Head Lice

  • Medical Author:
    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Quick GuideHead Lice Treatment, Symptoms and Pictures

Head Lice Treatment, Symptoms and Pictures

What is the treatment for a head lice infestation (pediculosis)?

For effective elimination of head lice, the infested individual, family members that are also infested, and the home must all be treated. It is important to remember that treatment should only be started if there are clearly live lice identified. According to the American Academy of Pediatrics in a recent clinical report, "The ideal treatment of lice should be safe, free of toxic chemicals, readily available without a prescription, easy to use, effective and inexpensive."

Treatment of the individual and the infested family members

Over-the-counter (OTC) or prescription medications are used to treat the affected people and their families. Follow these treatment steps:

  1. Remove all clothing.
  2. Apply lice medicine, also called pediculicide, according to the label instructions. If a child has extra-long hair, one may need to use a second bottle. Warning: Do not use a cream rinse or combination shampoo/conditioner before using lice medicine. Do not rewash hair for one to two days after treatment.
  3. Have the infested person put on clean clothing after treatment.
  4. If some live lice are still found eight to 12 hours after treatment but are moving more slowly than before, do not retreat. Comb dead and remaining live lice out of the hair. The medicine sometimes takes longer to kill the lice.
  5. If no dead lice are found and lice seem as active as before eight to 12 hours after treatment, the medicine may not be working. See a health-care professional for a different medication and follow their treatment instructions.
  6. Nit (head lice egg) combs, often found in lice medicine packages, should be used to remove nits and lice from the hair shaft. Many flea combs made for cats and dogs are also effective.
  7. After the initial treatment, check, comb, and remove nits and lice from hair every two to three days.
  8. Retreat in seven to 10 days.
  9. Check all treated people for two to three weeks until you are sure all lice and nits are gone. Continue Reading
Reviewed on 11/5/2015
References
REFERENCES:

American Academy of Pediatrics. "Pediculosis Capitis (Head Lice)." Red Book, 28th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2009.

Chosidow, O. "Oral Ivermectin Versus Malathion Lotion for Difficult-to-Treat Head Lice." New England Journal of Medicine 362 Mar. 2010: 896-905.

Devore, C., and G. Schutze. American Academy of Pediatrics. "Head Lice. A Clinical Report: Guidance for the Clinician in Rendering Pediatric Care." Pediatrics 135.5 May 2015: e1355-1365.

Feldmeier, H. "Pediculosis Capitis: New Insights Into Epidemiology, Diagnosis and Treatment." Eur J Clin Microbiolo Infect Dis. Mar. 2012.

Frankowski, Barbara and Joseph A. Bocchini Jr. "Clinical Report: Head Lice, a Policy Update." Pediatrics 126.2 Aug. 2010: 392-403.

Gunning, K., K. Pippitt, B. Kiraly, and M. Sayler. "Pediculosis and scabies: treatment update." American Family Physician 86.6 Sept. 2012: 535-541.

United States. Centers for Disease Control and Prevention. "Head Lice." Sept. 24, 2013. <http://www.cdc.gov/parasites/lice/>.

IMAGES:

1. iStock

2. iStock

3. iStock

4. "Male human head louse" by Gilles San Martin

5. iStock

6. "Bugbuster" by Thanks for the polite permission of the Community Hygiene Concern, Joanna Ibarra

7. iStock

8. iStock

9. iStock

10. Getty Images

11. iStock

Subscribe to MedicineNet's Children's Health & Parenting Newsletter

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

VIEW PATIENT COMMENTS
  • Head Lice - Describe Your Experience

    Please describe your experience with head lice infestation (pediculosis).

    Post View 26 Comments
  • Head Lice - Treatments

    What treatment was effective for your head lice?

    Post View 6 Comments
  • Head Lice - Signs and Symptoms

    What were the signs and symptoms experienced with head lice in you or a relative?

    Post View 2 Comments
  • Head Lice - Prevention

    What methods have you used to prevent head lice infestation? What do you tell your children?

    Post
  • Head Lice - Home Remedies

    Please share effective home remedies for head lice. Who in your household was treated?

    Post View 2 Comments

Health Solutions From Our Sponsors