This article contains information from the Centers for Disease Control and Prevention (CDC) on over-the-counter and prescription treatment products for head lice. Before treating young children, consult the child's doctor, or the health department, for the recommended treatment based on the child’s age and weight.

Head lice can be treated with over-the-counter or prescriptions medications. Over-the-counter medications contain either pyrethrins combine with piperonyl butoxide or permethrin.

Because these pesticides do not kill the eggs, a second treatment is generally needed, as listed on the label.

The following are listings of six over-the-counter medications and two prescription medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of head lice, as compiled and described by the CDC (CDC page from which information sourced was last reviewed and updated Sept. 24, 2013):

 

Head Lice Products: Over-the-Counter Medications

• Pyrethrins combined with piperonyl butoxide: A–200, Pronto, R&C, Rid, Triple X.

Pyrethrins are naturally occurring pyrethroid extracts from the chrysanthemum flower. Pyrethrins are safe and effective when used as directed. Pyrethrins can only kill live lice, not unhatched eggs (nits). A second treatment is recommended 9 to 10 days after the first treatment to kill any newly hatched lice before they can produce new eggs. Pyrethrins generally should not be used by persons who are allergic to chrysanthemums or ragweed. Pyrethrin is approved for use on children 2 years of age and older.

• Permethrin lotion, 1%: Nix.

Permethrin is a synthetic pyrethroid similar to naturally occurring pyrethrins. Permethrin lotion 1% is approved by the FDA for the treatment of head lice. Permethrin is safe and effective when used as directed. Permethrin kills live lice but not unhatched eggs. Permethrin may continue to kill newly hatched lice for several days after treatment. A second treatment often is necessary on day 9 to kill any newly hatched lice before they can produce new eggs. Permethrin is approved for use on children 2 months of age and older.

 

Products listed are not endorsed by CDC or D106, but are listed for identification purposes. These products are pesticides and should be used with care. Always read and follow all label directions. If crawling lice are seen after a full course of treatment, CDC advises that you contact your health care provider.

 

Head Lice Product: Prescription Medications

There are also medications for the treatment of head lice that are approved by FDA, but available only by prescription. CDC provides an alphabetical listing of those products as well:

• Benzyl alcohol lotion, 5%: Ulesfia lotion

Benzyl alcohol is an aromatic alcohol. Benzyl alcohol lotion, 5% is considered safe and effective when used as directed. It kills lice but it is not ovicidal. A second treatment is needed 7 days after the first treatment to kill any newly hatched lice before they can produce new eggs. Benzyl alcohol lotion is intended for use on persons who are 6 months of age and older and its safety in persons aged more 60 years has not been established. It can be irritating to the skin.

• Ivermectin lotion, 0.5%: Sklice

Given as a tablet in mass drug administrations, ivermectin has been used extensively and safely for over two decades in many countries to treat filarial worm infections. Ivermectin lotion, 0.5% was approved by the FDA in 2012 for treatment of head lice in persons 6 months of age and older. It is not ovicidal, 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. It should not be used for retreatment without talking to a healthcare provider.

• Malathion lotion, 0.5%: Ovide

Malathion is an organophosphate. The formulation of malathion approved in the U.S. for the treatment of head lice is a lotion that is safe and effective when used as directed. Malathion is pediculicidal (kills live lice) and partially ovicidal (kills some lice eggs). A second treatment is recommended if live lice still are present 7–9 days after treatment. Malathion is intended for use on persons 6 years of age and older. Malathion can be irritating to the skin. Malathion lotion is flammable; do not smoke or use electrical heat sources, including hair dryers, curlers, and curling or flat irons, when applying malathion lotion and while the hair is wet.

• Spinosad 0.9% topical suspension: Natroba

Spinosad is derived from soil bacteria. Spinosad topical suspension, 0.9%, was approved by the FDA in 2011. Since it kills live lice as well as unhatched eggs, retreatment is usually not needed. Nit combing is not required. Spinosad topical suspension is approved for the treatment of children 4 years of age and older. It is 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.

 

As with the over-the-counter products, the prescription medications listed are not endorsed by CDC or D106, but are listed for identification purposes. These products are pesticides and should be used with care. Always read and follow all label directions. If crawling lice are seen after a full course of treatment, CDC advises that you contact your health care provider.

 

For more information see

• Head Lice Symptoms and Identification: Does Your Child Have Lice?
• Head Lice Treatment