 
Treating Head Lice
How can I treat a head lice
infestation?
By treating the person infested
with head lice, other infested family members, and by cleaning the house.
Treat the
infested person:
Requires using an over-the-counter
(OTC) or prescription medication. Follow these treatment steps:
1. Before applying treatment,
remove all clothing.
2. Apply lice medicine, also
called pediculicide (peh-DICK-you-luh-side), according to label
instructions. If your child has extra long hair, you may need to use a
second bottle.
WARNING: Do not use a
creme rinse or combination shampoo/conditioner before using lice
medicine. Do not re-wash hair for 1-2 days after treatment.
3. Have the infested person
put on clean clothing after treatment.
4. If a few live lice are
still found 8-12 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 may take longer to kill lice.
5. If, after 8-12 hours of
treatment, no dead lice are found and lice seem as active as before, the
medicine may not be working. See your health care provider for a
different medication; follow treatment directions.
6. Nit (head lice eggs) combs,
often found in lice medicine packages, should be used to comb nits and
lice from the hair shaft. Many flea combs made for cats and dogs are
also effective.
7. After treatment, check hair
and comb with a nit comb to remove nits and lice every 2-3 days.
Continue to check for 2-3 weeks until you are sure all lice and nits are
gone.
8. If using OTC pediculicides,
retreat in 7-10 days. If using malathion, retreat in 7-10 days only if
crawling bugs are found.
Treat the household:
Head lice do not survive long if they fall off a person. You do not need
to spend a lot of time or money on house cleaning activities.
Follow these steps to help avoid
re-infestation by lice that have recently fallen off the hair or crawled
onto clothing or furniture.
1. To kill lice and nits,
machine wash all washable clothing and bed linens that the infested
person touched during the 2 days before treatment. Use the hot
water (130o F) cycle. Dry laundry using high heat for at
least 20 minutes
2. Dry clean clothing that is
not washable, (coats, hats, scarves, etc.) OR
3. Store all clothing, stuffed
animals, comforters, etc., that cannot be washed or dry cleaned into a
plastic bag; seal for 2 weeks.
4. Soak combs and brushes for
1 hour in rubbing alcohol, Lysol*, or wash with soap and hot
(130o F) water.
5. Vacuum the floor and
furniture. Do not use fumigant sprays; they can be toxic if inhaled or
absorbed through the skin.
Prevent Reinfestation:
Lice are most commonly spread directly by head-to-head contact and
indirectly though contaminated clothing or belongings. Teach your child to
avoid playtime and other activities that are likely to spread lice.
- Avoid head-to-head contact
common during play at school and at home (slumber parties, sports
activities, at camp, on a playground).
- Do not share clothing, such
as hats, scarves, coats, sports uniforms, or hair ribbons.
- Do not share infested combs,
brushes, or towels.
- Do not lie on beds, couches,
pillows, carpets, or stuffed animals that have recently been in
contact with an infested person.
My child has head lice. I dont.
Should I treat myself to prevent being infested?
No, although anyone living with
an infested person can get head lice. Check household contacts for lice
and nits every 2-3 days. Treat only if crawling lice or nits (eggs) within
a 1/4 inch of the scalp are found.
Should my pets be treated for
head lice?
No. Head lice do not live on
pets.
My child is under 2 years old
and has been diagnosed with head lice. Can I treat him or her with
prescription or OTC drugs?
For children under 2 years old,
remove crawling bugs and nits by hand. If this does not work, ask your
childs health care provider for treatment recommendations. The safety
of head lice medications has not been tested in children 2 years of age
and under.
What OTC medications are
available to treat head lice?
Many head lice medications are
available at your local drug store. Each OTC product contains one of the
following active ingredients.
1. Pyrethrins
(pie-WREATH-rins): often combined with piperonyl butoxide (pie-PER-a-nil
beu-TOX-side):
Brand name products include
A-200*, Pronto*, R&C*, Rid*, Triple X*.
Pyrethrins are natural extracts
from the chrysanthemum flower. Though safe and effective, pyrethrins only
kill crawling lice, not unhatched nits. A second treatment is recommended
in 7-10 days to kill any newly hatched lice. Treatment failures are
common.
2. Permethrin (per-meth-rin):
Brand name product: Nix*.
Permethrins are similar to
natural pyrethrins. Permethrins are safe and effective and may continue to
kill newly hatched eggs for several days after treatment. A second
treatment may be necessary in 7-10 days to kill any newly hatched lice.
Treatment failures are common.
What are the prescription drugs
used to treat head lice?
Malathion (Ovide*):
Malathion has just been reapproved for the treatment of head lice
infestations. Malathion treats both lice and head lice eggs. When used as
directed, malathion is very effective in treating lice. Few side-effects
have been reported. Open sores from scratching may cause malathion to
sting the scalp. Click here for instructions on how
to use malathion to >Should household sprays be used
to kill adult lice?
No. Spraying the house is NOT
recommended. Fumigants and room sprays can be toxic if inhaled or absorbed
through the skin.
Should I have a pest control
company spray my house?
No. Vacuuming floors and
furniture is enough to treat the household.
*Use of trade names is for
identification purposes only and does not imply endorsement by the Public
Health Service or by the U.S. Department of Health and Human Services.
This fact sheet is for
information only and is not meant to be used for self-diagnosis or as a
substitute for consultation with a health care provider. If you have any
questions about the disease described above or think that you may have a
parasitic infection, consult a health care provider.
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