Head lice can't jump or fly; they can only crawl.
Head lice can’t jump or fly; they can only crawl.

There are several prescription medications, over-the-counter medications, and home remedies available to treat head lice and their eggs.

How do head lice spread?

Head lice can’t jump or fly; they can only crawl. Lice usually directly transfer from the hair of one person to another. Hence, head lice infestation may not always be a sign of poor personal hygiene or an unclean environment. Pets, such as dogs and cats, usually don't play a role in spreading head lice. Some possible ways of transmission include: 

  • Direct and close contact with another person that has head lice
  • Sharing hats and scarves
  • Brushes and combs
  • Hair accessories
  • Headphones
  • Sharing pillows, towels, and clothing

Over-the-counter medications

Before using any over-the-counter (OTC) medications, the hair should be thoroughly washed with shampoo, without a conditioner. Rinsing the hair with white vinegar prior to treatment may help dissolve the glue that holds the eggs to hair shafts. OTC medications include the following:

  • Permethrin: Permethrin is a synthetically produced chemical similar to pyrethrin obtained from chrysanthemum flowers that can kill lice but not the eggs, and treatment needs to be repeated 9-10 days after the first application. Side effects may include redness and itching of the scalp.
  • Pyrethrin with additives: Pyrethrin is a naturally occurring compound that is isolated from chrysanthemum flowers. Pyrethrin is combined with other chemicals to enhance its effectiveness. This product only kills lice, and it should be reapplied 9-10 days after the first treatment. Side effects may include itching and redness of the scalp. Pyrethrin shouldn't be used if your child is allergic to chrysanthemum or ragweed.

Prescription medications

Prescription medication is usually used when over-the-counter (OTC) treatments fail.

  • Ivermectin is a medication that kills lice and can be used in anyone over six months of age. It is usually applied once to dry hair and then rinsed off with water after 10 minutes. Ivermectin can also be taken orally.
  • Malathion is a lotion that can be used in those older than six years. It is applied to the scalp and rinsed off with water after 8-12 hours. The treatment may be repeated seven to nine days after the first treatment.
  • Spinosad can kill lice and eggs. It is usually applied only once to dry hair and rinsed off with warm water after 10 minutes.

Lifestyle and home remedies

Alternative lifestyle and home remedies can be used alongside medical treatment to help get rid of lice faster. Home remedies alone may not be effective because there is no scientific proof of their effectiveness, and one may consult with a doctor before following them.

  • Wet combing: Combing the entire hair from the scalp to tips when it is wet using a fine-toothed comb can remove lice and some eggs. Using a lubricant like olive oil or coconut oil while combing the hair makes the lice come out easily. This can be repeated every three to four days for a few weeks until there are no more lice found.
  • Essential oils: Certain essential oils such as tea tree oil or ylang-ylang oil may kill lice by suffocating them.
  • Smothering agents: There are several common home products that may kill lice by depriving them of air and smothering them. These products include petroleum jelly (Vaseline), olive oil, butter, or mayonnaise. Any of these products may be applied to the scalp and hair, covered with a shower cap, and left on overnight. 
  • Dehydration: Applying hot air with a special machine operated by a professional can cause dehydration, possibly killing the eggs and lice.
  • Household cleaning: Lice usually can’t live more than a day without feeding off a human scalp, and the eggs can’t survive if they aren't incubated at the temperature in the scalp. Despite this, as a precaution, it is advised to clean items affected by a person with life infestation who has used them in the previous two days. Cleaning recommendations include:
  1. Washing clothing, soft toys, and bedding in hot soapy water at a temperature of 130°F (54.4°C) at least, and they should be dried at high heat.
  2. Cleaning hair care items such as hair combs, brushes, or hair accessories by soaking them in hot soap water for at least 10 minutes.
  3. Safely sealing items that cannot be washed in plastic bags for at least two weeks.
  4. Vacuuming the floor and furniture can help get rid of lice.

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Medically Reviewed on 10/15/2020
References
https://www.cdc.gov/parasites/lice/head/gen_info/faqs.html

https://medlineplus.gov/ency/article/000840.htm

https://www.aad.org/public/diseases/a-z/head-lice-treatment

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