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Head Lice Treatment Myths & Realities

When your child has been diagnosed with head lice, you want to get rid of them quickly—and effectively. But, you may not be aware of all available treatments.

Read on to find out what's true—and false—about current treatment options.

True or false?

Over-the-counter (OTC) head lice treatments sometimes are not the most effective.

  • True. Here's why: Head lice can be resistant to the active ingredients in over the counter (OTC) treatments in some communities. These are the ones you can buy in the store without a prescription. If head lice are resistant it means the treatments may not kill them. The likelihood of resistance varies across the country. Your pediatrician can help you choose an appropriate treatment option for your child.

Prescription treatments always cost more than OTC treatments.

  • False. Here's why: Parents sometimes treat their children with OTC treatments up to 5 times before seeking help from their pediatrician. You should consider the cost of potential multiple treatments. That said, though, prescription medications are usually more expensive to purchase and may not always be covered by health insurance. So, it is a good idea to check your coverage when you are making your decision.

All head lice treatments call for 2 applications.

  • False. Here's why: Several prescription treatments suggest using only 1 application. Sometimes, a third treatment is needed if live lice persist following the second treatment.

Prescription head lice treatments involve being left on the scalp and hair for 8 to 12 hours.

  • False. Here's why: Some prescription products have application times as short as 10 minutes followed by a simple rinse with water. That is why it is essential for parents to read and follow manufacturer instructions exactly as written.

All head lice treatments instruct users to nit comb.

  • False. Here's why: There are some prescription products that don't call for nit combing. Nits are lice eggs. Even when nit combing is not required to get rid of an infestation, you may choose to comb out nits while hair is wet with a fine-tooth comb. Removing nits may help to decrease embarrassment to your child or teen, as well as eliminate potential conflicts with school officials that you have not treated your child.

Due to stronger ingredients, prescription head lice treatments should only be used as a last resort.

  • False. Here's why: Prescription medications have different active ingredients than the OTC products and may need to be used in the initial treatment of head lice in some communities based upon local resistance patterns. Many newer prescription treatments can be used safely when prescribed by a pediatrician and carefully applied according to instructions. Several prescription treatments are safe to use on children as young as 6 months of age.

Home remedies to treat head lice are safe and effective.

  • False. Here's why: Mayonnaise, olive oil, margarine, butter and similar home "remedies" have not been proven as effective head lice treatments. Substances like gasoline or kerosene have not been clinically proven—plus, they are flammable, carrying substantial risk. When your child has head lice, it is best to call your pediatrician before treatment. Like any other health concerns you have about your child, consulting your pediatrician first can help you decide whether an OTC or prescription treatment is best for your child.

Once I apply lice treatment, it is ok to place a shower cap or plastic bag on my child's head and leave my child alone until the treatment is complete.

  • False. Here's why: It is dangerous to place anything made of plastic on a child's head because it sends a message that it is ok for them to do when you may not be around. If left unattended a child might fall asleep with the plastic bag on their head, and it could slip over their nose or mouth and suffocate them. While treating for head lice can be an annoyance, it can also be "found" time for a parent and child to spend quiet time together and bond during a close and caring encounter. Similarly, a child should never be left unattended with any wet chemicals on their head to avoid the chemicals dripping into the eye.

More Information:

Last Updated
American Academy of Pediatrics (Copyright © 2022)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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