area around you.

  • Gather the bed linens, clothing and other items that the infested people have touched in the past 2-3 days.
  • Wash them in hot water, and use the high heat dry cycle.
  • If there are items that can’t be washed, tie them in plastic bags for two weeks.
  • Soak combs and brushes in hot water for at least 10 minutes, and carefully vacuum the furniture and floor that the infested people might have used.

3. Tips for Choosing Medications

There are many potential medications to treat head lice. You might need to use more than one of these solutions to get rid of head lice for good.

1. OTC Medications




These are made with naturally-occurring pyrethroid extracts, which are relatively gentle on the scalp. They kill lice but not nits; a second treatment on day nine is recommended to kill new lice before they can lay eggs. It is recommended for use on children aged two years and older.

Available brand: Pronto*, A-200*, R&C*, Triple X*, Rid*

Permethrin Lotion 1%

This lotion is made of synthetic pyrethroid. It works much the same as pyrethrins, but is approved for use on children two months of age or older.

Available brand: Nix*

2. Prescription Medications



Benzyl Alcohol Lotion 5%

This treatment derived from aromatic alcohol can kill lice but not nits, and should be used a second time seven days after the first treatment. It is suitable for those between the ages of 6 months and 60 years. Use carefully, as it can cause skin irritation.

Available brand: Ulesfia lotion*

Ivermectin Lotion 0.5%

A single treatment has been proven effective in killing live lice as well as killing nits when they hatch. It is most effective as a single application on dry hair and without combing for nits. A second use must be authorized by a physician. It can be used from the age of six months.

Available brand: Sklice*

Malathion Lotion 0.5%

This is a more intense lotion recommended for use in those aged six and older. It kills lice and prevents some nits from hatching. It can be irritating to the skin, and the lotion is flammable, so avoid any use of hair dryers or heat-based styling tools while the hair is wet. A second treatment should be given 7-9 days after the first if lice are still moving on the hair.

Available brand: Ovide*

Spinosad 0.9% Topical Suspension

This solution typically kills both lice and eggs, with no need for combing or a second treatment. It is suitable for use after four years of age. If lice are seen after seven days, a second treatment can be given.

Available brand: Natroba*

Lindane Shampoo 1%

This treatment can be considered dangerous to many people, and so should be seen as a last resort. The shampoo can be toxic if inhaled, swallowed or overused, so it should be used only for those who don’t respond to other treatments. Those who have open sores on the scalp, pregnant women, children, elderly, those who weigh less than 110 pounds or those who have some medical conditions should not use this treatment.

Available brand: N/A

How to Prevent Head Lice

Preventing head lice is the best way to avoid any problems. Once head lice have taken hold in the hair, it can be very difficult to stop the spread. Here are a few ways you can prevent head lice from getting a good start:

  • Do not share combs, brushes or towels.
  • Don’t share clothing, especially things like hats, hair ribbons, scarves, coats and the like.
  • Tell children to avoid touching heads with other kids, especially at school, sleepovers and similar activities where several children are together in the same place.
  • If someone has been infested with head lice, avoid sleeping in the same area or sitting in the same spot as they usually use.
  • Always wash linens and clothing that might be infested in very hot water and use the high heat cycle on the dryer.
  • Regularly vacuum the floor to remove any lice that might have fallen from the head.
  • Avoid sprays or fogs; they are not really effective and can be very harmful to the people who live in your house.