Lice Treatments

How to choose lice treatments

If your child comes home from school with a lice-infested scalp, don't panic. Most lice alerts can be handled without a doctor's care. Just arm yourself with an over-the-counter lice treatment—a medicated shampoo or cream rinse—and a fine-toothed comb.

Active ingredients of lice treatments

The Food and Drug Administration has approved two anti-lice agents—permethrin and pyrethrins such as pyrethrum—as effective and safe for children because the body doesn't absorb them:

• Many top brands, like Nix, contain permethrin, a pesticide that kills lice and nits by paralyzing their nerve cells.
• Products like Pedicide and Pronto, which use a similar ingredient called pyrethrins, are equally effective.
• Some brands, like Rid and A-200, use permethrin for lice sprays and pyrethrins for shampoos and cream rinses.

By prescription only

Prescription lice treatments aren't necessarily better, and they have the potential for more side effects. But when over-the-counter products don't do the job, some doctors prescribe Elimite cream (concentrated permethrin), lindane, or Ovide (malathion). Or they may use an antibiotic (Bactrim or Septra) to kill some bacteria in the intestinal tract of lice that are necessary for them to survive.

How to use lice treatments

When using anti-lice shampoos and rinses, carefully follow instructions on the product label. Most say the following:

• Before using the anti-lice product, wash the hair thoroughly, using regular, non-medicated shampoo. Dry the hair thoroughly.
• To prevent contact with the skin, don't use anti-lice treatments in the bath or shower. Instead, stand over the sink for applying and rinsing.
• Shampoo again using the anti-lice product.
• Leave the product in the hair for about 10 minutes. Never leave the cream or shampoo on the scalp for longer than the prescribed time.
• Rinse the product out in the sink to prevent contact with skin.
• Comb the hair with a nit comb.
• If necessary, repeat treatment a week to 10 days later to destroy remaining lice.

Nit-picking basics

• Buy a good metal lice or nit comb (often packaged in anti-lice kits with medicated shampoo).
• Choose a well-lit area in your home for your lice-picking station.
• Comb through the hair a section at a time, using metal clips to divide sections—and a magnifying glass if you have one handy.
• After each stroke, remove lice and nits from the comb with a tissue, or rinse the comb in sudsy hot water between strokes.
• Continue combing for at least 30 strokes or until the scalp and hair are nit-free. Then try to handpick the remaining ones.
• Repeat the procedure every two days for two weeks.

Added precautions

Don't fumigate your house, because lice can't live long away from a warm human body. But do take the following precautions:

• Immediately wash all your child's clothing, towels, and anything that may have come in contact with infested items. Don't overlook backpacks or lunch sacks.
• Don't treat a child when he or she is wearing any clothing that may be infested. Have your child put on lice-free clothing after treatment.
• Thoroughly clean every imaginable louse outpost in your home, such as bedding, mattresses, pillows, and stuffed animals. Don't overlook your car, yard forts or tents, and other places your child frequents.
• Wash bedding and clothing in hot water and place it in a hot dryer. Dry-clean things when appropriate.
• Vacuum all your house's carpeting, curtains, and upholstered furniture, especially in your children's rooms.
• Place all stuffed animals in sealed plastic bags for about a month. (Lice live only about 25 days.)
• To kill lice in clothing and furniture, consider using any of the anti-lice sprays. They contain the same active ingredients as anti-lice hair treatments.