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Treatments and drugs
By Mayo Clinic staff
Over-the-counter products
Shampoos containing either pyrethrin (Rid, others) or permethrin (Nix) are usually the first option used to combat lice infestations. These work best if you follow the directions very closely.
In some geographical locations, lice have grown resistant to the ingredients in over-the-counter lice treatments. If over-the-counter preparations don't work, your doctor can prescribe shampoos or lotions that contain different ingredients.
Prescription medications
- Malathion (Ovide). You apply malathion to your hair, and then rub it into your hair and scalp. This medication is flammable, so keep it away from heat sources, such as hair dryers, electric curlers and cigarettes. If you're pregnant or breast-feeding, talk to your doctor before using this product, because the medicine could affect your baby.
- Lindane. This prescription medication is available as a cream, lotion or shampoo. Your doctor may not recommend using lindane if you weigh less than 110 pounds (49.9 kilograms), you're pregnant, breast-feeding, have seizures or HIV infections. Side effects may include skin irritation and seizures.
- Benzyl alcohol lotion. This newly approved treatment should not be used in children younger than 6 months. Side effects may include irritations of the skin, scalp and eyes. According to the Food and Drug Administration, serious side effects — such as seizures, coma or death — may occur if this product is used on premature infants.
Combing wet hair
If you don't want to employ insecticides, a fine-toothed or nit comb can physically remove the lice from wet hair. Repeat every three to four days for at least two weeks. This method is recommended as the first-line treatment for children under age 2.
- Goldstein AO, et al. Pediculosis. http://www.uptodate.com/home/index.html. Accessed March 27, 2009.
- Head lice: Fact sheet. Centers for Disease Control and Prevention. http://www.cdc.gov/lice/head/factsheet.html. Accessed March 27, 2009.
- Head lice: Treatment. Centers for Disease Control and Prevention. http://www.cdc.gov/lice/head/treatment.html. Accessed March 27, 2009.
- Ectoparasites. In: Rakel RE, et al. Textbook of Family Medicine. 7th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/128370895-3/822018529/1481/307.html#4-u1.0-B978-1-4160-2467-5..50029-4--cesec39_1386. Accessed March 27, 2009.
- Schlossberg D. Arthropods and leeches. In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/128370895-5/822078666/1492/1286.html#4-u1.0-B978-1-4160-2805-5..50385-2--cesec27_16133. Accessed March 27, 2009.
- Burkhart CN, et al. Fomite transmission in head lice. Journal of the American Academy of Dermatology. 2007;56:1044.
- FDA approves benzyl alcohol lotion for the treatment of head lice. U.S. Food and Drug Administration. U.S. Food and Drug Administration. http://www.fda.gov/bbs/topics/NEWS/2009/NEW01993.html. Accessed April 15, 2009.
- Head lice: Prevention and control. Centers for Disease Control and Prevention. http://www.cdc.gov/lice/prevent.html. Accessed March 27, 2009.
