It’s back to school time and one of the biggest, grossest part of the entire year is upon us: head lice season. Fresh from adventures around the world, the children all culminate in one single place – school – and they pass head lice around like a note. What should you do? And what are best head lice products that have the safest ingredients? You’ve trusted Mamavation to bring you topics like safest sunscreens, safest bug sprays, and safest cookware, now join us as we bring you something that’s going to make you feel itchy–head lice.
What Are Head Lice?
For those of you blissfully unaware, head lice are incredibly common – almost a rite of passage – among children from preschool to elementary age and the families that love them. Head lice or Pediculus humanus capitis while disgusting parasites that feed on blood, are a parasitic insect that can be found on the head, eyebrows, and eyelashes of people who have shared a space with another infested person, are yet not known to carry disease.
While lice do feed on human blood at least three times a day and haven’t been linked to any diseases, however, researchers at the National Institute of Health are beginning to believe that the sores developed from scratching could potentially cause certain epidemics and endemics of diseases to occur.
Head lice are extremely prevalent, so while infestations may make you feel like you’re disgusting and dirty, know that you are not alone. Up to 12 million cases of head lice occur each year, especially during ages three to eleven, and children blithely pass the head lice around to the whole family.
Some of the signs of a head lice infestation include:
- An allergic reaction to the bites of the head louse can lead to incredible itching
- A feeling of something moving in your hair
- Troubles sleeping – head lice are more active in the dark
- Sores on the head and around the scalp that are caused by your scratching – sometimes these sores become infected (by the bacteria living in your scalp – not the lice)
How Do You Get Infested With Head Lice?
Most lice infestations result form direct head-to-head contact, such as by hugging or sharing a pillow. Within seconds, these lice can crawl from one head to the other and begin colonizing. Some people have reported getting head lice from sharing hats, combs, brushes, headphones, and – more infrequently – from sharing clothing or directly from furniture or carpet. Do remember though, that lice can only survive without a human head for a day or two and nits can only last up to a week without a host.
In the (awful) event that your child’s school (or friend) reports that head lice has been found, inspect your child’s head immediately, as a female louse can easily lay six eggs a day. These eggs are generally found stuck to the hair shaft closest to the head, most often on the back of your child’s next or behind their ears. It takes a month for a child to develop the sensitivity to the saliva of the louse, so you may notice that your child has bugs in their hair, rather than itching complaints. A lot of people mistake a lice infestation as dandruff – but remember this: lice don’t go away after a hair washing.
What To Do If You Find Lice
Okay, so you’ve determined that your kid has lice. Sucks, I’m sorry, but it’s going to get far wilder. Each member of the household must be inspected for signs of lice infestations. While your immediate reaction may include cleaning the crap out of your house, don’t worry too much about doing so, lice do die after a day or two without a host. Instead, determine what your child’s head has touched for the past few days: clothing, bedding, hats, headphones, brushes, combs.
To launder the clothing or bedding touched by your child, wash and dry their clothing and bedding at a temperature above 130 degrees (F) which will kill any nits or lice clinging to them.
For the things that you can’t wash, seal them in a bag for 2 weeks.
How Do You Avoid Lice Infestation?
Prevention is, as they say, worth its weight in gold. There are a number of ways that you can attempt to shield your family from developing a lice infestation, including
- Reminding your child(ren) not to share hats, coats, pillows, combs, or brushes
- Avoid head-to-head contact, such as during sports or at sleepovers
- Wash the bedding/clothing that has been used by the person who has lice at temperatures at least higher than 130 degrees (F)
- Seal up things you can’t wash in airtight packing for at least two weeks, lice do require air to breathe to survive
- Soak combs and brushes in hot water for at least 15 minutes
- Vacuum areas of the house where the infected person has recently been sitting or sleeping
What Are The Life Cycles of Head Lice?
As is the case with parasites, head lice are found in different states and on the scalp, eyebrows, eyelashes of your body. Most types of head lice treatment attempt to kill off the lice by killing its eggs, thus termed “ovacidal.”
There are three types of head lice stages:
- Eggs (also called Nits): Nits are lice eggs that are laid by an adult female head louse, generally located on the hair/skin closest the scalp. Oval shaped and firmly anchored to the hair shaft, Eggs are oval-shaped and extremely small (about the size of a knot in thread) which makes them hard to see. Away from the body, lice nits can appear white or yellow – but live nits occasionally appear to be the same color as the hair of the infested person. This means that these lice eggs can be mistaken for dandruff or scabs. Nits usually take about eight to nine (horrifying) days to hatch – the most likely eggs to hatch (shudders) are the closest to the scalp on a hair shaft.
- The Nymph: Nymphs are young, underdeveloped louse that are hatched from the egg (dying inside). A nymph looks like an adult head louse, but is smaller and must feed on blood for nine to twelve days after hatching to become mature.
- Adult Head Lice: A fully developed adult louse is about the size of a sesame seed, has six (awful) legs, and is tan to grayish-white in color, though in people with darker hair, they may look to be darker. Adult head lice must feed off human blood; if the louse doesn’t feed, within one or two days, it will die. Adult female lice can lay six eggs/nits a day.
What About These “Super Lice?”
Unfortunately, similar to the way nosocomial (hospital-acquired) infections such as MRSA have emerged from overuse of antibiotics, some strains of lice have developed an immunity to some of the over-the-counter (OTC) lice treatments. For over 20 years, head lice treatment has been primarily dependent upon topically-applied insecticides found in commercially available formulations (over-the-counter, or OTC) including the natural pyrethrin esters (pyrethrum) and the synthetic “pyrethroids” (permethrin, phenothrin).
Due to of their widespread and intense in the United States, the lack of suitable alternatives (until recently) resistance to the pyrethrins or pyrethroids is common in lice thanks to a genetic mutation caused by pesticide resistance of these “super” lice.
In a recent study, researchers collected lice from 138 different sites in 48 states. Their findings are frightening: 98 percent of lice collected had genetic mutations that would make them resistant to permethrin and pyrethrin, the active ingredients in Nix and Rid.
The CDC, however, still lists permethrin and pyrethrin as suitable, FDA-approved over-the-counter (OTC) lice treatments.
Okay, How Do You Treat Lice Infestations?
One of the most important things you can do when dealing with a lice infestation is to know your options. There is plenty of treatments for lice out there, but not all of them are as good as another, or both together. Generally, you need to employ a number of treatments at once to find a combination that works for you. Try your hardest not to get discouraged if one remedy doesn’t work and you have to try another.
Here are some guidelines to follow when you’re treating a lice infestation:
- Don’t use more amounts than recommended by your doctor or pharmacist; insecticides are wonderful, but they can be dangerous if not used as the package direction states
- Avoid the eyes when using these products, flush the eyes with water if they get into your eyes
- Call poison control if any products are ingested – just because they’re natural doesn’t mean they’re safe
- If a type of medication isn’t working, call the doctor – they may be able to suggest a different medication
- Don’t use the medication more than two or three times if it’s not working – you could have a super lice infection or may not be using the product correctly.
Avoid using more than one medication to treat head lice at a time unless your doctor and pharmacist agree that you should do so.
There are numerous and sundry types of lice treatments, but the most effective is both simple and non-toxic. No medications are needed for this process. It is, however, important to note that this process is time-consuming and requires a lot of patience.
Hop on over to Amazon, and you’ll see “lice combs” abound and the metal variety are the most effective way to truly get the nits out. One study showed that the Lice Meister brand of metal nit combs are more effective than others, however, other studies haven’t found any particular metal comb is better than the next.
Nitpicking can be performed by you – and in certain areas, you can hire a professional nitpicker or “lice person” to remove the lice from the hair.
So how do you do it?
Grab a bottle of conditioner, which is cheap, or olive oil, which is not, and rub in deeply into your child’s hair. Make sure that you especially get the scalp covered as the area closest to the scalp is the area where lice eggs are found.
Now, you’re going to want to separate your child’s hair into sections. Then use your metal nit comb to comb through each section.
After each time you comb through, wipe the comb with a paper towel and look for lice. Then, continue using a nit comb until you cannot see any more lice – each section may take up to an hour to comb through, depending upon the thickness and length of your child’s hair.
Then, your child can rinse their hair. Be sure to throw the lice comb into hot water (over 130 degrees (F)) for at least fifteen minutes following each session.
This procedure needs to be repeated every three days for at least three weeks. Continue this procedure for two weeks after any combing session that you find an adult louse.
What’s The Deal With Shampoo Shields?
These natural shampoos that claim to repel lice, like Lice Shield or Hair Genies and prevent lice infestations and they are by far the most popular choice among parents of younger children.
Here’s the deal, and I’m sorry to burst your bubble. This evidence is in: these products cannot be used to clear up an active lice infestation.
In fact, even as preventative treatments, these may be effective: in 2014, the FTC (federal trade commission) charged one product – Lice Shield – with false advertising. Its parent company, Lornamead, settled by paying $500,000 and was prohibited from making further deceptive lice prevention claims, per the FTC.
Because most of these lice shield shampoos are labeled as “natural,” the FDA hasn’t done any testing to determine their efficacy. While some of the individual ingredients have been studied, there is simply not enough data to make any claims about the usage of these shampoos.
Additionally, the instructions for these lice prevention products are also not registered, these products may cause more problems than they’re worth. Some of these products may:
- Be toxic and
- Irritate the skin,
- Be flammable
- Damage the lungs if inhaled.
Additionally, these products tend to run between ten and twenty dollars, which is far more expensive than most regular shampoos, especially as these products are to be used regularly.
As of this publishing, there is a need for increased testing of lice shampoo shields and we at Mamavation cannot recommend their use.
Home Remedies For Lice Treatment
Just about everyone you know has some home remedy they swear by for getting rid of lice infestation most commonly suggested “home remedies” (vinegar, isopropyl alcohol, olive oil, mayonnaise, melted butter, and petroleum jelly) are thought to cause the lice to die from asphyxiation. There’s not a ton of research available regarding lice infestation, but what research is available states that these types of home remedies do not work.
Most home remedies didn’t kill lice eggs, despite prolonged exposure. The scientists in this study proved that 100 percent of the tested lice survived 8 hours in a sealed container without oxygen and 6 hours immersed in water; many for far longer. It was discovered that it is extremely challenging to drown lice, even after eight hours in the water – which shows that depriving the lice of oxygen doesn’t work to kill them.
Only the application of petroleum jelly caused significant louse mortality but no treatment prevented lice from laying eggs. Petroleum jelly caused the greatest egg mortality, allowing only 6% to hatch, but this rate is much, much lower than treatment with over-the-counter non-pesticide lice treatments.
Essential Oils As Lice Treatments
One of the emerging thoughts is that certain types of essential oils may helpful as potential natural products for lice control, that can promoting selective effects against resistant insects, and (hopefully) prevent the rapid development of resistance.
Plant-based compounds like flowers bud extract of Syzygium aromaticum, Melia azedarach, lavender oil, eucalyptus oil, lemon tea tree oil, thymol, and geraniol have been thought of as potential lice eradicators based upon their activity against both insects and their eggs and could represent an interesting approach to limit the emergence and the spread of head lice. Further studies are needed.
Tea tree oil is a compound containing the Australian native plant Melaleuca alternifolia. It has well-established quality control procedures and is reported to have a wide variety of biological properties, including antimicrobial, anti-inflammatory, anticancer, and insecticidal activities. Additionally, insecticidal properties may be useful in the treatment of the nits while the repellent effects may protect against reinfestations.
At this a moment, unfortunately, there’s very little research into the efficacy of these products.
Non-Pesticide Over-The-Counter Lice Treatments
With the growing climate of discovering the dangers of pesticides, it’s not surprising that families and companies are looking for alternatives to using other types of head lice treatments on their families. Some of the lice treatments we studied include the following:
- Dimethicone is a group of silicone oils that to immobilize the lice and block the spiracles, thereby causing physiological stress and ultimately death to the lice. The way dimethicone works means that resistance (or Super Lice) are unlikely to develop. These products are not flammable, but treated hair can readily burn if ignited so care should be taken to keep away from naked flames and not to smoke when using them Dimeticone may be more effective at eradicating lice infestation than using products that contain malathion or permethrin, though this statement needs more research.
- Isopropyl myristate and Cyclomethicone causes lice to die by dissolving the waxy coating on the exoskeleton of the louse, which leads to death by dehydration. Similarly, its mechanism of action is unlikely to add to the creation of super lice.
- Carpylylol glycol works to disrupt the cuticle on the louse and causes death by dehydration.
Hot Air Lice Treatments
The newest rage in lice treatments (is there REALLY a rage over lice treatments?) is by using hot air as a means to kill lice, and it may work. Studies have shown that lice and eggs are dried out and died in as little as five minutes after exposure to air that is 122° to 131° F (50° to 55° C).
Unfortunately, one of the major studies utilized was conducted by the makers of an over-the-counter device designed for this purpose.
These machines cost schools and other non-profits up to $3,000, but there are salons located around the US that perform this treatment for about $200-$400 bucks a pop.
However, a more recent study found that children who’d used the hot air treatments killed more lice than those who did not. After a week, about 90% of the kids who’d used the hot air treatment discovered that they had no lice.
Over-The-Counter (OTC) Lice Treatments
The CDC still recommends starting with a pediculicide containing pyrethrins or pyrethroids which are available at your local pharmacy.
Each of the FDA-approved treatment contains one of the following as active ingredients:
- Pyrethrins combined with piperonyl butoxide; (FDA-approved for use on people aged two years and older) These medications are made of naturally-occurring pyrethroid extracts from the chrysanthemum flower and are considered safe and effective by the FDA when used as directed. Pyrethrins can only kill live lice, not unhatched eggs (nits), which means that a second treatment is usually recommended nine to ten days after the first treatment to kill any newly hatched lice before they can produce new eggs.
- Permethrin lotion, 1% (FDA–approved for people age two months and older).Permethrin is a synthetic pyrethroid similar to naturally occurring pyrethrins. A 1% permethrin lotion is approved by the FDA for the treatment of head lice and is safe and effective when used as directed. Permethrin kills live lice but not unhatched eggs and may continue to kill newly hatched lice for several days after treatment. A second treatment may be necessary on day nine to kill any newly hatched lice before they can produce new eggs.
Know this about OTC and prescription ice treatments:
- After rinsing the OTC product from the hair and scalp, you should use a fine-toothed comb or special “nit comb” to remove dead lice and nits. Most lice treatment kits are packaged with a nit comb.
- Be sure to soak the nit comb in water over 130 degrees (F) for 15 minutes after each use
- Apply the product only to the scalp and the hair attached to the scalp – scabies, body lice, is something different and should be treated by your doctor
- Before treating children, talk with your child’s doctor or your pharmacist for recommended treatments based on a child’s age and weight.
- Use the medication exactly as directed on the label and never more often than directed unless advised by your health care professional.
- Use OTC lice treatments on children only under the direct supervision of an adult.
If you choose an OTC or prescription lice treatment, make sure you read all of the directions before you should begin, taking special note of whether or not you need a follow-up treatment. Most of these OTC products don’t kill the lice eggs, you often must follow up with another treatment later to kill any newly-hatched lice.
Prescription Medications To Treat Lice
The FDA has approved a number of types of medication that can be prescribed to treat a lice infestation. These are listed in alphabetical order only; we cannot state that one is better than another – this is up to your doctor.
- Benzyl alcohol lotion, 5%; (Ulesfia is FDA-approved for people over the age of 6 months and may be contraindicated in people over 60 as the irritation is causes hasn’t been studied in that age group). Benzyl alcohol is an aromatic alcohol has been approved by the FDA for the treatment of head lice and is considered safe and effective when used as directed. It kills lice but it is not ovicidal (does not kill eggs/nits) so it generally, it takes two treatments to work.
- Ivermectin lotion, 0.5%; (Sklice is approved for people over 6 months of age)
Ivermectin lotion, 0.5% is not ovicidal (doesn’t kill nits/eggs), but appears to prevent nymphs (newly hatched lice) from surviving. It is effective in most patients when given as a single application on dry hair without nit combing, however, ivermectin lotion should not be used for retreatment without talking to your doctor.In addition to the lotion, Ivermectin comes in a pill form that has been proved to safely and effectively for 20 years in a number of countries as an anti-parasitic medication used to treat filarial worm infestation. It is not currently FDA-approved for the treatment of lice, tablets given in a single oral dose and repeated in 9-10 days has been shown effective against head lice. It should not be used in children weighing less than 15 kg or in pregnant women.
- Malathion lotion, 0.5%; (Ovide is approved for approved for those over 6 years of age) Malathion is an organophosphate that is considered safe and effective that works as a pediculicide (kills live lice) and a partial ovicide (kills some lice eggs). It may require a second treatment if live lice still are present 7–9 days after treatment. Some of the drawbacks of Malathion is that can be irritating to the skin and it’s flammable. Don’t smoke or use electrical heat sources, such as hair dryers, curlers, and curling or flat irons, when applying malathion lotion or while the hair is wet.
- Spinosad 0.9% topical suspension; (FDA-approve for use in those over 6 months of age), derived from soil bacteria. Spinosad was approved by the FDA in 2011. Spinosad kills live lice as well as unhatched eggs, which means that retreatment is usually not needed. Nit combing is not required and is considered safe and effective when used as directed. Repeat treatment should be given only if live (crawling) lice are seen 7 days after the first treatment.
Second line of treatment (and a new guideline)
- Lindane shampoo 1% Lindane is an organochloride that is no longer recommended by American Academy of Pediatrics (AAP) as a pediculocide. While lindane shampoo 1% is approved by the FDA for the treatment of head lice, it is not recommended as a first–line treatment. Overuse, misuse, or accidentally swallowing lindane can be toxic to the brain and other parts of the nervous system; Lindane should be only used on people for whom prior treatments have failed or those who cannot tolerate other medications that pose less risk. Lindane should not be used to treat premature infants, persons with HIV, a seizure disorder, women who are pregnant or breast–feeding, persons who have very irritated skin or sores where the lindane will be applied, infants, children, the elderly, and persons who weigh less than 110 pounds. Retreatment should also be avoided.
Mamavation’s Investigation of Head Lice Treatment Products
Mamavation investigated over 50 brands of lice treatment and/or prevention products.
These brands only offer essential oils which have not yet been studied to determine their efficacy and also have a number of bad ingredients in them. In time, we may learn that these treatments are excellent, but as of now, we simply do not know. It’s nice that these products are more natural, but we don’t think you should waste your money on them.
- Babo Botanicals Lice Repel Conditioning Spray
- Babo Botanicals Lice Repel Shampoo
- ClearLice Head Lice Prevention Shampoo
- Fairy Tales Rosemary Repel Conditioning Spray
- Fairy Tales Rosemary Repel Daily Kid Shampoo
- Hair Genies Lice Prevention Shampoo
- Happyheads® Bye-Bye Lice®
- Honeydew Head Lice Treatment Shampoo
- Kid’s Dandruff Shampoo for Sensitive Scalp
- Ladibugs Lice Elimination Mousse
- Ladibugs Lice Prevent Conditioner
- Ladibugs Lice Prevention Detangler Spray
- Ladibugs Lice Prevention Leave in Spray
- Ladibugs Lice Prevention Mint Spray
- Ladibugs Lice Prevention Shampoo
- Lice Eliminator Oil
- Lice Shield Leave in Spray
- Lice Shield Shampoo and Conditioner
- Lice Shield Shampoo and Conditioner in 1
- LiceLogic Head Lice Shampoo (preventative, not for treatment of active infection)
- LiceLogic Treatment
- Little Green Lice Guard Hair Gel – Safely and Naturally Repel Lice
- Little Green Lice Guard – Lice-Repelling Shampoo
- Nit Free Head Lice Mint Oil Peppermint Spray
- Poofy Organics Lice Prevention
- Pure Tea Tree Oil Shampoo – PREVENTION
- Schooltime Shampoo for Head Lice & Nit Removal
- Scootie-Cootie – Happyheads Prevention
- Shiny Leaf Premium Tea Tree Shampoo PREVENTION
- SoCozy Boo! Lice Scaring Shampoo Scares Away Lice
- SoCozy Boo! Lice Scaring Spray Scares Away Lice
These brands contain the old-school over-the-counter formulas for lice treatment. While they can be effective (as per the CDC), the emergence of super-lice means that many lice are immune to their effects. These can be a great starting place, though, if you’re looking to start treating a lice infestation, and remember – it’s likely that you’re going to combine your approaches. Most of these brands come in kits with a plastic nit comb. These brands contain Pyrethrum and Piperonyl Butoxide.
- LiceMD Head Lice Treatment contains Pyrethrum Extract with Piperonyl Butoxide
- Nix Lice Killing Creme Rinse Family Pack contains Permethrin
- RID Lice Killing Shampoo contains Piperonyl butoxide and Pyrethrum extract
These brands contain non-pesticidal lice treatments that are becoming the first choice among parents. These treatments, like the rest, should be used along with a nit-comb to comb out the eggs after killing the adult lice. These include Dimethicone, Isopropyl myristate, & Cyclomethicone.
As always, make certain to follow the directions as stated on the packaging.
- Full Marks Solution Spray 150ml contains Isopropyl Myristate and Cyclomethicone.
- Head Hunters Pro Lice Treatment contains Dimethicone
- Hedrin 4% solution contains Dimeticone
- Hedrin Once contains Dimethicone
- Lice Treatment Kit by Lice Clinics contains Dimethicone and Isopropyl Myristate
- LICE.ORG Complete Lice Kit contains Dimethicone
- Little Bugs Lice Elimination Kit contains Dimethicone
- NIX Ultra Lice & Nits Treatment contains Dimethicone
- Quit Nits Natural Lice Treatment, Head Lice Shampoo and Preventative Spray Kit contains Dimethicone
- RID Lice Comb-out Spray contains Dimeticone