Lice Medication: What Works and How to Use It

If you’ve ever dealt with a head‑lice outbreak, you know how annoying it can be. The good news is there are plenty of meds that actually work, and you don’t have to guess which one to pick. Below you’ll find the most common over‑the‑counter products, the prescription options for tougher cases, and simple steps to make sure the treatment does its job.

Over‑the‑counter options

OTC lice meds usually come as shampoos, lotions, or foams that you apply to dry hair, leave on for a set time, then rinse out. The active ingredients are most often permethrin (1%) or pyrethrin combined with piperonyl butoxide. Both knock out lice on contact and are safe for kids over two months when used as directed.

To use an OTC shampoo, wash the hair with regular shampoo first, then apply the lice product. Make sure you cover the scalp and every strand, because lice hide in the nape, behind ears, and near the crown. Leave it on for the time the label says—usually 10 minutes—then rinse thoroughly. After the wash, comb the hair with a fine‑toothed nit comb to pull out any dead nits.

Lotions and foams work the same way but don’t need a second shampoo step. They’re handy for quick treatment at school or travel. Just remember: a single application might not kill every egg, so a repeat treatment after 7‑9 days is often recommended.

Prescription treatments

When OTC meds fail or you suspect resistance, a doctor can prescribe stronger options. Common prescriptions include 1% or 5% malathion, spinosad, or benzyl alcohol lotion. These work in a slightly different way, attacking the lice’s nervous system or suffocating them.

Malathion is an oil‑based solution you apply to dry hair and leave overnight. It’s especially good for stubborn infestations, but it can be messy and isn’t safe for infants. Spinosad, sold as a spray, kills lice and their eggs in one go, so you usually don’t need a second treatment. Benzyl alcohol works by suffocating the insects; it’s safe for most ages but also requires a repeat dose after a week.

Before you start any prescription, ask your doctor about possible side effects. Most people only notice mild scalp irritation, but it’s worth checking if you have a history of skin reactions.

Regardless of the product you choose, the following steps will boost your success rate:

• Wash all bedding, hats, and brushes in hot water (at least 130°F) and dry on high heat.
• Seal non‑washable items in a plastic bag for two weeks.
• Use a fine‑toothed nit comb daily for a week after treatment.
• Check every family member; lice spread quickly.

These simple actions remove any hidden nits and keep re‑infestation from happening. If you follow the directions, most people see clear results after the first round.

In short, start with an OTC product if the outbreak is fresh, and move to a prescription if you see lice surviving the first try. Pair the medication with thorough cleaning and regular combing, and you’ll be lice‑free in no time.