ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Effective Head Lice Treatment, Tactics: New Advice by Academy of Pediatrics

Updated on November 15, 2016
janderson99 profile image

Dr. John uses skills in Biochemistry, Physiology (PhD) to review topics on mental health, depression, sleep, stress, setting positive goals

The scourge of head lice is likely to continue as every child is likely to be reinfected periodically. The American Academy of Pediatrics has recently updated its recommendations for how doctors (and parents) should treat children and their families infected with head lice.

Parents should read this updated advice to know what to do. Seeing your family doctor is a good idea as the prescription treatments are much more effective, though they can be expensive. The published article includes a review of common chemical treatment methods and a variety of natural and herbal remedies.

A summary is provided as a brief guide and introduction.

Head lice have been an ongoing problem through the ages with families engaged in detection and treatment
Head lice have been an ongoing problem through the ages with families engaged in detection and treatment | Source
Adult head lice cannot survive away from their food sources for 1-2 days. This duration is important for natural remedies
Adult head lice cannot survive away from their food sources for 1-2 days. This duration is important for natural remedies | Source
Head lice egg capsule are highly resistant to many chemicals and natural treatment methods. They are firmly attached to hair shafts
Head lice egg capsule are highly resistant to many chemicals and natural treatment methods. They are firmly attached to hair shafts | Source
The search for an effective head lice treatment can yet to be found as re-infection occurs with head-to-head contact.
The search for an effective head lice treatment can yet to be found as re-infection occurs with head-to-head contact. | Source
This head lice comb dates from the 1700s.
This head lice comb dates from the 1700s. | Source

How Head Lice Infections Start and Spread

► There is no real way to prevent lice infections because young children frequently come into head-to-head contact with other children frequently while playing or at school.

► Bathing every day does not prevent infections because the louse can survive submerged below water for at least 20 minutes.

► Louse eggs, which are glued to hair shafts, cannot be removed using regular shampoo and combs.

► Regular check by parents to find, and quickly treat infestations early, before they spread to other members of the family, is recommended by the academy advice.

► Teaching children not to share personal items, such as hats, brushes and combs is a good idea, but most lice found on combs are likely to be dead and the eggs resist the action of normal combs. Live eggs remain glued to hair and many adult lice found on combs, and egg capsules are likely to be dead.

► Lice cannot jump or hop. They can only crawl so head-to head contact is their major means of shifting from person to person. However, it has been shown that combing dry hair infected with lice, can build up enough static electricity to propel live insects for a distance of three feet (one meter).

► Adult lice on clothing bedding or on combs die within a day once separated from a head and their blood supply meals. Similarly eggs removed from the warmth of the body temperature cannot hatch. This suggests that fanatical household cleaning is not generally required if all family members are treated and their bedding, seating, head coverings such as combs and brushed and other personal items are treated. Leaving a house vacant for a day or so is likely to kill all adult lice.

Tips for Treatment and Management of Head Lice Infections

The keys points from the latest review by the American Academy of Pediatrics are:

► Hair length and how often it is washed and brushed has little effect on the risk of an infestation. However, shorter hair is easier to treat and check. Shaving of heads is not required.

► Optimal treatments should be safe, thorough, and continued long enough to kill all lice, larval stages and their eggs. This means two or more treatments. Some of the treatments, only available on prescription, only require one (or two treatments) and they are more effective, especially for eggs which resist other treatments. However, the prescription-only treatments are mostly very expensive. The treatment chosen should rapidly get rid of live lice, viable eggs, and residual nits to risk spreading the infection. It should be easy to use, not rendered ineffective due to local resistance, and should not cause an allergic reactions to the person being treated. Sometimes allergies only develop one to two weeks after the lice have been effectively treated. Similarly some treatments are continued for too long or are started due to misdiagnosis.

► Treatment should only be used for people on whom living lice are found, with treatment not started unless there is a clear evidence of living lice. Overuse of treatments can lead to resistance. Short treatments can also promote resistance as all lice will note be killed. The lice that remain are the resistant ones and this can make future treatments ineffective. People sometimes confuse hair casts, sand, dandruff and even residual droplets from hair spray as louse eggs. This can needlessly expose children to treatment pesticides and other chemicals. It can also waste time and money, and even unnecessary frantic clean ups of households. Live eggs are dark and hard to see; empty egg cases are clear or white, and often confused as signs of a continuing infestation.

► The ideal treatment of lice should be safe, free of toxic chemicals, readily available without a prescription, easy to use, effective, and inexpensive. Local patterns of resistance (if known), ease of use, and cost also are other considerations when choosing a treatment choice.

Some Chemical Treatment Options

Permethrin 1% lotion (Nix)
Over the Counter
Pyrethrins + piperonyl butoxide (Rid)
Over the Counter
Malathion 0.5% (Ovide)
Benzyl alcohol 5% (Ulesfia)
Spinosad 0.9% suspension (Natroba)
Ivermectin 0.5% lotion (Sklice)

Some suggested treatments are:

► Home remedies like Cetaphil skin cleanser, Pantene hair conditioner, tea tree oil, and even mayonnaise can be quite effective with diligent use, but longer treatments are necessary. None of these remedies have been evaluated for safety and effectiveness by the Food and Drug Administration.

► A good first choice chemical treatment is 1% permethrin or pyrethrins, which use a natural insecticide and are unlikely to cause allergies or other reactions

► It is always important to follow the instructions with all chemical treatments. Also most treatments do no kill all the eggs and so a second follow-up treatment is generally necessary.

► Manual treatments by using fine combs to remove nits and adults via “wet-combing” using hair conditioner can be effective, but several treatments are required to ensure all lice are removed. Cetaphil cleanser and petroleum jelly have been reported to be effective with thorough and repeated application.

► Benzyl alcohol 5% is a stronger chemical treatment for children older than 6 months. Malathion 0.5% is another one that can be used for children over 2 years. Spinosad and topical ivermectin are new preparations that have yet to be evaluated, but their high cost means that they should only be considered for more difficult cases.

► The cream rinse, Nix applied to damp hair after shampooing (without conditioner) is a good over the counter choice, or similar ones containing 1 percent permethrin or pyrethrins. It should be rinsed off after 10 minutes in warm water over the sink, not in the bath or shower to minimize exposure of the skin to the chemical. The Nix residue that remains on the hair can kill emerging nymphs. A second treatment after about nine days is optimal, but probably worthwhile.

© 2015 Dr. John Anderson


Submit a Comment

  • sgbrown profile image

    Sheila Brown 

    3 years ago from Southern Oklahoma

    I found this very interest and useful! Our youngest granddaughter that stays with us while our daughter is working, got head lice after she stayed at her dads for a few days. Apparently her half sister brought them home from school. Our daughter used Rid and it seemed to work well. She is due another treatment in a couple of days. I am glad to learn that they are not passed on as easily as I first thought!


This website uses cookies

As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at:

Show Details
HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
LoginThis is necessary to sign in to the HubPages Service.
Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
AkismetThis is used to detect comment spam. (Privacy Policy)
HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
MavenThis supports the Maven widget and search functionality. (Privacy Policy)
Google AdSenseThis is an ad network. (Privacy Policy)
Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
Index ExchangeThis is an ad network. (Privacy Policy)
SovrnThis is an ad network. (Privacy Policy)
Facebook AdsThis is an ad network. (Privacy Policy)
Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
AppNexusThis is an ad network. (Privacy Policy)
OpenxThis is an ad network. (Privacy Policy)
Rubicon ProjectThis is an ad network. (Privacy Policy)
TripleLiftThis is an ad network. (Privacy Policy)
Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)