ask your pharmacist

Are there any over-the-counter treatments for head lice?

The best treatment for children age two years and older is permethrin 1 percent cream rinse (brand name Nix). It’s even more effective than prescription treatments, curing 99 percent of cases after a single application. Nix continues to work for up to 2 weeks after the first application. It also kills lice eggs. A second Nix treatment in seven days may increase its effectiveness. The most commonly reported side effects of permethrin products include mild itching and stinging of the scalp.

Another over-the-counter medicine is >pyrethrin (Rid) shampoo. It’s effective in 93 percent of people after one application and rarely causes any side effects. Rid does not have long lasting activity or kill lice eggs.

Make sure that hair is completely dry before using Nix or Rid. Do not use any cream rinse or conditioning shampoos before or for 2 weeks after using these products. This is because they will coat the hairs and protect the lice from the killing effect of Nix or Rid.

>Clear Lice Egg Removing Comb and Enzyme Gel System is an optional product that is used after a lice-killing product. It can make removing lice eggs from hair easier, but isn't necessary. Step 2 is applied to wet hair after rinsing out Nix or Rid. Leave it in the hair for 10 minutes, then rinse it off. Hair is then dried and combed with a special egg-removing (nit) comb. Metal nit combs are more effective than plastic and can be purchased separately. Step 2 can remove 93.5% of eggs.

Sources:
Handbook of Nonprescription Drugs. American Pharmaceutical Association, 1996
Mayo Clinic Family Health Book. William Morrow & Co., 1996.
Dodd, C. "Interventions for treating head lice," The Cochrane Library, 1999.
Burkhart, C.G., "An Assessment of Topical and Oral Prescription and Over-the-counter Treatments for Head Lice" Journal of the American Academy of Dermatology 38 (1998).
Medline Plus. Medline, 2007.

This answer prepared 10/25/2000.
This information updated 1/11/2007.