How to Get Rid of Head Lice: Treatments That Actually Work

A photo from my memories popped up on my phone the other day, and my immediate thought was, “Eww, that’s when my three kids all had lice.”

The telltale sign in the picture was my son’s shaved head. At the time, he was 10 years old, and in a desperate attempt to end the itching, he asked his dad to buzz it all off. But it didn't work. In fact, it felt like nothing worked.

Unlike their brother, my daughters didn’t want to cut their long hair, which meant I spent hours every night “nitpicking.” I later learned that’s where the word comes from: the tedious task of pulling lice eggs, or nits, out of your hair. My head feels itchy just thinking about it.

After weeks of combing, picking, and trying every home remedy, including pouring olive oil on their hair, I finally called their pediatrician. She prescribed a special shampoo. No luck. Then she prescribed a stronger one that wasn’t covered by insurance, and finally, we were rid of the lice.

My husband and I never got lice, which was shocking, especially since the bugs lived among us for about two months.

Even though the Centers for Disease Control (CDC) estimates that 6 to 12 million lice infestations occur every year among children ages 3 to 11, there are plenty of myths and confusion about this common childhood problem.

Here, we separate fact from fiction and share expert advice on how to get rid of head lice.

Types of lice

“There are three types of lice, and the confusion usually comes from mixing them up,” says Dr. Jill Roberts, a professor and molecular epidemiology expert at the University of South Florida College of Public Health.

Roberts explains that the three types are head lice, pubic lice (crabs), and body lice. Body lice are rare, but they can carry and spread infectious diseases. Head and pubic lice, on the other hand, are common and harmless, aside from causing a really annoying itch. My kids had head lice, which is also the type children typically get.

Even though lice don’t notice the seasons, human behavior causes cases to increase during back-to-school and over winter, when kids are in close contact.

Myths about lice

The most common myth about head lice is that having them means you have dirty or unkempt hair.

“A person could wash their hair 10 times a day, and the process of shampoo would not remove the problem [of lice],” says Dr. Christy Rivers, a pediatrician at New Way Pediatrics in Oregon.

"Head-to-head contact is common in younger children and is not a sign of uncleanliness." — Dr. Jill Roberts

Roberts agrees, pointing out that it’s about proximity, not hygiene. “Head-to-head contact is common in younger children and is not a sign of uncleanliness," she adds.

Other misconceptions are that lice can fly or transmit diseases. “Lice do not jump or fly from person to person,” says Dr. Rivers. “They can only crawl.” She adds that they don’t carry diseases, and they only spread through direct contact with other humans, not from pets or other animals.

How to get rid of head lice

It may be necessary to try several different treatments to get rid of head lice, as I learned the hard way. A good place to start is with over-the-counter products from your local pharmacy.

“The AAP [American Academy of Pediatrics] recommends over-the-counter topical products to treat lice that contain permethrin or pyrethrins,” says Dr. Lyndsey Garbi, the co-founder and chief medical officer at Blueberry Pediatrics in New York City.

Sometimes, though, that doesn’t solve the problem. “Unfortunately, there are many areas where lice are resistant to the first-line chemical medication, which is over-the-counter permethrin 1% shampoo,” says Dr. Rivers. “If lice persist, the person may need a prescription for a stronger topical or oral medication.”

Even though it’s tedious, it’s important to keep combing in addition to using the shampoo. “Combing the hair out with a specialized comb to get rid of the eggs is important because the hair products don’t reliably kill the eggs,” says Dr. Garbi. For best results, a specialized metal-toothed lice comb scrapes the glued-on eggs off the hair.

While you’re trying to get rid of the lice, it can feel like a never-ending, lonely task. But there are lots of other people who have struggled with it.

“Lice is a rite of passage,” says Dr. Garbi. “If you are never impacted by it, you’re just lucky.”

…..

Thankfully, that’s all a distant memory now since my three kids will all be at college this fall. But anytime I hear someone use the word “nitpick,” I can’t help but scratch my head.