Treat drug-resistant super lice. No pesticides needed.
The rise of “super lice”
A new strain of “super lice” has evolved resistance to the chemicals in most drugstore products. We recommend products with dimethicone, which is non-toxic and effective against super lice.
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According to the AAP, “several studies have found that, over the past 4 decades, clinical effectiveness of Permethrin and Pyrethrins [the chemicals found in many over-the-counter brands] has declined from near 100% to as low as 25%.”
The AAP also warns about the safety of these pesticides, which are neurotoxins: “Caution must be taken given reports of neurologic symptoms, respiratory symptoms, and dermatitis with ingestion, inhalation, and contact exposure, respectively.”
So what should I use? We recommend products with dimethicone, a non-toxic, silicone-based material. It coats both nits and lice—instead of poisoning them—and causes them to suffocate. Research has found dimethicone to be safe and effective.
The essentials of treating (and cleaning)
Before treating, check all family members using a lice comb. Lice can be difficult to see—especially in the early weeks of an infestation—and itching may or may not be present. At their largest, adult lice are the size of a sesame seed. A lice comb will collect nits (eggs), nymphs (baby lice), and adult lice.
After treating, clean effectively to ensure that lice aren’t hanging around your home.
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You CAN treat effectively at home! Here’s what you’ll need:
#1: A product that works on “super lice.” We recommend products with dimethicone, which is non-toxic.
Comb regularly post-treatment, and complete a follow-up treatment ~10 days later. Although dimethicone is effective against nits (eggs) and lice, missing just a few eggs could re-trigger an infestation once those eggs hatch. Waiting 10 days for a follow-up gives any lingering eggs enough time to hatch, but not enough time to reach the adult stage in which they’ll begin laying eggs of their own.
#2: A high-quality lice comb. This should be metal, not plastic. And don’t waste your money on the electric ones. A lice comb will trap nits and lice in its grooves. Separate hair and comb thoroughly in sections, starting at the scalp. Wipe comb on a white paper towel and check for nits or lice. There are many helpful videos online.
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Professional treatment involves visiting a lice clinic or having someone visit your home. Most professionals do thorough comb-outs, and others use techniques like exposing hair to significant heat or cold. These advanced techniques can be more expensive, and some are more backed by research than others. One thing is clear though: a professional, thorough comb-out is always an effective way to treat lice.
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You’ve removed the lice from your head - next, ensure that lice aren’t hanging around your home.
Here’s the good news - you don’t need to clean your entire house or place your entire wardrobe in the laundry. Lice will die within two days off someone’s head, and nits (eggs) won’t hatch if they aren’t on a head.
Hair accessories (brushes, headbands, hair-ties, etc.) that have been used within the last 48 hours: Put in a bag and place in the freezer for 12 hours. Alternatively, soak in hot water (at least 130°F) for 10 minutes.
Stuffed animals, clothing, sheets, hats, etc. that have been used within the last 48 hours: Place in the dryer on HIGH HEAT for 40 minutes. (You can wash too, but it’s not the washing machine that kills lice - it’s the heat of the dryer!).
Headboards, car seats / headrests, couch cushions, and other places where heads have been recently: Vacuum or place things like car-seat covers in a dryer on high heat for 40 minutes. We do not recommend vacuuming your floors and every crevice of your house. Remember that lice cannot jump or fly, they stay on heads pretty firmly, and they don’t live more than two days off a head. Above all, use your judgment when cleaning.
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Use our free and anonymous notification tool to email others who may have been exposed to lice. Also, view our simple prevention steps to ensure that lice don’t return—because there’s no limit to the number of times you can have lice.
The products we do (and don’t) recommend.
These are the products that we’ve learned—through trial and error and endless research—actually work. This is what we use on our own children. Like you, we prefer products without pesticides.
Kill Lice
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This has everything you need to treat lice at home. And it works on super lice. With a pleasant scent and no pesticides, this product’s key ingredient (dimethicone) is proven to be safe and effective in treating lice.
No sulfates, parabens, or phthalates.
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This 4-Step Kit from Lice Queen is a great alternative. Like our #1 pick, the active ingredient is dimethicone (making it effective and pesticide-free) and this includes a high-quality lice comb. Plus, there’s a bonus repel spray included. The downside? It’s a bit pricier than our #1 choice, with a slower turnaround from Amazon.
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Many over-the-counter products contain the chemicals Permethrin and Pyrethrins, which lice have evolved resistance to. This has created a new strain of drug-resistant “super lice.”
Avoid products with these chemicals, which are also pesticides and neurotoxins. Look for the ingredient dimethicone instead.
Comb Lice Out
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If you don’t purchase the Lice Elimination Kit (which includes a comb), you’ll need this one. It’s easy to use, and traps both nits and lice in its grooves. A high-quality comb is essential for at-home treatment, and for prevention via weekly comb-throughs.
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This 2-sided comb from Nix is slightly cheaper and still effective. There are many other brands out there too, and any metal comb specifically designed for lice/nits should get the job done.
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Do not buy any lice comb that is plastic - it won’t trap the lice/nits effectively. And don’t waste your money on the pricy electric combs that claim to detect and instantly kill lice. They are overpriced and you won’t find any research-backed evidence of their effectiveness.
Repel Lice
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Every. Single. Morning. That’s how often we spray our kids’ hair with Rosemary Repel. The lovely, natural scent is unappealing to lice.
Prevention only. No sulfates, parabens, or phthalates.
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We also love this spray from So Cozy and this one from Ladibugs (though it’s pricy). Both use natural scents, just like our #1 pick. The Ladibugs spray can also be combined with a matching shampoo + conditioner.
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There’s no need to buy a lice-repelling spray that uses harsh chemicals (compared to natural scents like rosemary and peppermint). And while different than repelling sprays, we recommend against most lice-killing sprays that are sold for treatment purposes because it’s difficult to ensure your hair is properly coated with a spray.
Clean After Lice
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We use this low-cost, handheld vacuum to ensure that lice haven’t hung onto car seats, headboards, etc.
You don’t need to vacuum your whole house, but it’s smart to quickly vacuum the key places that heads touch.
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If you’re willing to spend a bit more, we love this handheld vacuum from Shark, which is powerful yet sleek.
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We don’t find it necessary to use a larger, traditional vacuum to clean every inch of your house (learn why on our Treatment page). A handheld vacuum can more easily target the spots that stray lice will most likely be found.
Avoid lice-killing sprays designed for furniture, bedding, etc. Some use chemicals like permethrin that lice have evolved resistance to. A handheld vacuum will always be better than coating your home in a spray.
Keep Hair Up
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It’s not technically a lice-prevention product, but this makes our mornings much easier. It helps us put—and keep—our kids’ hair up. It’s especially nice for the littlest ones, with their fine hair and fly-aways. Plus, it’s only $5 and one stick lasts (seemingly) forever.
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This stick from Dolhair works well too, as does anything that gets kids to wear hair up (or covered)—and keep it that way all day.
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N/A for this one, just a reminder to not wear hair down, as lice spread from hair-to-hair contact.
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