Treatments and drugs

By Mayo Clinic Staff

Use medications that treat lice only as directed. Applying too much can cause red, irritated skin.

Head lice

Treatment for head lice may involve:

  • Over-the-counter products. Shampoos containing 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) is a prescription medication that you apply to your hair and then rub into your hair and scalp. Malathion 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.

    Benzyl alcohol lotion (Ulesfia) is a prescription treatment that you apply to the scalp and hair for 10 minutes and then rinse off with water. Seven days later you repeat the treatment. Possible side effects include irritation of the skin, scalp and eyes as well as numbness at the application site. This medication isn't recommended for children younger than 6 months of age.

    Ivermectin lotion (Sklice) is a topical, single-dose treatment for head lice. You apply the lotion directly to dry hair and the scalp for 10 minutes and then rinse with water. Do not repeat this treatment without talking to your doctor first. Possible side effects include eye irritation or redness, dandruff, dry skin, and a burning sensation at the application site. This medication isn't recommended for children younger than 6 months of age.

    Spinosad topical suspension (Natroba) is a newer prescription treatment for head lice. You apply the medication to dry hair and the scalp for 10 minutes and then rinse with water. Repeat the treatment after seven days only if live lice are still present. Possible side effects include redness or irritation of the eyes and skin. This medication isn't recommended for children younger than age 4.

    Finally, lindane is a prescription shampoo that's sometimes prescribed when other measures fail. However, due to increasing resistance of lice to this medication and to serious neurological side effects, lindane is no longer recommended as a first line treatment for head lice.

Body lice

If you have body lice, you don't need treatment. However, you must take the same self-care measures, such as treating clothing and other items, as you would for head lice. If self-care measures fail to get rid of the lice, your doctor might recommend trying one of the nonprescription or prescription treatments for head lice.

Pubic lice

Pubic lice can be treated with many of the same nonprescription and prescription treatments used for head lice. Carefully follow the package instructions. Talk to your doctor about treatment of lice and nits on eyebrows or eyelashes.

Self-care important

Whether you use over-the-counter or prescription shampoo to kill lice, much of the treatment involves self-care steps you can take at home. These include making sure all the nits are removed and that all clothing, bedding, personal items and furniture are decontaminated. In most cases, killing lice on your body isn't difficult. The challenge is getting rid of all the nits and avoiding contact with other lice at home or school.

Mar. 28, 2015

You Are ... The Campaign for Mayo Clinic

Mayo Clinic is a not-for-profit organization. Make a difference today.