When you discover lice, you want them gone immediately. The itching is unbearable. The insects are unsightly. An infestation can be embarrassing for older children and teenagers, and you want to make sure they don’t spread to other friends and family members.
Lice removal is always urgent, but it can also be a little confusing. You may get conflicting advice about treatments and removal options, and you don’t know which medication is best.
The good news is that in-home lice removal is easy once you have the right information and a few simple steps to follow.
1. Don’t panic.
Head lice is not all that uncommon—especially in Caucasian children—and it’s really not scary. Lice don’t carry disease, and they’re not an indicator of poor hygiene. Lice are just as likely to live in clean hair as dirty hair.
Many people think that adults can’t get lice, or that BIPOC individuals (children included) can’t get lice, but these are nothing more than common myths. Black people are less likely to get lice because of the texture of their hair, and adults are less likely to get lice because of personal behaviors, but anyone with hair can get lice.
2. Know your enemy.
Effective lice removal starts with understanding how lice spread and how they live.
How Lice Spread (and Don’t Spread)
Head lice are most commonly spread by head to head contact or hair to hair contact, which happens when hugging or crowding around a smartphone, toy, or computer screen. They can spread by sharing personal items like hats or combs, but lice don’t survive long off a host, so it is very uncommon.
The head lice that infest humans don’t live on cats or dogs either. That means they didn’t come from your pets, and they won’t spread to your pets.
Head Lice Life Cycle
Lice attach eggs (called nits) to the base of the hair follicle, near the scalp. The lice eggs need to be very close to the scalp in order to absorb enough heat to survive. Many lice nits die without hatching, because they don’t get the heat they need to fully develop. Lice eggs that do live, hatch after about six to nine days.
When nymphs hatch, the casing (empty egg shell) turns yellow and remains attached to the hair. Nymphs become adult lice in about a week.
Adult lice can live on a host for about a month. They feed on the host’s blood several times each day, and will die within one or two days if removed from the host.
3. Survey the damage.
Before you start hair lice removal treatments, check the rest of the family and consider informing the families of your child’s close friends.
In most cases, lice have to become relatively abundant in order to be discovered, which means they’ve been around for a few days. Check each family member’s hair and scalp to be sure no one else in the family has lice, and call the families of close friends so they can check their children’s hair as well.
4. Consider medication and other lice treatment options.
Many salons offer professional lice removal services, but in-home lice removal is simple. There are two types of lice removal medication: over-the-counter treatments and prescription medications. These treatments are available as lotions, shampoos, cream rinses, and evaporation treatments.
Some OTC shampoos and rinses are sometimes less effective than prescription treatments, but they are also more readily available. It can take a day or two to get a prescription and get it filled. OTC medications and treatments, on the other hand, can even be purchased ahead of time so you have them when you need them.
5. Review OTC treatment ingredients.
Most OTC lice removal medications use one of two main ingredients. It’s a good idea to learn about the options ahead of time, so you can decide on the best lice removal method for your family ahead of time.
- Pyrethrins is an extract from the chrysanthemum flower. It’s safe on children aged two years and older—unless the individual is allergic to chrysanthemums or ragweed (allergic reactions are rare). Pyrethrins kill live lice, so another treatment is required after about a week, to kill additional lice that may have hatched since the first treatment.
- Permethrin lotion is a synthetic pyrethrin, safe on children two months and older. It kills lice and kills nits, but normal hair products dilute its effectiveness. A second treatment is usually recommended about a week after the first treatment.
A third OTC lice removal treatment option is the Novokid lice removal kit, which uses only 100% natural, plant-based ingredients:
- Vinegar and rosemary oil applied as a dry vapor is the only head lice treatment free from chemicals, pesticides, and silicone, that is scientifically proven as an effective lice treatment.
6. Start with an OTC lice removal treatment.
Most families start with over-the-counter lice removal products, because it’s quicker to get—or because they already have it on-hand. Be sure to read the directions for any treatment thoroughly before beginning, and apply as directed. Follow up with the recommended second (and third, if applicable) treatment at the right time.
Lice Removal FAQs
Discovering head lice isn’t really scary and removing lice at home isn’t that hard. Many parents, however, still have some lingering questions.
What if it didn’t work?
There are two reasons an OTC lice removal treatment may not work. The first is user error. Parents often try to stretch medications, shorten waiting times, or skip additional treatments, and any of these could cause the treatment to be ineffective.
The second reason is, unfortunately, that head lice seem to be growing more resistant to common pyrethrins-based (natural or synthetic) medications. In those cases, a different option, like evaporation treatments or a prescription medication, may be necessary.
Do I have to comb out all the lice nits?
This is another common myth, but remember that many nits are not viable and many more are actually empty casings. Some people find that using a special lice comb, such as a fine toothed comb to remove every nit and casing helps them feel more assured that the problem is over, but it is not medically necessary.
Do other traditional home remedies for lice removal really work?
There are proponents of head lice treatments that include “smothering” the lice with oil or cream before using a lice comb to remove every lice and nit. There are also claims about a variety of essential oils (such as tea tree oil), but these treatment suggestions also involve thorough combing.
If these treatments are effective, it likely has more to do with the combing. There is some anecdotal evidence that these natural, “smothering” methods are effective, but more testing is required to scientifically prove they are reliable options.
How do I know if I have lice?
The first sign of head lice, for most people, is an itchy scalp. Pulling the hair apart in sections will provide a view of the scalp to confirm the presence of lice. If you look closely, you will be able to see lice on the scalp and hair follicles, and lice nits attached near the base of the hair.
Getting Started with Lice Removal
If you or a family member has head lice, you want to act quickly. It’s important to remember that while head lice are a little creepy, they’re not dangerous and they’re not a sign of bad hygiene. They also don’t spread as easily as some people think, although it’s a good idea to check other family members just in case.
Your first step—whether you’re dealing with head lice now, or wanting to be prepared for the future—is to decide which OTC treatment to start with. If your children are younger than two years old, you might want to keep a permethrin lotion in your cabinets.
If your kids are older, consider a natural, dry treatment like Novokid to treat head lice. The 10-minute application is 100% natural, but just as effective as any other OTC lice removal solution.
Jennifer Andreoli is a New York Times bestselling author. She was born and raised in the Bronx and was a bookseller before shifting to children’s publishing and copywriting. She’s worked at a literary development company and a creative writing website for teens and as a book reviewer of children’s and young adult novels. She loves long walks on the beach and traveling to exotic locales and lives in Los Angeles. When she isn’t reading or writing great stories, she’s probably singing or watching racy shows on Netflix.