How to Treat Your Child’s Head Lice

Published: September 12, 2021
Kara Kassekert
By Kara Kassekert, Pharm.D. Candidate, Class of 2022

Lice are tiny parasitic insects that feed on human blood. They live on your hair often close to the scalp and are easily spread among school children when their heads touch or sometimes if they share hats, brushes, or headbands. Lice can also spread among family members by sharing bedding, sleeping bags, or brushes.

Caring for a child who has lice can be stressful. Rest assured that you are not alone— lice are one of the most common conditions affecting children next to the common cold. With so many products available over-the-counter (OTC) and with a prescription, it can be overwhelming to determine the right option for your child. Pharmacists are equipped to provide you with the necessary information so that you can safely and effectively get rid of lice.

OTC treatments for lice:
There are many OTC products to treat lice. Look for a product that includes one of the following ingredients:

  • Permethrin lotion 1%:  Do not use in children younger than 2 months.
  • Ivermectin lotion 0.5% (Sklice): Do not use in children younger than 6 months. This product prevents newly hatched lice from surviving, so it does not typically require a second treatment in most individuals.
  • Pyrethrins: Do not use in children younger than 2 years. This requires a second treatment 9-10 days after the first treatment because it does not kill unhatched eggs.

Prescription treatments for lice:
An OTC product is a convenient first option, but a product prescribed by a doctor may be needed if lice are found after finishing the OTC treatment or in areas where resistance to treatment has been found. Prescription products include:

  • Benzyl alcohol lotion 5% (Ulesfia): Do not use in children younger than 6 months; a second course of treatment is required 7 days after the first because it does not kill unhatched eggs.
  • Spinosad 0.9% topical suspension (Natroba): Do not use in children younger than 6 months.
  • Malathion lotion 0.5% (Ovide): Do not use in children younger than 6 years; may contain an unpleasant odor and can be flammable, so heat sources should not be used to dry hair following application.

Dos and Don’ts of lice treatment application

  • DO consider using a lice comb to manually remove lice and eggs. Check to see if one comes with your product or you can purchase one separately.
  • DO check everyone in your family for lice when one member is found to have lice.
  • DO seek the help of a doctor if lice are found in your child’s eyebrows or eyelashes.
  • DO rinse the product from your hair over a sink, rather than in a tub or shower, to limit skin exposure.
  • DO NOT use lice treatment products on or near eyes.
  • DO NOT use hair conditioner prior to applying lice products as this can prevent the product from working.
  • DO NOT use extra amounts of medication or use more than one product at the same time unless instructed by a medical professional.

Tips for killing lice in your home
Although lice typically don’t live very long when they are away from your scalp, it is a good idea to clean bedding, brushes, combs, stuffed animals, and anything else that has been in close contact with the person who has lice.

  • Machine wash any clothing, bedding, or towels used in the past 2 days in hot water and dry using high heat.
  • If items cannot be laundered, dry-clean or seal them in a plastic bag for 2 weeks.
  • Soak combs and brushes in hot water (at least 130°F) for 5-10 minutes.
  • Vacuum furniture and floors to remove hair that may have eggs. Lice can survive about 1-2 days if they fall off your body.

Summary
There are many options available to help get rid of your child’s lice. Your pharmacist is an excellent resource and always happy to answer questions and recommend treatment options.

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