Children's Health

There are both over-the-counter medicines and prescription products to treat head lice and pubic lice. Most products come as a shampoo, creme rinse, or lotion (topical treatment) that is applied to the affected areas, left on for a period of time, and then rinsed off. Doctors sometimes prescribe a pill to treat lice when two or more approved topical medicines have not worked.

Permethrin 1% creme rinse (such as Nix) is a common first method of treating lice. It is safe and effective and continues to kill lice and their eggs (nits) even after the cream has been rinsed off. This product is available without a prescription.

When treating lice with medicine, keep in mind:

• A second treatment 7 to 10 days after the first treatment is usually recommended to ensure that any newly hatched lice are also killed.
• Itching may persist even after successful treatment. Do not reapply medicated products unless you are advised to do so by a doctor. Excess use of these products may increase the risk of negative side effects such as nausea, headaches, or more serious side effects.

If lice infest the eyelashes, applying petroleum jelly (such as Vaseline) to the eyelashes several times a day for a week can kill the lice.

Because body lice live in clothing, not on the body, drugs are generally not needed unless the person is severely infested. The most common way to kill body lice and eggs is to wash clothing and bedding in hot water [130�F (54.44�C) or higher] in a washing machine.

Medication Choices

Over-the-counter products for head or pubic lice

• Permethrin creme rinse 1% (such as Nix) is a common first choice for treating head lice. It kills lice and their eggs for 2 weeks or more after it has been rinsed off.
• Shampoos containing pyrethrins and piperonyl butoxide (such as A-200, Pronto, Rid) are left on the hair for 10 minutes and then rinsed out. A second treatment is needed 1 week after the first to kill newly hatched lice.

Check the product label. Be sure to follow the directions about proper use and safety. And talk to your doctor or pharmacist about whether these products are safe for young children.

Prescription products for head or pubic lice

• Permethrin cream 5% (Elimite) is used to treat head lice or pubic lice. It is applied to the skin or scalp, left on for 8 to 14 hours, and then rinsed off.
• Malathion lotion (Ovide) is used to treat head lice. It is applied to hair on the head, left on for 8 to 12 hours, then rinsed off. If lice are still present 7 to 9 days later, a second treatment must be done.
• Benzyl alcohol 5% (Ulesfia) is used to treat head lice. It is applied to the hair on the head, left on for 10 minutes, and then rinsed off.
• Spinosad (Natroba) is used to treat head lice. It is applied to the hair on the head, left on for 10 minutes, and then rinsed off.
• Lindane shampoo is used to treat head lice or pubic lice. It should only be used when other products fail to get rid of lice or when a person cannot use any of the other products. Lindane contains potentially harmful toxins that can cause negative side effects when it is not used properly.