The truth: Several pesticide-based treatments are available, either over the counter or by prescription. But these may not always be the best choice.
Sometimes called “super lice,” many of the pests in the U.S. and other parts of the world have developed resistance to over-the-counter lice treatments that contain certain pesticides, notably permethrin and pyrethrins. In a 2016 study on this topic, scientists found that 98 percent of the lice they evaluated—collected from 138 sites in 48 states—had a gene mutation indicating possible pesticide resistance. The researchers say that while the mutation doesn’t guarantee that an OTC lice product with permethrin or pyrethrins will fail, it does reduce the chances treatment will succeed.
Prescription lice treatments may be more effective but can be expensive. For instance, according to drug pricing website GoodRx, Sklice, a prescription treatment that contains the pesticide ivermectin, can cost $350 or more for a tube, and it might not be covered by insurance. And some pesticide products carry risks, such as malathion (Ovide and generic)—it’s flammable, and it can cause stinging and burns. CR’s experts recommend against using products containing the active ingredients malathion and lindane.
Note that some prescription pesticide treatments should be used on children only of certain ages, may need to be used more than once, and are applied for varying lengths of time, so it’s important to read directions carefully.
And there are effective alternatives to pesticide-based products. Consumer Reports’ scientists have long advocated the use of wet-combing: coating your child’s head with conditioner or oil and combing out lice and nits with a fine-tooth metal nit comb. The AAP also recommends this method for parents who prefer not to use one of the available lice pesticides, or whose children are too young for them.
Another effective alternative is the comprehensive 5 step process at Torrance Lice Removal. Our process is chemical free, has a 99% success rate, take about 90 minutes, and comes with an optional 30 day lice free guarantee.