Lice Treatments: Explained

Back to school means head lice season

(RxWiki News) Back to school may often mean head lice season.As your kids get ready to start a new school year and as fall approaches, children may be more likely to come into contact with head lice.

Here is what you need to know:

Lice can be treated at home with over-the-counter (OTC) medication or with a prescription. 


1. Piperonyl butoxide with pyrethrins. These can be found under the brand names: A-200, Pronto, R&C, Rid and Triple X.

Note: Pyrethrins are made from the chrysanthemum flower. This said, these options are not recommended if you have an allergy to chrysanthemums (mums) or ragweed. These treatment options are approved for kids 2 years old and older.

2. Permethrin lotion 1% (Nix). This is approved in kids 2 months and older.

3. Ivermectin (Sklice). This was available only by prescription until fall of 2020 when it made the switch from prescription to OTC. This product is approved for children ages 6 months and older. 

Prescription Treatments:

  1. Malathion (Ovide). It is approved for kids 6 years and older. 
  2. Spinosad (Natroba). It is approved for kids 6 months and older.
  3. Ivermectin (Stromectol). This is an oral medication that may be an option when other treatments fail. 
  4. Lindane shampoo. Although this medication is FDA-approved to treat lice, the American Academy of Pediatrics AAP no longer recommends Lindane shampoo because it has been linked to nervous system damage.

When treating lice at home, a few things to remember:

  1. Always carefully read and follow the directions on the label. 
  2. Only use only one product at a time. 
  3. Never apply more than what the labels says to apply unless instructed to do so by your physician or pharmacist.
  4. If the product comes with a comb, use the lice comb. This is because the teeth on a lice comb are closer together than the teeth on a regular comb which makes it easier to remove the lice and their nits.
  5. In order to limit skin exposure, the AAP recommends rinsing all topical lice medication from the hair over a sink versus in the shower or bath. Furthermore, the AAP recommends using warm water rather than hot water to minimize the absorption.
  6. Do not use the same medication to retreat more than 2–3 times if it does not seem to be working. Speak with your health care provider or pharmacist if this is the case. 
  7. Apply the medication only to the scalp and the hair attached to the scalp and do not apply to other body parts/hair.