Head lice are very small insects that live on the human scalp and feed on blood. They multiply quickly, and most infestations aren’t caught for several weeks. By the time the itching becomes a cause for concern and the bugs are discovered, there are probably a good number of both live insects and eggs waiting to hatch.
But if you ask a dozen people, or Google a dozen questions, you’ll probably get a dozen opinions on which lice treatment to use and which are just old wives tales.
The truth is, there are several treatment options that work and several that are nothing more than popular rumors. Here are the best lice treatments (tested and proven) and the ones you should avoid.
1. Best overall lice treatment: Dry vapor treatments
Dry vapor treatments for head lice use a hair cap and a small vaporizer to transform an all-natural head lice treatment solution into steam. The short treatment can be applied to dry hair to kill adult lice and loosen nits (lice eggs) from where they are attached to hair follicles.
The vapor treatments are scientifically proven to be effective for treating head lice and are extremely simple (and tidy) to administer. Lice and eggs can be combed out after the treatment with a lice comb.
2. Best lice comb: Nit Free Terminator Lice Comb
There are several different styles and brands of lice comb on the market—from the classic circle-handle to electric, vacuum combs.
Lice combs can, theoretically, be used as a treatment option on their own, if you are really dedicated to the task of combing out every last insect and almost-microscopic nit. But adult lice run away, and they’re not easy to catch. It is much easier to use a lice comb in conjunction with another treatment option that kills or immobilizes lice and loosens nits.
Most other types of lice treatment will recommend combing after each application as well. So whether you’re just using a comb, or using a comb with a vapor, shampoo, etc., it’s important to get a good one.
Our review of the top five lice combs landed on a traditional style from a trusted brand as the very best: the Nit Free Terminator Lice Comb.
This comb features the typical lice comb teeth—extremely close together and stainless steel for easy cleaning. Unlike some other lice combs, though, the Nit Free comb has micro-grooved teeth. Those grooves give the comb a much finer grip, so it can gently scrape each individual hair.
3. Olive Oil
Olive oil is frequently used to suffocate adolescent and adult head lice. It also makes the hair extremely oily, which can help a lice comb move through it. Olive oil has been proven to be one of the most effective home remedies for treating head lice.
The difficulty with olive oil—as with most smothering methods—is that it is very difficult to wash out of the hair afterwards.
4. Essential oils: Rosemary, Anise
Love or hate essential oils, there is no denying that at least a couple are actually effective against head lice.
- Rosemary oil has been proven to be as effective or more effective than traditional OTC lice treatments, and it helps soothe irritated skin.
- Anise oil has been tested in conjunction with olive oil and proven effective at killing live lice.
For more details on how to use essential oils as a head lice treatment, see “Home Remedies for Head Lice.” →
5. Coconut oil
Similarly to olive oil, coconut oil is used to smother lice before they are combed out. When compared to over-the-counter head lice medications, coconut oil proved just as effective at killing lice as drug store products.
As with olive oil, the challenge of coconut oil is cleanup.
6. Over-the-counter shampoos and creams
There are several popular brand names in OTC lice removal products. Many of these lice treatments worked remarkably well for decades, and in some cases they still do.
But the truth is, their effectiveness is waning. Most of the head lice strains in the U.S., and throughout the West, have developed a resistance to the active ingredients in these products—namely permethrin and pyrethrin. These insects are known as super lice, and they are responsible for about 98% of the head lice cases in the U.S.
If the strain of lice that you are battling is not resistant to these medications, the drug store lice treatments will work very well. Just be sure to follow the directions exactly, comb out insects and nits afterwards, and repeat again as directed.
The challenge with OTC treatments is that you never know if you’re dealing with resistant lice until after the treatments have failed—which is at least one week after you first started. Further, many parents have concerns about the toxicity of the chemicals being applied to their childrens’ scalps.
7. Hair dryer
It may sound silly, but hot air can be an effective head lice treatment, if it’s done right. One study tested six types of dryers on children with head lice, for 30 minutes, and found them 89 to 98% effective at killing nits and up to 80% effective at killing live lice.
Caregivers, of course, need to be mindful of the child’s comfort level—those with sensitive scalps may not be able to sit under the heat for 30 minutes. Lice and nits still need to be combed out after blow drying.
8. Prescription head lice treatments
Your family practitioner or pediatrician can write a prescription for a stronger head lice medication, with active ingredients more effective than permethrin and pyrethrin. These are still good options against strains of super lice.
The challenge with prescriptions is that you have to get in to see your physician and no one wants to wait even a day to start treatment on a head lice infestation. Additionally, some families prefer more natural treatment options.
Contrary to popular belief, vinegar has not been proven to kill lice, however, apple cider vinegar has been demonstrated effective at dissolving the “glue” that keeps nits cemented to hair follicles. This makes them much easier to comb out.
Most lice treatments—natural or drug store treatments—make no claim to kill nits. That’s why second applications are almost always recommended. Further, nits are cemented pretty well to hair shafts. Even with a good lice comb, they can be difficult to scrape off.
That’s why vinegar is commonly used as one part of a natural treatment for head lice, in addition to whatever you decide to use to kill adult lice.
(Note: Vinegar is a key ingredient in the Novokid vapor treatment formula, so no additional treatment is necessary to help remove nits.)
Four “Lice Treatments” That Don’t Actually Work
Head lice are not a new problem, and people have been inventing ways to “treat” them for a long, long time. Many of these rumored treatments still get passed down, and some of them almost seem to make sense.
But these lice treatments have either never been reliable or have been proven ineffective, so don’t waste time and money on them.
Ineffective: Drowning Lice
You may have heard that you can soak the scalp in a warm bath to drown lice, but this isn’t true. In fact, one study actually demonstrated that 100% of head lice survived up to six hours of water submersion and half survived underwater for 24 hours!
Ineffective: Petroleum Jelly
Olive oil and coconut oil have proven effective for smothering lice, but studies on petroleum jelly are inconclusive.
Worse, petroleum jelly is extremely thick and oily, which makes cleaning it out of hair a nightmare. Even if it did work, there are so many other good options that it’s not worth the cleanup.
Mayonnaise as a head lice treatment is another common misconception based on the fact that it is thick and oily. Similar to petroleum jelly, however, it has never been proven effective, and it’s almost as impossible to clean up.
Ineffective: Plastic Wrap
Many unproven smothering techniques also recommend wrapping the scalp in plastic overnight. The hope is that the smothering agent and the plastic combined will suffocate the head lice, since it can take hours.
There are two problems with this theory, though. The first is that it is extremely dangerous. Never send a child to bed with plastic wrapped around their head. These wraps or bags can loosen as the child moves in the night and become a serious suffocation hazard.
Second, even an overnight smothering isn’t long enough to kill most of the lice. Studies have concluded that it takes 16 hours of oxygen deprivation to effectively kill lice.
Additional Lice Treatment Considerations
There are a few more options for lice treatments that deserve mention and/or explanation.
Can you get lice professionally removed?
Yes. If you’re squeamish about bugs or just don’t trust your skills with a lice comb, there is probably a lice clinic in your city or a salon that offers delousing services. These clinicians and stylists have experience with how to check for and remove lice.
In some areas there are even delousing services that will come to your home.
What about lindane shampoos?
Lindane is a medication traditionally prescribed to treat head lice and scabies, but it is no longer recommended. In 2003, the FDA issued a statement warning of the neurotoxin effects of lindane, including dizziness, headaches, paresthesia, and even seizures and death. Children are among the groups of people especially susceptible to these side effects.
The FDA now recommends the use of lindane only if other treatments have failed, but with so many other effective applications, it’s not worth the risk.
How to choose the best lice treatment
All of these options means it is sometimes hard to choose. When you or a child has head lice, you want the scratching to end as soon as possible. You don’t want to try a half-dozen options to find the best one.
Here are a few tips for choosing the lice treatment that’s best for your family.
Do you want a natural solution?
The first important consideration is whether or not you have strong feelings about using chemicals or pesticides on your child’s scalp. Some people don’t mind using drug store or prescription medications, while some prefer more natural solutions.
How much time do you have?
Some treatments take longer than others. The hair dryer method, for example, takes at least 30 minutes of heat, and getting a prescription can take days. A vapor treatment, on the other hand, takes only 10 minutes.
How much cleanup do you want to deal with?
Some lice treatments are messier than others. Vapor treatments, for example, work on dry hair, so there’s no showering required—before or after the treatment. Oils, while effective, leave hair greasy and require an additional shower (and sometimes some grease-cutting dish soap) after the treatment.
The Secret of the Best Lice Treatment
The very best lice treatment is the one you have on-hand when you need it. Lice are more active in the dark, and many times an infestation is discovered when a child can’t sleep at night because of an itching, “tickling” feeling on their scalp. Don’t get stuck making a late-night run to the corner store for essential oils, combs, and/or OTC shampoos (that might not work anyway).
Once you’ve decided which lice treatment is best for your family, place an order. Be sure to get a good lice comb too, because every treatment option is better with a thorough combing.
To have an all-natural, scientifically proven vapor treatment on-hand, visit the Novokid shop to compare your options.