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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 newer prescription treatment for head lice. You apply the lotion to the scalp and hair for 10 minutes and then rinse it 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.

    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 the same nonprescription and prescription treatments used for head lice.

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.

Lifestyle and home remedies Tests and diagnosis
References
  1. Head lice: Frequently asked questions. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/lice/head/gen_info/faqs.html. Accessed Feb. 14, 2012.
  2. Body lice: Frequently asked questions. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/lice/body/gen_info/faqs.html. Accessed Feb. 14, 2012.
  3. Pubic "crab" lice: Frequently asked questions. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/lice/pubic/gen_info/faqs.html. Accessed Feb. 14, 2012.
  4. Mandell GL, et al. Mandell, Douglas, and Bennett's Priciples and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2010. http://www.mdconsult.com/book/player/linkTo?type=bookPage&isbn=978-0-443-06839-3&eid=4-u1.0-B978-0-443-06839-3..00293-9. Accessed Jan. 20, 2010.
  5. Goldstein AO, et al. Pediculosis capitis. http://www.uptodate.com/index. Accessed Feb. 16, 2012.
  6. Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=2898131. Accessed Feb. 17, 2012.
  7. Burkhart CN, et al. Fomite transmission in head lice. Journal of the American Academy of Dermatology. 2007;56:1044.
  8. Head lice: Treatment. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/lice/head/treatment.html. Accessed Feb. 14, 2012.
  9. Body lice: Treatment. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/lice/body/treatment.html. Accessed Feb. 14, 2012.
  10. Pubic "crab" lice: Treatment. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/lice/pubic/treatment.html. Accessed Feb. 14, 2012.
  11. Mumcuoglu KY, et al. Repellency of citronella for head lice: Double-blind randomized trial of efficacy and safety. Israel Medical Association Journal. 2004;6:756.
  12. Semmler M, et al. Repellency against head lice (Pediculus humanus capitis). Parasitology Research. 2010;106:729.
  13. Frankowski BL, et al. Head lice. Pediatrics. 2010;126:392.
DS00368 May 22, 2012

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