How To Get Rid Of Head Lice, KidsHealth NZ

How To Get Rid Of Head Lice

How To Get Rid Of Head Lice

Head lice are small insects that live on the human scalp. They are common and cause concern and frustration for parents, children and young people. Dimethicone lotion is a very effective treatment that your family doctor can prescribe — check out our step by step guide.

Key points to remember about getting rid of head lice in children

Dimethicone lotion is a very effective treatment that your family doctor can prescribe — it’s not an insecticide.

  • head lice are small, flat insects that live and lay eggs on the human scalp — the scalp provides food and warmth for the eggs to hatch
  • head lice are sometimes called nits, kutis, kutu bugs, utu or riha
  • they are a common problem and cause concern and frustration for parents and children
  • anyone can catch head lice — catching them has nothing to do with poor hygiene
  • head lice spread by crawling from the hair of one person to another
  • if you find live head lice or eggs on your child’s scalp, treat your child and check everyone in the house
  • 4 percent (4%) dimethicone lotion is a very effective treatment that your family doctor can prescribe
  • wet combing with cheap conditioner and a fine-tooth head lice (nit) comb is also an effective way to find and remove head lice, if done properly
  • if you choose to use another chemical or herbal treatment, speak to your pharmacist, doctor or nurse for advice about what treatment to use and how to use it
  • never use fly spray, kerosene or treatments intended for animals — these may harm children and adults

Check out a couple of resources for printing at the bottom of the page.

What are head lice?

Head lice are small insects found on the human head. They grow to about the size of a pin head, sesame seed or grain of sand.

Head lice live on the hair and feed by sucking blood from the scalp. They are pale grey (before feeding) and reddish brown (after feeding). Head lice do not carry or pass on disease.

Who can get head lice?

Anyone can get head lice. They are a common problem and cause concern and frustration for parents and children.

Catching head lice has nothing to do with poor hygiene.

How do people get head lice?

People get head lice from head to head (hair to hair) contact with someone who already has head lice. This can easily happen when children play or sleep together and their heads touch.

Head lice can only crawl from hair to hair. They can’t fly or jump from head to head.

Head lice only survive on humans. They die quickly when they are not on the head, usually within 24 hours.

How do I check for and get rid of head lice?

Head lice can live all over the head but particularly like warm places behind the ears, around the bottom of the hair line, and on top of the head. They can look like grains of sand or dandruff.

Check out the 2 options for treating head lice below. Whichever treatment you use, you need to remove any eggs by hand. That’s because eggs attach firmly to the hair. You can put conditioner or water on the hair before combing. This loosens the eggs from the hair and makes combing easier.

4 percent (4%) dimethicone lotion — to get rid of head lice

4 percent (4%) dimethicone lotion is a very effective head lice treatment that your family doctor can prescribe. You only need to put it on your child’s head twice — with a week in between each use.

Some head lice shampoos from supermarkets and pharmacies are becoming less effective because head lice have developed resistance to them. Dimethicone is not an insecticide. It kills head lice by suffocation and disrupting the ability of the head lice to regulate water. It is unlikely head lice will develop resistance, as they can with other products.

Wet combing with conditioner — to find and get rid of head lice

Wet combing with cheap conditioner and a fine-tooth head lice (nit) comb is also an effective way to find and remove head lice, if done properly. You don’t need to buy ­expensive products to get rid of head lice. You can buy a fine-tooth head lice comb from your pharmacy. It can take up to an hour to do a wet combing session. It depends how long and how thick your child’s hair is.

What about checking and treating other family members for head lice?

If you find head lice, you should check the rest of your family. If you find head lice on other family members, treat them all on the same day.

If your family has head lice, tell anyone who has had head-to-head contact with them, so that they can check and treat their family if needed.

Tell your school so that they can tell other parents to check their children for head lice and treat if necessary.

Can you prevent head lice?

It’s very difficult to prevent — there is no product available that prevents head lice.

See also:  Sklice Reviews - Ratings at

Tying long hair back and checking weekly for lice, using the conditioner and comb method, can help prevent the spread.

Once you think your child is free of head lice and eggs, make sure to check them once a week.

You don’t need to wash clothing and bedding on a hot wash — it’s unlikely to help prevent the spread of head lice.

How to Treat Head Lice

‘Tis the season for pesky head lice. Check out this round-up of the best lice treatment options, from over-the-counter medications to louse and nit combing.

During back-to-school season, your child might bring home an unwanted visitor: head lice. According to the Centers for Disease Control and Prevention (CDC), anywhere from 6 million to 12 million children aged 3-11 are infested by head lice each year. The tiny insects attach to human hair and feed on the host’s blood, usually causing intense itching. But since lice move fast and avoid light, the tip-off to their presence is often their eggs (called nits), which are small gray or light-brown specks that seem glued to the hair shaft.

  • RELATED:Head Lice Prevention: Everything Parents Should Know

Lice prefer children to adults and long hair to short hair, says Alan Greene, MD, FAAP. They spread from person to person when kids’ heads touch during playtime, but the insects can also be spread by sharing clothing, headphones, hats, combs, towels, or toys. Fortunately, head lice can’t live off the head, and once separated from their human host, they can’t survive for more than two days. Proper treatment is key to warding off infestation and getting rid of the insects for good (although it’s important to note that head lice don’t carry disease).

Wondering how to treat head lice on your kids – or yourself? Check out our round-up of the best lice treatment options.

Best Lice Treatment Options

Louse and Nit Combing

Louse and nit combing is the oldest lice treatment approach. Grab a finetooth nit comb (we recommend the LiceMeister comb). Before using, slow down lice by moistening hair with any thick white conditioner, a dimethicone-based product such as LiceMD PesticideFree, or a mix of conditioner and baking soda (for extra grip, especially if your child has fine hair). Separate the hair into small sections and run the comb through it at a 45-degree angle (don’t forget the scalp!) Comb the entire head every day for two weeks, wiping off the nits and lice frequently. The process can take more than an hour and works only if you get every louse and viable egg. For complete instructions, check out our article on removing head lice.

Many parents use louse and nit combing in conjunction with another lice treatment option. And don’t worry about contracting lice by simply treating your child. «Lice don’t jump,» says Paradi Mirmirani, M.D., a board-certified dermatologist with the American Academy of American Dermatology (AAD). «You can’t get lice from looking at or touching your child’s hair.»

Over-the-Counter Chemical Lice Treatment

There most common over-the-counter lice treatment products are shampoos containing bug killers, such as Nix (for kids 2 months and up) and RID (2 years and up). They get their power from the chrysanthemum flower, either through its extracts (pyrethrin) or a synthetic version (permethrin). Treatments that have these ingredients are the only OTC products that are FDA-approved to treat head lice.

After applying the shampoo or rinse, you’ll typically need to leave it on the hair for ten minutes. According to Dr. Greene, these shampoos work by temporarily paralyzing the muscles the lice need to breathe, and they ultimately die from lack of oxygen. But be warned that OTC products can’t completely kill the lice eggs, so you’ll need to nit-comb and re-treat nine days later to kill any newly hatched lice.

  • RELATED:Head Lice Symptoms and Signs

Another downside to OTC lice treatment options: the insects are becoming increasingly resistant to them. Dr. Greene says that product may need to be left on for longer than the time recommended on the package – sometimes for 30 minutes or more. Even so, the American Academy of Pediatrics (AAP) recommends this type of treatment as the first line of defense. «It has the longest safety track record, it’s available without a prescription at a fair price, and it will work in the majority of cases if used correctly,» says Barbara Frankowski, M.D., professor of pediatrics at The University of Vermont College of Medicine and coauthor of the AAP’s most recent report on head lice.

Prescription Head Lice Treatment

If over-the-counter treatments don’t work, your child’s lice are probably immune to them. In these cases, your doctor may prescribe prescription-strength solutions, including:

Malathion Lotion: This lotion (brand name: Ovide, for ages 6 and up) is an insecticide commonly used to fight agricultural pests. It’s about 90 percent effective, but is also flammable and needs to be left on a child’s head for eight to 12 hours. It’s supposed to kill lice and eggs in one treatment, though you can re-treat in seven to nine days if needed. It’s available only by prescription and is the only Rx treatment that comes in generic form (which costs less).

Benzyl Alcohol (Ulesfia): Approved for kids 6 months and up, this works by asphyxiating lice; it’s not a chemical pesticide. It also doesn’t kill the eggs, so you need two rounds of the lotion. Combing is also recommended, and irritated skin is a common side effect.

Natroba (Spinosad): Derived from the fermentation of a soil bacterium, Natroba (for ages 4 and up) paralyzes the lice, but is safe because it can’t get into the human nervous system. Its cure rate is about 85 percent. Unlike Ulesfia, Natroba kills the eggs, which means your child probably needs only one treatment. It should also mean no nit-combing, but this med (and others that don’t require nit-picking) only kills the eggs; it doesn’t make them disappear. So if you don’t want your kid to have a head full of dead lice eggs or her school has a no-nit policy, you have to comb them out.

Sklice (Ivermectin): This also works by paralysis and should need only one application, but its cure rate is about 75 percent. It’s for ages 6 months and up.

See also:  The most effective remedy for lice and nits

Lindane (Kwell): This shampoo is FDA-approved to treat head lice. However, this product can be toxic when misused, and it has been linked to nervous system damage, so the American Academy of Pediatrics advises against using it.

Alternative Lice Treatment

Nix and similar products contain a pesticide, so Dr. Greene prefers using an alternative treatment if possible. “At Stanford University School of Medicine (where I work as a clinical faculty), we use regular shampoo mixed with three tablespoons of olive oil, one teaspoon of tea tree oil, and one teaspoon of rosemary or eucalyptus oil,” he says. “We mix it all together, work it into the hair, and leave it on for 30 to 60 minutes under a tight-fitting shower cap. We seem to get good results with this, though unlike Nix, there are no controlled studies to provide statistics on success.” If you treat head lice with this method, keep in mind that eucalyptus oil is very poisonous, so it’s important to be careful when using it on children.

Here are some of the other best lice treatment options involving natural, alternative methods:

Essential Oils: Studies have shown that some essential oils do, indeed, possess anti-lice properties. But, like other natural products, lice treatments based on these scented oils aren’t required to be tested and FDA-approved. Heather Jeney, M.D., an integrative pediatrician in Montclair, New Jersey, has found certain formulas – including Fairy Tales lice treatment products, like their Rosemary Repel line – to be effective. Similarly, Stuart Ditchek, M.D., a pediatrician in Brooklyn, New York, and an author of Healthy Child, Whole Child, stands behind Licenders’ peppermint oil-containing products. Both companies’ products are designed to be applied regularly to repel lice and to eliminate an active infestation, when used in combination with proper nit and lice removal. A word of caution: Never use an undiluted essential oil on your child without consulting her doctor –it can be irritating and potentially toxic.

  • RELATED:Home Remedies for Head Lice

AirAllé: This device, which was formerly called LouseBuster and is cleared by the FDA, uses controlled, heated air to kill lice and eggs in a single treatment. Research results have been impressive: In one study, 95 percent of lice and eggs were killed. A drawback is availability, because the device can be used only by a certified operator (find one at Another consideration is cost: Expect to pay between $150 and $250, depending on where you live, though the fee is commonly reimbursed through flexible-spending accounts.

Lice-Removal Services and Salons: These businesses do the nit-picking for you, usually for a hefty price. Staffers also may use (and sell) their own shampoo and other products. Going this route may work – or it may not. The companies aren’t regulated, so there’s no set standard for training, knowledge, or success.

How To Treat Head Lice in the House

Lice live on a very simple diet: human blood. If they do not have access to blood, they will die – usually within 48 hours, though sometimes they live a bit longer. After treating lice, focus on cleaning all the areas and things your child has come into contact with in the last day or so. Soak all hairbrushes, combs, and recently worn hair clips or bands in hot water for at least two hours or place them in a plastic bag and throw them in the freezer for 2 hours. Wash your child’s bed sheets, blankets, and towels in very hot water, and be sure to throw everything in the dryer on a high-heat setting for at least 30 minutes. If your child sleeps with a stuffed animal, throw it in the dryer for 30 minutes also. For extra protection, experts recommend that you vacuum your child’s room and any carpet, chairs, sofa, or car seats she might have touched. Although fumigating your entire home with an anti-lice pesticide spray may seem tempting, the Centers for Disease Control and Prevention recommends avoiding these sprays because they contain harsh chemicals that can be dangerous, especially for anyone with respiratory conditions.

Returning to School After Lice

If he’s treated properly, your child should be able to return to school the very next day. To be certain, reexamine his hair thoroughly to ensure that all lice and their eggs have been removed. Keep in mind that many schools adhere to a no-nit policy, which means that every single nit must be removed before a child will be readmitted. If your school enforces this policy, your child may need to be examined by the school nurse before he heads back to class. Since even a truly thorough search can miss a few nits or bugs, experts suggest continuing to check your child’s head for three weeks after treating.

Lice Treatment Do’s and Don’ts

DO rinse chemical treatments in the sink (rather than the tub) to minimize skin exposure; nit-comb over a disposable drop cloth.

DO pay special attention to the nape of your child’s neck and behind the ears – a louse’s favorite places to hang out.

DO use only one product. Using a combination of two products to treat head lice can be dangerous, unless your dermatologist or doctor says otherwise.

DON’T think continued itching means that a treatment has failed. A kid can keep itching for days after lice are gone.

DON’T wash your child’s hair obsessively during an outbreak. Head lice aren’t a sign of poor hygiene.

DON’T use any household insecticides, such as those for roaches or ants. They are not intended for human use and shouldn’t be applied to hair or skin.

  • By Renée Sagiv Riebling, Jennifer Wilson, and Chelle E. Cohen

Smart Ways to Prevent Kids From Getting Head Lice

Head Lice Basics

Jonathan Jassey, DO, is a board-certified private pediatrician at Bellmore Merrick Medical in Bellmore, New York.

Head lice are everywhere. If you have kids and they are around other kids, they are at risk of getting head lice. They are in every community and school district, from the richest to the poorest.

Although the focus of parents and pediatricians is usually on treating head lice infestations, with more lice being resistant or hard to treat, it is probably even more important to teach your kids to avoid head lice. Since head lice can’t jump from child to child or crawl into your home, preventing head lice infestations isn’t as hard as it may sound.

See also:  Removing Nits Completely So You Stay Free Of Head Lice

Tips to Prevent Head Lice

Use these practical tips to prevent your child from getting lice.

  1. Encourage your kids to avoid sharing things that have been on or near another child’s head, including hairbrushes, combs, hats, scarves, towels, helmets, pillows, sleeping bags, etc.
  2. Teach your kids to hang up their coats and hats on an individual hook, or some other separate area when they get to school, instead of just throwing them in a pile with other classmates’ clothing.
  3. Regularly clean things that your child’s head has direct contact with that they share with other children. Examples are car seats, pillows, and headphones.
  4. Review head lice pictures to help you understand what you are looking for in your child’s hair, including live lice and nits (lice eggs).
  5. Check your child for nits and live head lice at least once a week. Although you may find head lice anywhere, they are often found at the back of your child’s head, near his neck, and behind his ears. Wash your child’s hair with a regular shampoo and hair conditioner. It’s easier to comb through your child’s hair if you use hair conditioner. Check your child’s hair while it is still damp.
  6. Recognize the symptoms of head lice, which include an itchy scalp and small red bumps or sores on the back of your child’s neck and scalp. Don’t panic, though, if your child must be treated for head lice.  
  7. Review all of these head lice prevention steps before and after sleepovers, school field trips, or when your child goes camping.
  8. You won’t prevent head lice by keeping your child’s hair short or in a ponytail. Nor will special shampoos, conditioners, or hairspray help. You should avoid using potentially toxic products if your child doesn’t have an active infestation.

Be extra vigilant for head lice if there have been frequent reports of head lice at your child’s school or in your child’s classroom.

Preventing the Spread of Head Lice

If your child gets head lice, these tips can help prevent a recurrence or spreading it to others:  

  1. Remove all of the nits on your child’s head. Missing some nits is a common way for kids to have a persistent infection, as lice keep hatching and keep the infestation going.
  2. Don’t hesitate to tell other people, especially the parents of kids with which your child has close contact, that they should likely check their own kids for lice. Your child might get lice again, even after being properly treated, if the kids around her aren’t also treated.

A Word From Verywell

Kids most commonly get head lice through direct head-to-head contact with other children. Watching school-age kids play and interact with each other, you know that can’t be eliminated. Concentrate on catching lice infestations early and do what you can to encourage your kids not to share objects that touch their heads. That said, sharing a helmet or other protective gear rather than going without one is not a big risk, and could potentially save your child from having a serious injury.

Head Lice Doctor Discussion Guide

Get our printable guide for your next doctor’s appointment to help you ask the right questions.

How to get rid of lice in your child’s hair

If your child has lice, you’ll need to take steps to get rid of them.

Lice are itchy and annoying and they won’t go away on their own. And your child can spread them to others – even to you – through close, usually head-to-head contact. That’s why parents often find themselves scratching too.

First, confirm that your child has lice

Before you go down this labor-intensive road, make sure your child has a confirmed case of head lice. That means you’ve spotted viable nits (lice eggs) or live lice in your child’s hair.

If you haven’t seen the signs yourself or feel uncertain about what you’re seeing, find out how to tell for sure whether your child has lice.

Then, choose a method for getting rid of lice

You’ll hear lots of conflicting recommendations for dealing with lice. Even official health sources such as government agencies and doctor associations differ. And friends, relatives, and online resources offer all sorts of home remedies and alternative medicines.

Consult your doctor or another health professional to make sure the method you choose is likely to be safe and effective.

Here are the options recommended by doctors, lice experts, and parents:

1. Lice medicine and lice combing combined
Many parents try this approach: Apply drugstore lice medicine to the hair and follow up with frequent comb-outs using a high-quality metal lice comb.

Read our complete articles on how to use over-the-counter head lice medicine and how to use a lice comb, which includes a printable illustrated guide to doing a lice comb-out.

2. Over-the- counter lice-killing medicine alone
A 2010 American Academy of Pediatrics (AAP) report on head lice recommends using a drugstore pediculicide (lice-killing product). These are sold as a cream rinse, shampoo, gel, mousse, or other hair product. The AAP recommends applying as directed and then reapplying on day nine to catch any lice that may have hatched.

The report says that lice combs don’t help eradicate lice once you’ve applied the lice medicine, although they’re useful for diagnosing a case of head lice and for combing out lice and eggs killed by the pediculicide.

3. Lice comb alone
The National Pediculosis Association is one group that advocates combing lice and nits from the hair with a special lice comb instead of using a pediculicide. The group doesn’t rule out pediculicides completely but warns that these medicines are pesticides and potentially harmful to children. It states on its website, «The NPA believes that the mechanical method of removing head lice with a comb is the safest and most effective method.»

Read our complete article on how to use a lice comb, which includes a printable illustrated guide to doing a lice comb-out.

4. Alternative methods
You’ll find all sorts of «natural» lice remedies at drugstores, natural food stores, and online. These products are not regulated by the FDA and there’s no scientific proof that they’re safe or effective (and some could be toxic, so be careful). Home remedies ranging from olive oil, baby oil, mayonnaise, and petroleum jelly to using a blow dryer are also popular, but not scientifically tested.

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