Lice treatment for kids
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- Nix Lice Killing Creme Rinse. Best for: Children 2 months and older. See options on Amazon
- RID Lice Killing Shampoo. Best for: Children 2 years and older. See options on Amazon
- Metal nit comb. Best for: Removing nits after treatment. See options on Amazon
Comparing the two OTC treatments
| Product | Active ingredient and age | How it is applied |
|---|---|---|
| Nix Creme Rinse | Permethrin 1%; 2 months and older | On shampooed, towel-damp hair for 10 minutes, then rinse |
| RID Lice Killing Shampoo | Pyrethrins 0.33% with piperonyl butoxide 4%; 2 years and older | On dry hair for 10 minutes, then lather and rinse |
Details are from each product's Drug Facts label on DailyMed; ages match the CDC's clinical care page. The CDC says pyrethrins kill only live lice, not unhatched eggs, and that permethrin kills live lice but not unhatched eggs, which is why retreatment matters.
Check everyone first
The Nix label says all household members should be checked by another person. Use a magnifying glass in bright light, part the hair in small sections 1 to 2 inches wide, and look for tiny nits near the scalp, starting at the back of the neck and behind the ears. Unlike dandruff, which moves when touched, nits stick to the hair. The CDC says to treat all infested household members, close contacts and anyone who shares a bed at the same time.
Applying the treatment
- No conditioner first. The CDC and Nix label say not to use conditioner or a shampoo with conditioner before treatment, since it can reduce how well the medicine works.
- Protect the eyes. Keep eyes tightly closed and cover them with a washcloth; flush with water if product gets in.
- Start behind the ears and at the back of the neck, and saturate the hair and scalp, as both labels direct.
- Leave on 10 minutes, but no longer, then rinse as the label says.
- Long hair. The CDC notes that shoulder-length or longer hair might need a second bottle.
- Wait to rewash. The CDC says not to rewash the hair for 1 to 2 days after removing the medicine.
Nit combing
Both labels direct you to comb out lice and nits with a fine-tooth nit comb while the hair is slightly damp, re-wetting it if it dries. The RID label says to work in sections starting on top of the head, lifting a 1 to 2 inch strand and combing from as close to the scalp as possible; on longer hair this may take 1 to 2 hours. Remaining nits can be removed by hand using a throw-away glove.
The CDC advises checking hair and removing nits and lice every 2 to 3 days for 2 to 3 weeks after treatment.
Retreatment and when to call a doctor
The CDC says to treat a second time 9 to 10 days after the first pyrethrin treatment, and that with permethrin you may need to treat again on day nine, to kill newly hatched lice before they lay eggs. The Nix label says to give a second treatment if live lice are seen seven days or more after the first.
If lice persist, ask a provider about prescription options. The CDC lists ivermectin lotion 0.5% for people 6 months and older, spinosad for children 6 months and older, and malathion for people 6 years and older.
Warnings and home cleaning
- Ragweed allergy. Both labels say to ask a doctor first if you are allergic to ragweed, since use may cause breathing difficulty or an asthma attack.
- Not near the eyes, nose, mouth or vagina, and not for lice in eyebrows or eyelashes; see a doctor for those.
- Pregnancy or breastfeeding: ask a health professional before using Nix.
- Home. The CDC suggests washing items used in the 2 days before treatment in hot water at 130 degrees F with high-heat drying, sealing non-washable items in a plastic bag for 2 weeks, and vacuuming floors and furniture. It advises against fumigant sprays or fogs.
What to look for when you buy
Nix Lice Killing Creme Rinse
Best for: Children 2 months and older
Its label lists permethrin 1%, left on damp hair for 10 minutes, with a nit comb.
Watch out: Ask a doctor first if allergic to ragweed.
See options on AmazonRID Lice Killing Shampoo
Best for: Children 2 years and older
Its label lists pyrethrins with piperonyl butoxide, applied to dry hair for 10 minutes.
Watch out: Retreat 9 to 10 days later, per the CDC.
See options on AmazonMetal nit comb
Best for: Removing nits after treatment
Both labels and the CDC rely on nit combing to remove eggs the medicine may not kill.
Watch out: Comb damp hair in small sections.
See options on AmazonQuestions people ask
- What is the youngest age for lice treatment?
- The CDC says permethrin is approved from 2 months and pyrethrins from 2 years.
- Do lice treatments kill eggs?
- The CDC says permethrin and pyrethrins kill live lice but not unhatched eggs, so comb and retreat.
- When should I retreat for lice?
- The CDC says 9 to 10 days after pyrethrins, or about day nine with permethrin.
- Can I use conditioner before lice treatment?
- No. The CDC and Nix label say conditioner can make the medicine less effective.
- Do I need to clean the whole house?
- The CDC suggests hot washing items used in the last 2 days, bagging others for 2 weeks and vacuuming; no fogs.
Sources
- Treatment of Head Lice (cdc.gov), Centers for Disease Control and Prevention
- Clinical Care of Head Lice (cdc.gov), Centers for Disease Control and Prevention
- Nix Lice Killing Creme Rinse (permethrin) label (dailymed.nlm.nih.gov), DailyMed, U.S. National Library of Medicine
- RID Lice Killing Shampoo (pyrethrum extract, piperonyl butoxide) label (dailymed.nlm.nih.gov), DailyMed, U.S. National Library of Medicine