The 9 Best Lice Treatments of 2024

There are different methods available for preventing and treating lice, including non-toxic and chemical formulas.

We independently evaluate all recommended products and services. If you click on links we provide, we may receive compensation. Learn more.

Lice Treatments

Health / Kevin Liang

Many of us have memories of the unpleasant head lice checks that were carried out in our schools during our childhood. Even as adults, the thought of having to deal with lice can be quite unsettling. But with some estimated 6 to 12 million kids between 3 and 11 years old in the United States getting lice infestations each year, the day may come when we’re forced to face these little wingless insects. Knowing the proper way to handle a lice infestation can ease discomfort for the entire family.

Lice infestations can be a nuisance, but fortunately, there are various treatments available to eliminate these pesky parasites. From over-the-counter solutions, prescriptions, and mechanical removal methods, our comprehensive guide aims to provide you with a range of options to tackle lice infestations head-on. Whether you're dealing with your first lice outbreak or seeking more effective methods to prevent future infestations, our recommendations are designed to help you find relief and regain peace of mind. A board-certified dermatologist on our Medical Expert Board reviewed this article for medical and scientific accuracy.

Types of Lice Treatments

  • Over-the-Counter (OTC) Products: OTC lice treatments include shampoos, lotions, and creams with insecticides like permethrin or pyrethrin. These kill lice and nits, but some lice strains may resist them.
  • Prescription Medications: Stronger medications may be needed for resistant lice strains. Topical treatments with ivermectin, malathion, or benzyl alcohol can be effective. Prescription treatments may have more side effects and should be used when necessary.
  • Natural Remedies: Some prefer natural remedies to avoid chemicals. These include essential oils (like tea tree, lavender, neem) and other substances (like coconut oil, vinegar). Natural remedies are safer, but may not always work against lice.
  • Mechanical Removal: Manually removing lice and nits with a fine-toothed comb, known as a nit comb, can be very effective but time-consuming. It may need to be combined with other treatments for best results.

Best Overall

Malathion Ovide Lotion

Malathion Ovide Lotion

Amazon

Why We Like It

Malathion Ovide Lotion is a prescription-strength lotion that comes highly recommended by experts for treating lice. It’s suitable for treating live adult lice and their eggs, known as nits.  Malathion is applied directly to the scalp and dry hair. This means it’s best not to shampoo or condition before applying the medication. Malathion should be left on the scalp and hair (uncovered) for 8-12 hours or by your healthcare provider’s recommendation. The CDC recommends avoiding washing your hair for 1-2 days after treatment and, if some lice remain, repeating treatment 5-7 days after the first treatment to kill remaining live lice or eggs. 

It’s Worth Noting

  • While it may be prescribed for children as young as 6, the safety and effectiveness of malathion in children under that age has not been determined in controlled clinical trials.

Product Details:

  • Key ingredient(s): Malathion 
  • Size/unit count: 1 bottle; 2 fl. oz.

Best Comb

Nit Free Terminator Lice Comb

Nit Free Terminator Lice Comb

Amazon

Why We Like It

The Nit-Free Terminator Lice Comb has grooved teeth designed specifically for targeting, lifting, and removing eggs and adult lice. The teeth ends are softly rounded, making for a gentle experience free of skin pricking, scraping, scratching, or hair pulling. Lice tend to stay close to the skin for warmth, so check within an inch or two of the scalp while combing out lice, says Brendan Camp, MD, FAAD, a double board-certified dermatologist at MDCS Dermatology in Manhattan. “Separate the hairs with your hands, a long wooden cotton-tipped applicator, or chopsticks,” he suggests. Then, start combing out lice and nits in small sections of hair.  The Nit-Free Terminator Lice Comb’s stainless steel material is durable, rust-resistant, and also easy to sterilize, so you can reuse the comb many times if necessary. 

It’s Worth Noting

  • No matter how well-designed this fine-tooth comb is, you’ll still likely need a magnifying glass to actually see the nits.

Product Details:

  • Key ingredient(s): Stainless steel material 
  • Size/unit count: One comb

Best Spray

Tec Labs Head Lice Spray

Tec Labs Head Lice Spray

Amazon

Why We Like It

The Licefreee Spray Head Lice Treatment spray uses a mineral-based formula with the addition of inactive ingredients such as benzyl alcohol to kill lice and their eggs. It’s best used on dry hair. While this product can be used for killing lice on surfaces, the CDC suggests this isn’t really a necessary step in lice treatment for your household. Head lice cannot survive for long if they fall off a person and are unable to feed. You don’t need to spend a lot of time or money on house cleaning activities, according to the CDC. The spray method is an appealing alternative to lotions or gels because it kills lice and nits without the need for gloves.

It’s Worth Noting

  • It does contain fragrance, which may be irritating to some with scent-sensitivities.

Product Details:

  • Key ingredient(s): Sodium chloride
  • Size/unit count: 6 fl. oz.

Best Shampoo

RID Lice Killing Shampoo

RID Lice Killing Shampoo

Amazon

Why We Like It

RID Lice Killing Shampoo is a type of OTC pediculicide that works by repelling lice in a few ways. The gel formula helps to reduce the static charge in hair that attracts lice in the first place. It also prevents lice from attaching to the hair and laying eggs. All of this helps reduce live lice count and risk of lice re-infestation. The main active ingredient in RID Lice Killing Shampoo is pyrethrin, the natural insecticide in chrysanthemum flowers. While highly effective, it’s still normal to require more than one application. This is becoming increasingly obvious as lice have become more resistant to this type of insecticide. Treatment applications should be a week apart depending on the medication, says Dr. Camp. This will help to treat lice that have emerged from eggs that may have been leftover from the first application and removal session.

It’s Worth Noting

  • You may not be able to find RID shampoo only and instead may need to use the RID shampoo and conditioner 2-in-1 formula or RID Lice Treatment Complete Kit that comes with the shampoo.

Product Details:

  • Key ingredient(s): Pyrethrin 
  • Size/unit count: 10 fl oz

Best Mousse

Fairy Tales Lice Good-Bye Mousse

Fairy Tales Lice Good-Bye Mousse

Amazon

Why We Like It

Fairy Tales Lice Good-Bye No-Drip Mousse is a clinically proven lice treatment that helps with lice removal and dissolving any residue leftover on the hair or scalp from nits. You’ll use it like a lotion or gel formula. The naturally derived formula is made from specific types of yeast and alcohol. Since lice are becoming more resistant to chemical pesticides, this non-toxic formula may be more effective against current lice outbreaks and future lice reinfestation (i.e., super lice). The Fairy Tales line of lice treatment products also uses essential oils. Several essential oils have also been reported as effective as lice therapy, says Lauren Penzi, MD, a board-certified dermatologist specializing in cosmetic and medical dermatology in Long Island. These essential oils have been incorporated into OTC lice treatments like this pick.

It’s Worth Noting

  • This product is also not suitable for people with an allergy to gluten.

Product Details:

  • Key ingredient(s): Brewer’s yeast, alcohol ethoxylate, essential oils 
  • Size/unit count: 4 fl. oz.

Best All-Natural

Pompeian Extra Virgin Olive Oil

Pompeian Smooth Extra Virgin Olive Oil

Amazon

Why We Like It

Using olive oil or coconut oil is an effective, albeit messy, way to smother and suffocate lice, says Dr. Camp. This treatment method usually requires more than one application and the use of a nit comb to remove dead lice and nits. While lice supposedly suffocate and die when olive oil plugs their breathing holes, you need to apply it for six to eight hours under a shower cap because lice can survive without breathing for hours. You'll also have to comb to remove nits, but the olive oil should help loosen them from the hair shafts. Dr. Penzi seconds the choice of olive oil as the best all-natural lice treatment. She says the oil works by helping to slow the lice movements, enabling them to be more easily combed from the scalp and hair.

It’s Worth Noting

  • This can become greasy and messy quite quickly.

Product Details:

  • Key ingredient(s): Olive oil
  • Size/unit count: 16 fl. oz.

Best for Kids

Ladibugs One and Done Lice Treatment Kit

Ladibugs One and Done Lice Treatment Kit

Amazon

Why We Like It

Ladibugs One and Done Lice Treatment Kit have a touch of everything. It includes a double-working serum with lice-repelling menthol and lice-killing dimethicone. It also comes complete with a mousse that is naturally derived and a nit comb for removal of lice and eggs. Together, the two family-friendly lice treatment products work to lubricate the scalp. Dr. Camp explains that lubricating the hair works by suffocating the lice.

It’s Worth Noting

  • The key ingredient, menthol, in the mint serum may have a cooling effect on the scalp, which may not appeal to every child.

Product Details:

  • Key ingredient(s): Menthol and Dimethicone 
  • Size/unit count: 1 kit containing mint serum, mousse, and a nit comb

Best for Sensitive Skin

Cetaphil Gentle Skin Cleanser

Cetaphil Gentle Skin Cleanser

Walmart

Why We Like It

Cetaphil Gentle Skin Cleanser is formulated to be extra gentle, making it an expert-recommended method of treating lice for people with sensitive skin. It can be applied to the scalp and allowed to dry so that the hair becomes brittle, which suffocates lice, says Dr. Camp. After about 10 hours, you rinse the product out and proceed to comb the lice and nits out. Cetaphil Cleanser often requires more than one treatment, adds Dr. Camp.

It’s Worth Noting

  • This is not a medicated formula for treating lice, meaning it doesn’t actively kill lice and their eggs.

Product Details: 

  • Key ingredient(s): Cetearayl alcohol
  • Size/unit count: 20 fl. oz.

Best for Prevention

Lice Shield Shampoo & Conditioner

Lice Shield Shampoo & Conditioner

Amazon

Why We Like It

Lice Shield Shampoo and Conditioner contains botanical plant oils such as rosemary to help naturally deter lice. It also contains additional essential oils that have been shown to repel lice. A comparison study between the effectiveness of essential oils and synthetic chemicals commonly used to treat lice found that the essential oils did help in lice treatment, mostly due to their slippery nature rather than repelling lice properties. This Lice Shield Shampoo and Condition can be helpful to integrate into your child’s skincare routine during the school year or used, along with close inspection, when others in the family catch lice, says Dr. Camp.

It’s Worth Noting

  • This is a preventative method, not a treatment method.

Product Details:

  • Key ingredient(s): Citronella, rosemary, lemongrass, cedar, and geraniol
  • Size/unit count: 10 fl. oz.

How We Selected

To determine the best lice treatments and tools, we consulted several board-certified dermatologists to see their recommendations. We prioritized FDA-approved prescription lice treatments that come highly recommended by dermatologists, along with everyday items you may already have at home.

In reviewing the best lice treatments, we considered the key ingredients that either kill lice and their eggs or make removal from scalp and hair easier and the size of the product. We also noted precautions that should be taken into account before choosing the best lice treatment, such as potential common side effects and how long the product should be left on the scalp and hair. We offer a range of options so you can find something to stop the infestation and bring back peace of mind to the whole household, no matter your budget or age. 

Our Experts

We spoke with two certified dermatologists to discuss what to look for when selecting a lice treatment. The experts we consulted included:

  • Lauren Penzi, MD, a board-certified dermatologist specializing in cosmetic and medical dermatology in Long Island
  • Brendan Camp, MD, FAAD, a double board-certified dermatologist at MDCS Dermatology in Manhattan.

What to Know About Best Lice Treatments

Ingredients to Look for in Lice Treatments

When it comes to the best lice treatments, experts recommend prescription and over-the-counter options that contain pyrethrin. Pyrethrin and permethrin (synthetic pyrethroid) are common insecticides or pediculicides found in most over-the-counter lice treatments. These chemicals are derived from the natural extract of Chrysanthemum cinerariaefolium (chrysanthemum) flower heads and are FDA-approved.

Other ingredients for treating lice, according to Dr. Penzi, may include:

  • Malathion: A topical insecticide that has a recommended treatment time of 8 to 12 hours
  • Ivermectin: A topical lice treatment FDA-approved in 2012 for people six months and older. Dr. Penzi notes that there is also an oral application for treatment-resistant lice infection, but it is not recommended during pregnancy or in children under 33 pounds or 15k g. 
  • Benzyl alcohol lotion: Works by asphyxiation or preventing the lice respiratory system from working
  • Dimethicone: A silicone oil that blocks lice’s ability to excrete water (i.e., they can’t regulate fluid levels) 
  • Spinosad lotion: FDA-approved for lice treatment in children four years and older. This natural insecticide from soil bacteria works by inducing muscle spasms and paralysis in lice.
  • Lindane: An industrial-strength insecticide found in lice treatment shampoos. It’s also a neurotoxin, though, and as such, is reserved for treatment-resistant cases of lice (i.e., for people who have not responded to typical OTC treatments found in this article).

You will want to avoid any ingredients to which someone in the household is allergic. For example, some chemical formulas may contain ingredients that negatively interact with certain medications. This information is listed in the contraindications, warnings, precautions, or important information section of company websites and instruction inserts.

Methods of Lice Treatments

  • The best lice treatment method is prevention. You can reduce the risk of infestation in the first place if you avoid close contact with others who have lice, do not share clothing, combs, or towels, and do not share the same bed, pillows, or stuffed animals, says Dr. Camp. “Make sure to wash clothing and linens used by someone with lice using hot water and heat. Vacuum heavy-trafficked areas and furniture,” he adds. 

  • Not all lice treatments work in the same way. According to Dr. Penzi, some treatments are ovicidal, which means they eliminate lice eggs or nits. However, other lice treatments can work to kill both live lice and eggs. For instance, malathion is pediculicidal, which means it can kill live lice, and is partially ovicidal, meaning it can kill some eggs. “Pyrethrin, permethrin, and benzyl alcohol, for example, are only pediculicidal, but not ovicidal,” adds Dr. Penzi. While some ingredients are effective in treating live lice and eggs in a single treatment, Dr. Camp warns that others may require a second treatment days later to treat lice that hatch later.

  • Manual methods involve combing lice and nits from the scalp and hair, as well as using home remedies that do not contain chemical insecticides to kill lice. 

  • Chemical methods include OTC and prescription options that contain insecticides. In some cases, chemical treatments come with a nit comb, and combing after chemical treatment is recommended for the best treatment. 

  • Home remedies can help slow adult lice movement, making it easier to capture them with a nit comb. However, they don't kill lice and may require multiple treatments. Combing through wet hair and applying suffocating products like mayonnaise, coconut oil, or petroleum jelly are some home remedies that can be used to treat lice.

How to Use Lice Treatments

  • Read and follow the instructions that come with lice treatments carefully. Some formulas may require a longer stay-on time than others. Depending on the treatment type, you may need to rinse and start combing, rinse, or just comb.

  • According to the experts, lice treatments should start working within a day. Dr. Penzi suggests waiting for 24 to 48 hours before determining whether the treatment has worked or not. It is recommended to do a second treatment after a week to kill any nits that may have survived the first application. Besides, the second application helps in defending against growing resistance to many pediculicides and reduces the risk of re-infestation, as stated by Dr. Penzi.

Who We Are

Michelle Pugle is a medical and health writer and news reporter featured in Healthline, Verywell Health, and Everyday Health. She is the author of Ana, Mia & Me: An Eating Disorder Recovery Memoir and Space to Grow, Poems.

Was this page helpful?
6 Sources
Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. CDC. Head lice: Epidemiology & risk factors.

  2. CDC. Head lice: Treatment.

  3. Devore CD, Schutze GE; AAP, Council on School Health, Committee on Infectious Dises. Head lice. Pediatrics. 2015;135(5):e1355–e1365. doi:10.1542/peds.2015-2696

  4. Greive KA, Barnes TM. The efficacy of Australian essential oils for the treatment of head lice infestation in children: A randomised controlled trial. Australas J Dermatol. 2018;59(2):e99-e105. doi:10.1111/ajd.12626

  5. Haghighizadeh A, Mortezanejad SAF, Dadpour S, Rajabi O. Evaluation of anti-lice topical lotion of ozonated olive oil and comparison of its effect with permethrin shampoo. Rev Recent Clin Trials. 2022;17(1):58-67. doi:10.2174/1574887116666211202122132

  6. Jahangiri F. Case report: a new method for treatment of permethrin - resistant head lice. Clin Case Rep. 2017;5(5):601-604. doi:10.1002/ccr3.899

Related Articles