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Medications for Head Lice

Over-the-Counter Medications for Head Lice

Many head lice medications are available at your local drugstore. Each over-the-counter product contains one of the following active ingredients:
 
  • Pyrethrin
  • Permethrin.
     
Pyrethrin
Pyrethrins are natural extracts from the chrysanthemum flower. Although safe and effective, pyrethrins only kill crawling lice, not unhatched nits (eggs). A second treatment is recommended in 7 to 10 days to kill any newly hatched lice. Treatment failures are common.
 
Recommendations to keep in mind when using this type of head lice treatment include the following:
 
  • Always carefully follow the instructions on any head lice treatment product.
     
  • If you see lice moving 10 minutes after the treatment, don't assume the treatment didn't work. It may take up to 20 minutes after a treatment for lice to die.
     
  • Using treatment products more often than recommended can cause serious side effects. Remember, these are pesticides!
     
  • One treatment will not kill all of the lice. You must continue to check the hair and pick the nits (see How to Get Rid of Head Lice). Do not reapply any pesticide product for at least seven days after the first treatment.
     
  • Most of these products can be bought as a package with a lice spray. However, evidence shows that lice sprays are not effective in killing lice or nits. They will only put poisons into the air. Save your money and avoid these products. Instead, pick the nits!
     
Brand-name pyrethrin shampoos include:
 
  • Rid®
  • A-200®
  • Clear®
  • R&C®.
     
Brand-name pyrethrin cream rinses include:
 
  • Pronto®
  • End Lice®.
     
Permethrin
Permethrins are similar to natural pyrethrins. They are safe and effective, and may continue to kill newly hatched lice for several days after treatment. A second treatment may be necessary in 7 to 10 days to kill any newly hatched lice that may have hatched after residual medication from the first treatment was no longer active. Treatment failures are common.
 
Suggestions to keep in mind when using this type of head lice treatment include the following:
 
  • Permethrins are the treatment of choice by the Centers for Disease Control (CDC), although they report that treatment failure is common.
     
  • Always carefully follow the instructions on any head lice treatment product.
     
  • Do not shampoo the head for at least 24 hours after treatment.
     
  • Do not reapply any pesticide product for at least seven days after the first treatment. Using treatment products more frequently than recommended can cause serious side effects. Remember, these are pesticides!
     
  • Use only a baby shampoo or a regular shampoo without conditioner for two weeks after the lice treatment. Do not use hair coloring, mousse, gel, or hairspray for at least two weeks after lice treatment.
     
  • When using Nix®, use the entire 2-ounce bottle. If the person has extremely short hair, use only half the bottle. If the person has long hair, use one and a half to two bottles.
     
Brand-name products include Nix, which has 1 percent permethrin. Elimite™ is available by prescription only. It has 5 percent permethrin.
 
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About Head Lice

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