Use drugs that treat lice only as directed. Applying too much can cause red, irritated skin.
Head lice
Head lice treatment may involve:
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Nonprescription products. Shampoos containing permethrin (Nix) are usually the first option used to combat lice. Permethrin is a synthetic version of pyrethrin, which is a chemical compound extracted from the chrysanthemum flower. Permethrin is toxic to lice. Follow the directions closely when using this product.
A lotion containing ivermectin (Sklice) also is available without a prescription. Ivermectin is toxic to lice. The lotion is approved for use in adults and children age 6 months or older. You can apply it once to dry hair and then rinse with water after 10 minutes.
Don't repeat the ivermectin treatment without talking to your health care provider first. Possible side effects include eye irritation or redness, dandruff, dry skin, and a burning sensation at the application site.
In some locations, lice have grown resistant to the ingredients in nonprescription treatments. If nonprescription treatments don't work, your health care provider can prescribe shampoos or lotions that contain different ingredients.
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Oral prescription drug. Ivermectin (Stromectol) is available by prescription as a tablet taken by mouth. The oral drug effectively treats lice with two doses, eight days apart. This drug is typically used when other treatments haven't been effective.
Children must weigh at least 33 pounds (15 kilograms) to take oral ivermectin. Side effects may include nausea and vomiting.
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Topical prescription drugs. Malathion is a prescription drug that you apply to the hair and then rub into the hair and scalp. Malathion has a high alcohol content and is flammable. So keep it away from heat sources such as hair dryers, electric curlers and cigarettes.
If you're pregnant or breastfeeding, talk to your health care provider before using this drug. The drug isn't recommended for children 2 and under. It's not clear if it's safe for use in 2- to 6-year-olds.
Spinosad (Natroba) is a newer prescription treatment for head lice. You can apply it to dry hair and the scalp for 10 minutes and then rinse with water. The treatment doesn't usually need to be repeated. But it can be used again after seven days if live lice are still present.
Possible side effects of spinosad include redness or irritation of the eyes and skin. This drug isn't recommended for children younger than age 4.
Body lice
If you have body lice, first bathe with soap and water. After bathing, apply permethrin (Nix) to the affected areas before bedtime and then shower in the morning. Repeat this treatment nine days after the first application.
Also take other measures to get rid of body lice. Wash clothing and bedding with hot, soapy water — at least 130 F (54 C) — and dry them at high heat for at least 20 minutes. Vacuum the floors and furniture. And seal unwashable items in an airtight bag for two weeks.
Pubic lice
Pubic lice can be treated with many of the same nonprescription and prescription treatments used for head lice. Carefully follow the package instructions. Talk to your health care provider about treatment of lice and nits on eyebrows or eyelashes.
Self-care
Whether you use nonprescription or prescription shampoo to kill lice, much of the treatment involves self-care steps you can take at home. These include making sure all the nits are removed and that all clothing, bedding, personal items and furniture are free of lice.
In most cases, killing lice that are on you isn't difficult. The challenge is getting rid of all the nits and avoiding contact with other lice at home or school.