How can I get rid of head lice?

Understanding Head Lice

What Are Head Lice?

Life Cycle of Head Lice

Head lice develop through three distinct stages: egg, nymph, and adult. An adult female lays about 6–10 eggs (nits) each day, attaching them firmly to hair shafts near the scalp. Eggs hatch in 7–10 days, releasing nymphs that resemble miniature adults but lack reproductive capability. Nymphs undergo three molts over the next 9–12 days, becoming mature adults capable of laying eggs. The complete life cycle therefore spans approximately 2–3 weeks under optimal temperature (30 °C) and humidity conditions.

Key points for effective removal:

Eggs remain viable for up to 10 days; treatment must target both live lice and newly hatched nymphs.
Nymphs cannot reproduce until after the third molt, providing a window for intervention before they become egg‑laying adults.
Adult lice survive only 30–40 days on a host, but can persist longer if transferred to a new host promptly.

Understanding this timeline enables precise scheduling of treatment applications. Applying a pediculicide or manual removal method on day 0, repeating after 9–10 days, and performing a final check at day 14 ensures that any surviving nits are eliminated before they mature, breaking the reproductive cycle and preventing re‑infestation.

How Head Lice Spread

Head lice move from one person to another primarily through direct contact with an infested head. The insects crawl quickly across hair shafts and can attach to a new host within seconds of contact.

Common routes of transmission include:

Close head‑to‑head interaction, such as sharing a pillow, hat, or scarf.
Contact with personal items that have recently touched an infested scalp, including hairbrushes, combs, hair clips, and earphones.
Use of shared bedding, towels, or clothing that have not been washed at a temperature of at least 130 °F (54 °C).

Indirect spread through furniture, carpets, or air is rare because lice cannot survive long away from a human head. Prompt removal of the insects and thorough cleaning of the listed items reduce the risk of re‑infestation.

Recognizing the Signs of Infestation

Common Symptoms

Head lice infestations manifest primarily through observable signs on the scalp and hair. The most reliable indicator is the presence of live insects, which appear as small, grayish‑brown bodies about the size of a sesame seed. Nits—lice eggs—adhere firmly to hair shafts, usually within a half‑inch of the scalp, and are oval, white or yellowish, and difficult to dislodge.

Additional symptoms include:

Persistent itching caused by allergic reactions to lice saliva.
Red or irritated skin, often concentrated at the nape of the neck and behind the ears.
Small, dark specks on clothing or bedding, representing crushed lice or shed nits.
A feeling of movement on the scalp, reported by some individuals.

These signs together provide a clear clinical picture of an active head‑lice problem and guide appropriate treatment decisions.

Visual Identification of Lice and Nits

Visual identification of head‑lice infestations begins with a careful examination of the scalp and hair. Live lice are small, wingless insects about 2–3 mm long, resembling tiny tan or gray beetles. Their bodies are oval, flattened, and they move quickly when disturbed. Look for active movement among hair shafts, especially near the nape of the neck and behind the ears, where temperature and humidity are highest.

Nits are the eggs laid by adult lice. They appear as tiny, oval, white or yellowish specks firmly attached to the side of a hair shaft. Unlike dandruff, nits cannot be easily brushed away; they are glued at an angle of roughly 45 degrees to the hair. Mature nits are tan or brown, indicating that hatching may be imminent. Unhatched nits remain translucent and are typically found within ¼ inch of the scalp, where the temperature supports development.

To improve detection:

Use a fine‑toothed nit comb on dry hair, starting at the roots and moving toward the tips.
Examine hair under bright, natural light or a magnifying lamp.
Separate sections of hair with clips to expose the scalp surface.
Check the occipital region, behind the ears, and the crown, where lice concentrate.

Distinguishing features:

Lice: mobile, visible eyes, six legs, darker coloration, may be seen crawling.
Nits: immobile, smooth shell, attached at an angle, color changes from translucent to brown as they mature.
Dandruff: loose, easily removed, no attachment to hair shaft.

Accurate visual identification is essential for confirming an infestation and selecting appropriate treatment measures.

Effective Treatment Strategies

Over-the-Counter (OTC) Treatments

Pyrethrin-Based Treatments

Pyrethrin-based shampoos, lotions, and sprays constitute a primary option for eliminating head‑lice infestations. These products contain natural extracts derived from Chrysanthemum flowers and are approved for over‑the‑counter use in many regions.

The active compounds disrupt the nervous system of lice by prolonging the opening of sodium channels in nerve cells, leading to rapid paralysis and death. Their rapid action reduces the need for prolonged exposure.

To apply a pyrethrin treatment correctly:

Wet hair thoroughly; shampoo if instructed by the label.
Apply the product evenly, ensuring coverage of the scalp and all hair strands.
Leave the preparation on for the time specified (commonly 10 minutes).
Rinse thoroughly with warm water.
Comb wet hair with a fine‑toothed nit comb to remove dead insects and nits.
Repeat the procedure after 7–10 days to address any newly hatched lice.

Safety considerations include:

Avoid use on children under two years of age unless directed by a physician.
Do not apply to broken or inflamed skin.
Discontinue use if signs of irritation, such as redness or itching, develop.
Store away from heat and direct sunlight to preserve potency.

Effectiveness data show cure rates between 80 % and 95 % when the protocol is followed precisely. Resistance to pyrethrins has emerged in some populations; therefore, a secondary treatment—such as a silicone‑based product—may be required if reinfestation occurs after the second application. Monitoring for residual lice after each treatment cycle ensures timely intervention.

Permethrin-Based Treatments

Permethrin-based products are the most widely recommended chemical option for eliminating head‑lice infestations. The active ingredient, a synthetic pyrethroid, disrupts the nervous system of lice, causing rapid paralysis and death.

Clinical data show a single 1 % permethrin lotion or shampoo eliminates approximately 90 % of live insects within 10 minutes of contact. Residual effect reduces hatching of eggs for up to 24 hours, decreasing the likelihood of reinfestation.

Application protocol:

Apply the product to dry hair, ensuring complete coverage from scalp to tips.
Leave the preparation on for the time specified on the label (usually 10 minutes).
Rinse thoroughly with warm water; avoid shampooing for 24 hours after treatment.
Comb hair with a fine-toothed nit comb to remove dead lice and nits.
Repeat the procedure after 7–10 days to target any surviving eggs.

Safety considerations:

Approved for individuals older than two months; infants under this age require alternative methods.
Mild skin irritation or itching may occur; discontinue use if severe reactions develop.
Do not use on broken or inflamed scalp.

Resistance monitoring indicates occasional reduced susceptibility in some populations. If treatment fails after two applications, consult a healthcare professional for alternative agents such as malathion or ivermectin.

How to Apply OTC Treatments Safely

Over‑the‑counter (OTC) lice products can eliminate infestations when used correctly. Follow these precise steps to maximize safety and effectiveness.

Read the label thoroughly before handling the medication. Identify active ingredients, contraindications, and age restrictions.
Apply the product to dry hair, following the exact amount specified. Do not exceed the recommended dosage.
Use a fine‑toothed lice comb immediately after the treatment period prescribed on the package. Remove each dead nymph and adult before rinsing.
Rinse hair with lukewarm water for the time indicated. Avoid hot water, which can degrade the active component.
After rinsing, wash all clothing, bedding, and personal items in hot water (minimum 130 °F/54 °C) or place them in sealed plastic bags for two weeks.
Repeat the application according to the product’s schedule, typically seven days after the first treatment, to eradicate newly hatched lice.
Store the medication out of reach of children and away from direct sunlight. Discard any unused portion after the expiration date.

Additional precautions:

Conduct a patch test on a small skin area 15 minutes before full application to detect potential allergic reactions.
Do not use multiple OTC products simultaneously; combining chemicals can cause irritation or toxicity.
If irritation, persistent itching, or rash develops, discontinue use and seek professional medical advice.

Adhering strictly to the manufacturer’s directions and the above protocol ensures safe, effective removal of head‑lice infestations.

Prescription Medications

Ivermectin Lotion

Ivermectin lotion is a topical antiparasitic formulation used to eradicate head‑lice infestations. The active ingredient, ivermectin, binds to glutamate‑gated chloride channels in lice nerve and muscle cells, causing paralysis and death. The lotion is applied directly to the scalp and hair, left for the manufacturer‑specified duration (usually 10‑15 minutes), then rinsed off. A second application after 7–10 days eliminates newly hatched nymphs that survived the initial treatment.

Key points for effective use:

Clean, dry hair before application; remove excess oil and styling products.
Apply lotion evenly, covering the entire scalp and all hair strands.
Follow the exact exposure time; exceeding it does not improve results and may increase irritation.
Repeat the treatment as directed to prevent re‑infestation.

Clinical studies report cure rates above 90 % when the regimen is followed correctly. Common adverse effects include mild scalp itching, redness, or temporary tingling; severe reactions are rare. Contraindications involve known hypersensitivity to ivermectin or other ingredients in the lotion.

Ivermectin lotion is available by prescription in many regions and over‑the‑counter in others, often marketed under names such as Sklice® or generic equivalents. Compared with traditional pediculicides (e.g., permethrin or malathion), ivermectin shows lower resistance rates and a simpler application protocol, making it a reliable option for managing head‑lice problems.

Malathion Lotion

Malathion Lotion is a prescription‑strength pediculicide used to eradicate head‑lice infestations. The product contains 0.5 % malathion, an organophosphate that inhibits cholinesterase, leading to paralysis and death of lice and nits.

The active ingredient penetrates the exoskeleton, affecting both adult insects and early‑stage nymphs. Its low volatility allows prolonged contact, which is essential for eliminating newly hatched nymphs that may survive shorter‑acting treatments.

Application protocol

Apply a thin layer of lotion to dry hair, covering the scalp from root to tip.
Massage gently for 10 seconds to ensure uniform distribution.
Leave the product in place for 8 hours (overnight is typical).
Rinse thoroughly with warm water; no shampoo is required before or after.
Repeat the procedure after 7 days to target any hatching eggs.

Safety considerations include:

Contraindicated for individuals with known malathion hypersensitivity or severe skin disorders.
Not recommended for children under 6 months or for pregnant or nursing women without medical supervision.
Possible adverse effects: mild scalp irritation, itching, or transient burning sensation.
Use gloves during application to avoid dermal exposure.

Clinical studies report clearance rates of 90 %–95 % after two applications, surpassing many over‑the‑counter options. Resistance to malathion remains low, but improper use can reduce effectiveness and increase the risk of irritation.

When administered according to the outlined regimen, Malathion Lotion provides a reliable solution for eliminating head‑lice populations, especially in cases where resistance to pyrethroids is documented.

Spinosad Topical Suspension

Spinosad topical suspension is a pesticide formulated for direct application to the scalp and hair to eradicate head‑lice infestations. The active ingredient, spinosad, disrupts the nervous system of lice, causing rapid paralysis and death within hours of contact.

The product is applied as follows:

Wet hair and scalp with warm water.
Dispense the measured dose onto the hair, ensuring thorough coverage from the roots to the tips.
Massage gently for 10 seconds to distribute the suspension evenly.
Leave the product on the hair for the time specified in the label, typically 10 minutes.
Rinse thoroughly with water; no shampoo is required before or after treatment.

Clinical studies report single‑application cure rates exceeding 95 % when the instructions are followed precisely. The formulation retains activity after drying, allowing it to continue killing newly hatched nymphs that emerge from surviving eggs, thereby reducing the need for a second treatment.

Safety data indicate low dermal toxicity and minimal irritation when used as directed. The product is contraindicated for children under six months and for individuals with known hypersensitivity to spinosad or any component of the formulation. Pregnant or breastfeeding persons should consult a healthcare professional before use.

To maximize effectiveness, combine the chemical treatment with mechanical removal: use a fine‑toothed lice comb on damp hair after rinsing, repeating the combing process for several days to capture any remaining nits. Proper laundering of bedding, clothing, and personal items eliminates residual eggs and prevents re‑infestation.

Non-Chemical Removal Methods

Wet Combing Technique

Wet combing removes lice and nits by pulling them from wet hair with a fine‑toothed metal comb. The method requires no chemicals, making it suitable for children, pregnant individuals, and those with sensitivities.

To perform the technique, gather the following items: a sturdy metal lice comb (spacing 0.2 mm), a spray bottle filled with lukewarm water, a few drops of conditioner (optional), and a towel. Begin by saturating the scalp and hair with water until strands are thoroughly damp. Apply conditioner if desired; it reduces friction and helps the comb glide. Section the hair into manageable portions, typically 1‑inch wide, and secure each section with a clip.

Proceed with the comb as follows:

Start at the scalp, place the comb’s teeth as close to the skin as possible.
Pull the comb slowly toward the hair tip, maintaining tension on the hair.
After each pass, wipe the comb on a white paper towel or rinse it in a bowl of hot water to expose captured lice and nits.
Repeat the process on the same section until no more insects appear, then move to the next section.

Complete the entire head, ensuring every part—including the nape, behind the ears, and crown—receives at least two passes. Repeat the routine every 2‑3 days for two weeks, then weekly for another two weeks to capture any newly hatched lice.

Effectiveness depends on thoroughness and consistency. Studies show wet combing can eliminate up to 90 % of infestations when performed correctly. Complement the practice with environmental measures: wash bedding and clothing in hot water, vacuum upholstered furniture, and avoid sharing personal items such as hats or hairbrushes.

Common pitfalls include dry hair, insufficient comb tension, and skipping sections. Address these by keeping hair wet throughout the session, using a firm grip on the comb, and following a systematic sectioning plan.

Essential Oils and Home Remedies («Are They Effective?»)

Essential oils are frequently marketed as natural alternatives for eliminating head‑lice infestations. Laboratory studies show that tea‑tree oil (Melaleuca alternifolia) at concentrations of 5 %–10 % can kill nymphs within 30 minutes, likely by disrupting the insect’s respiratory system. Lavender oil (Lavandula angustifolia) exhibits similar mortality rates when applied at 10 % concentration, while neem oil (Azadirachta indica) interferes with egg development at 2 %–5 % dilution. Peppermint and eucalyptus oils demonstrate limited efficacy; most trials report a 20 %–40 % reduction in live lice after a single treatment, insufficient for complete eradication.

Tea‑tree oil: 5 %–10 % dilution, 30 min exposure, repeat after 7 days.
Lavender oil: 10 % dilution, 30 min exposure, repeat after 7 days.
Neem oil: 2 %–5 % dilution, overnight application, repeat after 7 days.

Application requires a carrier such as coconut or olive oil to prevent skin irritation. After thorough soaking, the hair should be covered with a plastic cap for 30 minutes, then rinsed and combed with a fine‑toothed lice comb. Safety notes: essential oils may cause contact dermatitis in sensitive individuals; patch testing is mandatory before full‑head treatment.

Home‑based remedies rely on suffocating or detaching lice rather than killing them chemically. Vinegar (5 % acetic acid) loosens the glue that attaches nymphs to hair shafts, facilitating removal during combing. Mayonnaise and olive oil create an occlusive layer that impedes breathing; a 4‑hour application followed by vigorous combing can eliminate up to 70 % of live lice but rarely removes all eggs. Heat treatment—using a hair dryer set to low temperature for 10 minutes—reduces lice viability but risks scalp burns if misused.

Vinegar rinse: apply, wait 15 minutes, comb.
Mayonnaise/olive oil: coat hair, cover for 4 hours, comb.
Heat drying: low‑heat setting, 10 minutes, immediate combing.

Clinical guidelines recommend integrating these natural options with proven pediculicides to achieve complete clearance. Essential oils may reduce live‑lice counts, but they do not reliably eradicate nits; repeated applications and meticulous combing remain essential. Home remedies provide modest adjunct benefits but lack consistent evidence for full eradication. Users should prioritize safety, verify concentration accuracy, and consider professional evaluation if infestations persist.

Preventing Reinfestation and Managing Your Environment

Cleaning Your Home and Belongings

Washing Bedding and Clothing

Washing bedding and clothing removes live lice and unhatched nits that cling to fabric fibers, preventing re‑infestation after treatment.

Use the following protocol for all washable items:

Separate infested items from unaffected laundry.
Machine‑wash at a minimum of 130 °F (54 °C) for at least 30 minutes.
Include a full‑cycle rinse to flush detached insects.
Follow with a high‑heat dryer cycle (≥130 °F) for 20 minutes or longer; heat kills any remaining organisms.

For items that cannot withstand high temperatures, place them in a sealed plastic bag for two weeks. The sealed environment deprives lice of oxygen, causing death. After the sealing period, launder as described above using the warmest safe setting.

Non‑washable objects such as stuffed toys, pillows, or delicate accessories should be isolated in sealed containers for two weeks, then treated with a steam cleaner set to ≥212 °F (100 °C) for at least five minutes. Steam penetrates fabric layers, eliminating both lice and nits.

Repeat the washing and sealing process after seven days to capture any eggs that hatched after the initial cycle. Consistent application of these steps eliminates the reservoir of lice in the household environment.

Cleaning Combs and Brushes

Effective removal of head‑lice infestations depends on thorough decontamination of all grooming tools. After each use, combs and brushes must be cleaned to prevent re‑infestation and to eliminate any surviving nits.

First, rinse the items under hot running water to dislodge loose debris. Next, soak them for 10‑15 minutes in a solution of 0.5% sodium hypochlorite (approximately one tablespoon of bleach per liter of water) or an equivalent disinfectant approved for personal care accessories. Ensure the solution fully covers the comb teeth and brush bristles.

After soaking, scrub the surfaces with a small brush or an old toothbrush to remove residual material. Rinse thoroughly with hot water (minimum 130 °F/54 °C) to wash away chemical residues. Finally, place the cleaned tools in a sealed plastic bag and expose them to a dryer on high heat for at least 20 minutes, or store them in a freezer at –20 °C (–4 °F) for 24 hours if heat is unavailable.

Cleaning protocol summary

Rinse under hot water.
Soak 10‑15 min in 0.5% bleach solution or approved disinfectant.
Scrub to remove remaining debris.
Rinse with water ≥130 °F (54 °C).
Dry on high heat for 20 min or freeze at –20 °C for 24 h.

Regular application of this routine after each treatment session eliminates viable lice and nits from combs and brushes, supporting successful eradication of the infestation.

Vacuuming Furniture and Floors

Vacuuming furniture and floors eliminates live lice and nits that have dropped from the scalp, preventing re‑infestation. Use a high‑efficiency particulate air (HEPA) filter vacuum to capture the smallest particles and avoid spreading eggs.

Select a vacuum with strong suction and a sealed bag or container.
Attach a brush nozzle for upholstered surfaces and a crevice tool for seams, cracks, and floor edges.
Vacuum sofas, armchairs, cushions, and any fabric that contacts the head for at least 10 minutes, moving slowly to allow thorough extraction.
Run the vacuum over carpeted areas, rugs, and floorboards, focusing on corners, under furniture, and along baseboards.
After each session, empty the vacuum bag or canister into a sealed plastic bag and discard it outside the home.
Clean the vacuum filter according to the manufacturer’s instructions to maintain effectiveness.

Regular vacuuming—daily during the first week of treatment and then every other day for two weeks—removes residual nits and reduces the chance of a new outbreak. Combining this practice with direct hair treatment and laundering of bedding creates a comprehensive approach to eradicate head lice.

Informing Others

Notifying Schools and Daycares

When a child is diagnosed with head lice, the first responsibility is to inform any educational or childcare institution the child attends. Most jurisdictions require prompt notification to prevent further spread and to comply with health regulations.

The notification process should include:

Child’s full name and class or group.
Date of diagnosis and the date treatment began.
Confirmation that treatment has been completed according to recommended guidelines.
A brief statement that the child will be cleared for return only after a follow‑up check confirms no live lice or nits remain.

Contact the school or daycare as soon as treatment starts. Use the institution’s preferred communication method—typically a phone call followed by a written note or email. Keep a copy of the correspondence for personal records.

After the child returns, request a visual inspection from the staff to verify that the infestation has been eliminated. Encourage the facility to conduct routine head checks for all children, especially during peak seasons, and to share information about preventive measures with parents.

Maintain communication with the institution if additional cases appear. Prompt, clear reporting reduces the likelihood of an outbreak and demonstrates responsible care for the health of all children and staff.

Communicating with Close Contacts

When a lice infestation is confirmed, immediate notification of anyone who shares close physical space is essential. Directly inform family members, partners, and anyone who has had recent head-to‑head contact. State the diagnosis, the treatment chosen, and the date treatment began. Provide clear instructions for each person to inspect hair, apply the same medication, and repeat the process according to the product’s schedule.

Call the school or daycare administration; supply the date of treatment and request that they conduct a classroom sweep. Ask for written confirmation that the environment will be cleaned, including linens, hats, and shared equipment.
Email or message close friends and relatives who have visited recently; include a brief summary of the situation, recommended over‑the‑counter or prescription options, and a reminder to wash personal items at 130 °F (54 °C) or higher.
Arrange a follow‑up check with each contact within 7–10 days to verify that nits have been eliminated and no new symptoms appear.

Maintain a record of all communications, noting dates, recipients, and any responses. Use this log to confirm that every potentially exposed individual has taken appropriate action, reducing the chance of reinfestation.

Ongoing Vigilance

Regular Head Checks

Frequent scalp inspections are a cornerstone of any effective lice‑control strategy. Early detection limits spread, reduces treatment cycles, and prevents reinfestation.

Inspection should occur at least twice weekly during an outbreak and weekly for the next four weeks after treatment. In environments with high contact rates—schools, camps, sports teams—daily checks are advisable.

Use a fine‑toothed comb (0.2 mm spacing) on wet, conditioned hair. Section the hair into 1‑inch sections, pull each section taut, and run the comb from scalp to tip. Rinse the comb after each pass to avoid cross‑contamination.

Look for:

Live lice: brown or gray insects moving quickly.
Nits: oval, tan or white shells attached within ¼ inch of the scalp.
Empty nits: translucent shells that have already hatched.

If any lice or viable nits are found, begin an appropriate treatment protocol immediately and repeat inspections every 2‑3 days until two consecutive examinations show no evidence of infestation. Document findings to track progress and guide further action.

Maintaining Good Hygiene

Good personal hygiene reduces the chance of head‑lice infestation and supports treatment efforts. Regular cleaning removes eggs and nits that cling to hair and clothing.

Wash hair with a mild shampoo at least twice weekly; use a fine‑toothed comb to separate strands.
Change and launder hats, scarves, headbands, and pillowcases in hot water (≥ 130 °F) after each use.
Vacuum carpets, upholstery, and car seats; discard or wash stuffed toys in hot water or seal them in plastic bags for two weeks.
Avoid sharing personal items such as combs, brushes, hair accessories, and earbuds.
Keep hair tied back or trimmed short for children in group settings to limit contact.

Consistent application of these practices removes viable lice and prevents re‑colonization, complementing chemical or manual removal methods.

When to Seek Professional Help

Persistent Infestations

Persistent head‑lice infestations often result from incomplete treatment, re‑infestation, or resistant lice strains. Incomplete treatment leaves viable nits or adult insects, allowing the population to rebound within days. Re‑infestation occurs when close contacts—family members, classmates, or caregivers—remain untreated or when personal items are not properly decontaminated. Resistant lice survive standard insecticidal products, rendering a single application ineffective.

Effective resolution requires a systematic approach:

Apply a pediculicide according to label instructions, ensuring thorough coverage of the scalp and hair shafts.
Repeat the treatment after 7–10 days to target lice that hatched from surviving eggs.
Conduct a meticulous nit‑removal session 48 hours after each application, using a fine‑toothed comb on damp hair.
Inspect all household members; treat any additional carriers promptly.
Wash clothing, bedding, and towels in hot water (≥ 130 °F / 54 °C) or seal them in a plastic bag for two weeks to kill dormant lice and nits.
Vacuum carpets, upholstered furniture, and car seats to remove fallen hairs that may harbor nits.
Replace or treat combs, brushes, and hair accessories with a lice‑killing spray or hot water.

If infestations persist despite correct use of over‑the‑counter products, consider prescription‑strength treatments or a non‑chemical option such as a silicone‑based lotion that suffocates lice. Consult a healthcare professional to confirm resistance and obtain guidance on alternative regimens. Continuous monitoring for two weeks after the final treatment confirms eradication; any new live lice detected indicates a need for immediate re‑evaluation.

Allergic Reactions or Scalp Irritation

Allergic reactions and scalp irritation are common complications of lice eradication efforts. They arise from chemical pediculicides, essential‑oil preparations, or mechanical removal methods. Recognizing symptoms early prevents worsening and ensures effective treatment.

Typical signs include redness, itching, swelling, burning sensation, or rash at the site of application. Systemic responses such as hives, wheezing, or facial swelling indicate a true allergy and require immediate medical attention. Local irritation without systemic involvement may be managed with topical soothing agents.

Management strategies:

Discontinue the offending product as soon as irritation appears.
Rinse the scalp thoroughly with lukewarm water to remove residual chemicals.
Apply a fragrance‑free moisturizer or a thin layer of petroleum jelly to reduce dryness.
Use over‑the‑counter hydrocortisone cream (1 %) for mild inflammation; limit use to three days unless directed otherwise.
For severe or persistent reactions, seek evaluation from a healthcare professional; prescription steroids or antihistamines may be necessary.

Preventive measures:

Perform a patch test on a small skin area 24 hours before full‑head application of any new lice treatment.
Choose products with minimal irritants; avoid formulations containing alcohol, strong fragrances, or high concentrations of essential oils.
Opt for mechanical removal (fine‑tooth comb) combined with a mild detergent when possible, as it reduces reliance on chemicals.
Maintain scalp hygiene by washing hair with gentle, sulfate‑free shampoo after treatment.

If an allergic response escalates to difficulty breathing, swelling of the face or throat, or widespread rash, administer emergency epinephrine if available and call emergency services without delay.

Special Considerations («Infants, Pregnant Women, and Individuals with Certain Health Conditions»)

Infants require treatments that avoid neurotoxic insecticides and harsh chemicals. Use a fine‑tooth lice comb on damp hair, repeating the process every 2–3 days for two weeks. If a medicated product is considered, select a formulation specifically labeled for children under two years and follow the exact dosage instructions; otherwise, rely solely on mechanical removal and thorough laundering of bedding and clothing.

Pregnant individuals should limit exposure to permethrin, pyrethrin, and other common pediculicides, as safety data are limited. Preferred options include regular combing with a lice‑removal comb, washing all personal items in hot water (≥130 °F/54 °C) and drying on high heat, and, when necessary, applying a physician‑approved topical treatment that has been evaluated for use during pregnancy.

People with chronic health conditions—such as epilepsy, severe eczema, asthma, or immunosuppression—must avoid agents that can trigger seizures, respiratory irritation, or skin breakdown. Recommended actions:

Mechanical removal with a fine‑tooth comb, performed consistently over a 14‑day period.
Application of a prescription‑only treatment confirmed safe for the specific condition, after consulting a healthcare provider.
Strict hygiene protocol: wash all contaminated fabrics in hot water, vacuum upholstered surfaces, and isolate personal items to prevent reinfestation.

Across all groups, success depends on diligent repetition of removal techniques, thorough cleaning of the environment, and professional guidance when chemical options are considered.