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Treating Head Lice Infestations
- Nit removal is the key -
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Summary: Head lice infestations can be eliminated by careful nit removal and treatment of live lice with medicated shampoos or rinses. Treatment failures can often be traced to incomplete nit removal.
Jack DeAngelis, PhD
OSU Ext. Entomologist (ret.)
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 Head lice
treatment is debated by parents, teachers and health care providers.
There are many things that almost everyone agrees on but also a few
things that are disputed. See the main head lice page for background information.
(Almost) everyone agrees that ...
(1) Head lice don't live long off their host so it is not necessary to excessively clean the house, bedding and clothing. (2) Control efforts must include nit (egg) removal with a proper metal-tined comb. Many believe that nit removal is the single most important part of any head lice control program. (3) Products containing the insecticide lindane should never be used for head lice. (4) You should never treat hair with harsh chemicals or treat and wrap hair for long periods.
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human louse about 2 mm long
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Still disputed by some ...
Whether or not "no-nit-policies" in schools are effective. More people are coming around to the idea that these policies are not effective and may even be damaging.
Whether or not head lice are resistant to permethrin, the medication in products like Nix.
Whether or not shampoos and lotions containing insecticidal medications are safe.
Whether or not alternative head lice treatments are useful.
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Our opinions ...
We do not support the use of no nit policies in schools. Our reasons are detailed here.
Resistance - Based on peer-reviewed scientific studies from 1999-2002, some head lice populations in the US show resistance to permethrin. Some may even exhibit a level of resistance that will prevent control with these products alone. While some resistance has been identified not every population exhibits this characteristic. With a newly confirmed infestation the first choice for treatment should still be one of the over-the-counter (OTC) shampoos containing permethrin or pyrethrum. Follow treatment instructions carefully.
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Insecticides vs. alternatives - Everyone will decide for themselves if the use of insecticide-based shampoos or lotions is safe and warranted. Our position is, and testing confirms, that these products can be safely used. However, do not use products containing lindane as safer materials are available.
Anything can be made unsafe if used improperly, or to excess. The
greatest danger is when one believes that "if a little is good, more
must be better". Use products only as directed by the label.
If you do decide to try one of the alternative, non-traditional products, don't assume that "alternative" means non-toxic. There has been very little formal testing of the many alternative treatments for head lice. Oil or hair conditioner-based approaches probably work by improving the efficacy of nit combing. It is important that good metal lice combs are used. Products
containing essential oils probably help with nit combing as well.
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| Related information: [CDC Head Lice Information], [Human Lice Guide (pdf)] |
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| | Mission:
To provide accurate, up-to-date and unbiased information for solving
common insect and mite problems around your home, business and
landscape using least-toxic methods.
Jack DeAngelis, Ph.D.
Please
see the Disclaimer statements as well (sorry, but these really are necessary).
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