Although head-lice infestations most commonly affect school-aged children and their caretakers, I have only ever had lice as a 20-something. My freshman year of college, my boyfriend and I both contracted lice during midterms (and it remains a playful disagreement about who gave it to whom). It happened again last year: I got lice after summer camp, incidentally while living in a co-op with 27 other people. And even though lice spreads from head to head, often in close quarters, thanks to some straightforward at-home treatment and prevention measures, no one else in either my dorm room or co-op got infested (other than the person with whom I was sharing a bed).
If you also find yourself with lice, rest assured that you don’t have to shave your head or throw away all of your clothing. They can’t jump or fly, don’t spread disease, and aren’t a sign of poor hygiene. According to all six experts I spoke with, lice are most commonly spread by head-to-head contact, and they can’t live for more than 24 hours on non-human surfaces — including hair brushes and furniture. Unfortunately, no single treatment alone is going to eliminate them. “People want a miracle product, but if there was a miracle product, lice wouldn’t exist. The products simply make your job easier,” says Katie Shepherd, founder and CEO of the Shepherd Institute for Lice Solutions, who has been working in the at-home lice removal industry for over two decades.
From my experience, you only need a handful of drugstore essentials to remove head lice at home. If you want to really cover your bases, experts suggest that you clean items that have been exposed to head contact within the past 24 hours, like bedsheets, towels, and recently worn hats, in a hot dryer to kill any stray lice and nits. Items that can’t be put in the dryer, like stuffed animals, should be put in garbage bags for a day or two. But using a combination of the following treatments has worked for me — twice. So instead of ripping out your hair (literally), here are the products that made my life a little easier — with some insight from the experts on the safety and efficacy of each — most of which are only a drugstore away.
In my experience, the most labor intensive and essential part of treating lice and preventing reinfestation is the process of manually removing any live lice and nits (which are lice eggs that affix to hair shafts with cement-like glue) — and all of the lice removal professionals who I spoke to agree. “If they’re not there, you’re not going to have lice,” explains Dr. John Clark, professor of environmental toxicology and chemistry in the Department of Veterinary and Animal Sciences at the University of Massachusetts Amherst, who is in favor of nit removal (by people who have done it before) as an effective form of treatment. Successful nit removal requires good lighting, a high-quality nit comb, and someone who really cares about you — or at the very least is willing to go through your hair and remove all the nits until they are gone. “It’s a manual, labor intensive removal process, you’re just not going to get around that,” says Maria Botham, founder and president of Hair Fairies, who has professionally been removing lice for over two decades. “You have to take the time to comb and to methodically go through the hair, and even then I tell people to keep checking,” adds Shepherd.
When it comes to the world of nit combs, fine toothed means high quality, and both Shepherd and Lena Gorelik, owner of Lice Free Noggins, specifically vouch for the Nit Free Terminator. Shepherd calls it “absolutely the most effective comb in the world,” citing a Lice Solutions study that found the Nit Free Terminator comb to be three times as effective at removing nits compared to the others tested. Even though the comb is not sold in most pharmacies, both advocate for preemptively buying it online.
A couple of doctors advise against nit picking as the primary and sole method of treatment, which is where over-the-counter chemical rinses come in. Two of the doctors who I spoke to—Dr. Richard Pollack, President and Chief Scientific Officer at IdentifyUS who holds a Ph.D. in parasitology, and Dr. Bernard Cohen, professor of pediatrics and dermatology at John Hopkins—advocate for using these rinses, though the efficacy is debated in the scientific literature. However, all three doctors agree that they are most effective at killing live lice, and are safe to use — though if you’re looking for a treatment that’ll kill both nits and live lice, the doctors agree that you’re going to need something with a prescription.
There are two insecticides commonly found in over-the-counter rinses: pyrethrin, a composite of the chrysanthemum flower, and permethrin, its chemical compound equivalent. I’ve had the best results using a two-pack of generic permethrin-based rinse on the first day and again a week later. The idea behind this approach, which is recommended by Drs. Pollack and Cohen (but not Dr. Clark because of lice resistance) is that lice take 9-12 days to mature, so treatment initially targets live lice, and then later wards off any additional live lice that have since hatched from unremoved nits.