Topics you’ll find on this head lice treatment page:
- What You Should Know Before Applying Head Lice Treatments
- Do Lice Treatments Work? What Research Says
- Chemical Treatments for Head lice – What Research Says
- Home Remedies for Head Lice – What Research Says
- What Do Trusted Health Sources Say About Head Lice Treatments?
- How to Use OTC Head Lice Treatment Products
- How to Choose the Best Lice Shampoo
- Head Lice Shampoos and Resistant Head Lice
- Home Remedies and Natural Head Lice Treatments
As head lice is not a disease, there is a lack of research into effective techniques of head lice treatment, and to date, no lice treatment, whether physical or chemical, is 100% effective in treating head lice and their eggs.
Moreover, there aren’t any clear guidelines on how to treat head lice, which has led to a lot of misunderstanding, misdiagnosis, ineffective treatment, and an overuse of pesticidal products as well as resistance of lice to chemical treatments.
Of course, major efforts are being made to manage the problem effectively, from chemical lice treatments, head lice home remedies, no nit policies and other means.
Yet many people do not manage to get rid of lice for a variety of reasons, including resistance of lice, embarrassment, lack of know-how in removing lice, and lack of time or cost of treatments.
What You Should Know Before Applying Head Lice Treatments
Before you start treating head lice there are a few important points you need to be aware of.
Head lice are lice affecting the scalp: they are blood-sucking insects, feeding on blood about every six hours. They are very common in children and are transmitted by direct head-to-head contact. You can find pictures of head lice here.
There are adult head lice and there are nits, which are their eggs.
Adult head lice are about two millimeters long. The female louse lays about one hundred eggs during her whole lifetime, which lasts about one month.
There are two types of head lice eggs, also called nits:
1. Live nits, which are whitish, swollen and adherent to the hair. These nits have not yet hatched. Nits of lice hatch after about eight days, hence the usefulness of making treatments every eight days.
2. Dead nits, that is to say, hatched, which are grayish and flat.
The main symptom of lice is itching, sometimes there are also buttons on the neck and/or behind the ears and you can say that you have head lice when you can detect live lice or live nits in your hair.
Some head lice treatments aim to kill nits as well as adult lice. It requires a medical consultation, you need to advise your kid’s school, and you need to treat your child as soon as possible.
When should you apply a head lice treatment?
According to research, the recommendation is to treat active infestations ONLY, which means that no preventive treatment should be made.
An active infestation occurs when live lice or viable eggs can be found on the head. You can find more information on how to identify head lice here.
Do Lice Treatments Work? What Research Says
According to research, no treatment (chemical or natural) is 100% effective at getting rid of head lice. It appears that treatment options are a very personal choice in most cases; different methods are reported to have different success rates with different people. This means that one method can work very well for a child and not at all for another one.
According to research, the only two 100% methods for treating lice are combing and head shaving.
Shaving the head, which is the most effective solution apart from combing, is practiced in some countries, but can lead to a great distress for children, and should be considered as a last resort approach. Thus it is not recommended.
Chemical Treatments for Head lice – What Research Says
Chemical treatments are well-known by parents and school personnel because they have been widely used since the beginning of the 19th century. There are basically 2 types of chemical treatments: pediculicides, which kill nymphs (baby lice) and adult lice; and ovicides, which kill lice eggs.
Most products are pediculicides, and while they will help removing hatched lice and adults, they will most of the time have no effect on eggs, which means parents will need to use another method for removing eggs.
Studies suggest that most chemical treatments lead to lice resistance. This is actually a reality since the 1960s, when lice were thought to have become resistant to products such as Lindane or DDT. Then, resistance of lice to malathion as well as permethrin was reported in 1998. In a 2007 study, resistance appeared to be more prevalent in some geographical areas rather than others.
Studies also suggest that chemical treatments are not 100% effective, and sometimes less than 50%, and that they can have dangerous side-effects (especially if misused or overused).
Home Remedies for Head Lice – What Research Says
Research suggests that home remedies are not easy to apply and that some of them are really messy. In a 2004 study, 6 suffocating home remedies were compared: melted butter, vinegar, isopropyl alcohol, olive oil, mayonnaise and petroleum jelly (Vaseline). The results showed that no remedy was 100% effective at getting rid of lice, and of the 6 remedies, petroleum jelly was the most effective.
Most remedies failed to kill eggs, although petroleum jelly was shown to be most likely to kill them. The authors of the study did not recommend the use of these products.
However, it is important to note that these products, contrary to chemical ones, are not toxic, and they are readily available as well as pretty cheap.
In a 2006 study, hot air applications were evaluated, and the louse buster with hand piece was shown to kill up to 80% of nymphs and adult lice, and 98% of eggs. The authors of the study recommended the use of the louse buster by health care institutions as well as schools as an effective way to treat head lice.
What Do Trusted Health Sources Say About Head Lice Treatments?
Most trusted health sources online do recommend the use of pediculicides. However, remember that it is more a matter of personal choice, and that the only solution that works 100% is careful combing with a good lice comb.
Here is a short summary of these sources as well as the references if you wish to know more.
The Center for Disease Control and Prevention (CDC) is offering some practical information about this condition on its website: general guidelines regarding the treatment of lice, information about OTC medications, as well as prescription medications. Here is basically what the CDC recommends:
Treatment for head lice is recommended for persons diagnosed with an active infestation.
To be most effective, retreatment should occur after all eggs have hatched but before before new eggs are produced.
Lice and eggs are killed by exposure for 5 minutes to temperatures greater than 53.5°C (128.3°F).
Head lice do not survive long if they fall off a person and cannot feed. You don’t need to spend a lot of time or money on housecleaning activities.
Medicinenet.com offers detailed information about head lice and gives treatment guidelines. They recommend the use of pediculicides and treating the whole house.
Kidshealth suggests to use medicated products and gives some directions.
Your doctor can recommend a medicated shampoo, cream rinse, or lotion to kill the lice. These may be over-the-counter (OTC) or prescription medications, depending on what treatments have already been tried. Medicated lice treatments usually kill the lice and nits, but it may take a few days for the itching to stop.
It’s important to follow the directions exactly because these products are insecticides. Applying too much medication — or using it too frequently — can increase the risk of causing harm. Follow the directions on the product label to ensure that the treatment works properly.
Pediatrics.about.com gives a lot of recommendations and also recommends the use of chemical products.
How to Use OTC Head Lice Treatment Products
According to the American Academy of Pediatrics the ideal head lice treatment product should be free of harmful chemicals, inexpensive, available without a prescription and easy to use. Many of the different head lice treatment products available fulfill these criteria. Head lice treatments containing pyrethrin or those with permethrin are most commonly used and usually sold as a shampoo, cream rinse, mouse or a lotion.
Beware Of Common Head Lice Treatment Mistakes
Although over-the-counter (OTC) head lice treatments are considered safe to use, it is important to follow the instructions on the label or information leaflet closely. Here are some important things to avoid when applying head lice products:
- Never cover hair undergoing the treatment with a towel or bag.
- It’s not safe to use OTC head lice treatments in infants under two months of age or during pregnancy or breastfeeding.
- It’s not safe to use lice treatments more often than recommended on the package. In general, it is considered to be safe to reapply it after nine days.
- Don’t use OTC lice products on other parts of the body or face and never on skin with open sores or scratches.
- Never combine two different head lice treatment products during the same application.
Step-by-step Guide to Appling an OTC Head Lice Treatment
- Choose a OTC head lice treatment product
- Then you need to determine how much of the head lice treatment product you will need. In general, if your child’s hair is longer than shoulder-length or you are treating more than one child, you may need more than one bottle to finish the first treatment.
- Always consult the instruction leaflet in the package before starting the treatment.
- Make sure that the ingredients include either permethrin or pyrethrin and piperonyl butoxide.
- Permethrin creams should be applied to wet hair. Wet hair also inhibits the mobility of the lice and helps to saturate them with the cream.
- Products containing pyrethrin and piperonyl butoxide should be applied to dry hair.
- If you are using a permethrin based product, wash the hair, but don’t use conditioner. Conditioner lessens the effectiveness of the lice treatment.
- Towel dry the hair. It should be damp, but not dripping wet.
- Wear old clothes or drape an old towel around your child’s shoulders.
- Keep an old washcloth handy to hold over your child’s face so the cream can’t get in his eyes.
- Although not absolutely necessary, you can wear rubber gloves to protect your hands, especially if you have cuts or bruises on your hands.
- Squirt the cream or shampoo onto your hands and massage it into the scalp, from the roots to the ends. The scalp and hair should be completely covered.
- Make sure that you apply enough cream to the hairline on the back of the neck and the area around the ears. Lice are fond of attaching themselves in these areas.
- It is common to see head lice falling off the head while the treatment is going on.
- Set the alarm for ten minutes after you have applied the product to the whole head.
- After ten minutes, you can rinse or wash the hair depending on which product you are using.
- Once you are done, change your clothes as well as your child’s and wash all clothes, towels and washcloths on the hot cycle in the washing machine.
- Nit combs are often sold as part of OTC head lice products. Some experts feel that comb-outs after a head lice treatment is unnecessary, while others argue that it will help get rid of the remaining nits. Most parents will probably choose to go ahead and do a thorough comb-out right after the application.
What If the Lice Treatment Doesn’t Work?
Lice treatments usually don’t kill all the lice at once. It is a good idea to do an additional thorough comb through with a nit comb twelve hours after applying the product.
Lice treatments usually kill 70-80% of the nits and this combing session will help remove it. If you notice a few slow moving lice during this time, they are probably dying and it is not an indication that the treatment hasn’t worked.
How to Choose the Best Lice Shampoo
If you are looking for the best lice shampoo, there are several things you should know to select the most efficient and safest one.
First of all, you should know that head lice can be killed and gotten rid of in several ways.
There are the chemical treatments, which kill lice (think about Nix, RID, or any prescription lice shampoo), and physical treatments, which repel lice or kill them by suffocating them (think about a natural lice shampoo, home remedies, and a lice prevention shampoo).
You also have natural shampoos that are safer than chemical treatments. Here is one of them that gets great reviews from many parents:
Pesticide lice shampoos
Pesticide lice treatment shampoos may contain such working agents as permethrin or pyrethrin. These insecticides are the safest to use.
Permethrin is a synthetic pyrethrin, and does not cause plant allergies and only a very small part gets absorbed by the skin. There are other pesticides, such as malathion or lindane. These are more dangerous to people. They get absorbed by the skin and can intoxicate people.
This is originally a natural insecticide. It is made of the chrysanthemum flowers. It works as a neurotoxin and kills only adult lice or nymphs, the baby lice. It does not kill the lice’s eggs, called nits. Thus, it requires a second application 7 days after the first one to kill the newly hatched lice.
Pyrethrin is comparably non toxic for people. However, it should not be used for treating kids under 2 years of age or pregnant women.
Head lice can develop resistance to this pesticide, in this case it becomes ineffective.
This is a new generation pediculosis capitis insecticide. It is synthetic, but it was developed to match the formula and best qualities of pyrethrin. However, it is much less toxic than its natural equivalent.
Another benefit of permethrin is that it can be safely used by people with plant allergies.
Permethrin does not get easily absorbed into human skin. It kills adult lice and nymphs.
This is a pretty drastic head lice treatment. It possesses a strong and unpleasant smell. The malathion lotion has to be applied on dry hair and left for half a day. Then it should be washed off thoroughly.
Malathion can easily get on fire, so any contact with the fire during the treatment should be avoided.
It may cause such side effects as skin burning or eyes burning. So, it should be used with care, especially on kids.
Pesticide lice shampoos may provide fast head lice treatment, but sometimes lice get resistant to them.
NIX shampoo is one of the options to resort to. This shampoo contains permethrin. It kills lice fast. It should be applied to clean and wet hair, washed with regular shampoo and left for about 10 minutes. This time is enough to kill lice and nits. Then, the treatment has to be washed off thoroughly.
RID Lice Killing Shampoo is another affordable option of permethrin based head lice shampoo. This is a head lice solution pack. It includes head lice killing shampoo and conditioner in one bottle as well as a head lice comb. It should be applied to dry hair and left on for about 10 minutes and washed off thoroughly. Then the hair should be combed with a head lice comb.
Non toxic anti lice shampoos
Natural head lice shampoos may contain various ingredients, such as essential oils. Tea tree oil and lavender oil are great for head lice removal and also act as repellents. Mint oil is another option. Coconut shampoos have proved to be useful in head lice removal, too. Neem oil is another head lice shampoo alternative.
Using enzymes in shampoos is another nontoxic option of lice shampoos. The enzymes in it help to dissolve the glue of nits and easily remove lice and nits from the hair. Often, this shampoo can be gotten in a head lice removal kit. Such kit includes a shampoo plus a head lice hair conditioner and a head lice steel comb.
How do you go about selecting the best lice shampoo to treat your condition?
There are several factors that should be taken into consideration. First of all, the age and health condition of the person being treated with such shampoos. For pesticide shampoos, there are certain limits. For example, you should not treat kids under 2 years or pregnant or breast-feeding women, and there are other limitations.
Now, a person may have a certain skin condition, cuts, inflammation or allergy, and in this case, pesticides should be avoided, too.
When selecting an herbal or essential oil based shampoo to kill lice, also find out if you have allergies on its natural ingredients, as natural does not always mean harmless.
These factors along with the price of a product have to be taken into consideration when selecting the right lice shampoo to get rid of lice.
Head Lice Shampoos and Resistant Head Lice
Head lice shampoos are the main weapon of parents and school teachers in their battle against head lice. There has recently been a lot of buzz in the media around the resistance of head lice to chemical treatments.
Some experts will tell you that this is a myth, and others state that resistant head lice are an established fact. Let’s try to shed some light on this controversial subject.
Are there more lice now than before? And is it because they are resistant to head lice shampoos?
We hear that there are more head lice now than a few decades ago. And we commonly read in the media that this is because head lice have become resistant to treatments and shampoos. Actually this is only a part of the truth.
What happens is that there were already a lot of head lice decades ago, but the treatments we used to get rid of them were much stronger – and harmful for our health – than today’s head lice treatment products. Many of us parents can easily remember our mothers pouring those lice shampoos on our heads and our scalp irritated during weeks or months after the treatment.
For safety reasons, many of these products have been banned over the years, and an actual head lice treatment shampoo is simply not as effective. So most of the time the lack of effectiveness of head lice shampoos is not related only to the resistance of head lice.
What about the resistance of head lice to lice shampoos?
“Resistant head lice” means that the parasites will survive to treatments because they are genetically capable of doing so. First, it is important to realize that the resistance of head lice is a very controversial subject among scientists, pharmacists, healthcare professionals and manufacturers of head lice shampoos.
Some will tell you that from a scientific point of view, we cannot really say that head lice as a whole are resistant to chemical products because studies are scarce, local and sporadic and cannot really prove the resistance of lice.
And you will also hear that the insecticides that were very effective at the beginning of their use a few decades ago are becoming less and less active because head lice have adapted and genetic mutations have allowed the development of a phenomenon of resistance that makes the new generations of lice almost insensitive to the products.
A study published in Proceedings of the National Academy of Sciences on June 21, 2010, has shown that lice have a genome that make them great candidates for resistance to insecticides. And many other scientific studies show resistant head lice in many regions.
And the truth is that head lice are actually resistant to insecticides in many regions of the globe, but not everywhere, and not for everybody.
This is why head lice shampoos will still work very well for many people, and will not work at all for many other people.
Home Remedies and Natural Head Lice Treatments
There are many head lice home remedies available, and as said previously, although they have not been scientifically proven to work, many parents have used them with success. Here are more articles for each type of home remedy: