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Lice FAQs

Can I treat lice online?

Lice are tiny parasitic insects that live on the human body and feed on blood. They tend to live in areas of the body covered with hair, such as the scalp or pubic area. Sometimes they require treatment with prescription-strength shampoo or lotion. 

You can get a lice treatment online. If you think you have lice, make an appointment with one of our K Health providers. They can review your symptoms and, if appropriate, write you an electronic prescription for treatment that you can pick up at your preferred pharmacy. Quick treatment can prevent the lice from spreading and becoming a recurrent problem.    

Symptoms of lice 

Symptoms of lice may include intense itching in the areas of infestation. Sometimes the skin has an allergic reaction to the lice bites, which causes a skin rash. The itching can be so intense that the scratching causes bacterial infections in the skin.

How are lice treated? 

Lice infestation treatment involves over-the-counter (OTC) or prescription-strength shampoos and lotions. It also involves washing all clothing, bedding, and towels used by the person with the lice infection in hot water of at least 130°F and machine drying them using the hot cycle. Any items that cannot be laundered can be sealed in a plastic bag for two weeks. 

OTC treatments have specific instructions that must be followed. Most OTC treatments do not kill nits, so a second application is sometimes necessary to kill the nymphs when they hatch. Sometimes, a person needs treatment with prescription medicine that kills the lice, but this is not always necessary. 

OTC lice treatment medications include one of the following active ingredients:

  • Pyrethrins combined with piperonyl butoxide: Brand name products include A-200, Pronto, R&C, and Triple X. Pyrethrins kill only live lice and not the eggs (nits). A second treatment is usually recommended nine to ten days after the initial treatment to kill any newly hatched lice. These products are approved for children two years and older.
  • Permethrin lotion 1%: The brand name product is Nix. This lotion has approval from the FDA for treating head lice. Permethrin kills live lice but not the unhatched eggs. It may continue to kill newly hatched lice for several days after initial use. A second treatment is suggested on day nine to kill any newly hatched lice. This product is safe to use on children two months of age and older. 

After completing a full treatment, if you still see actively crawling lice, make an appointment with a healthcare provider for a prescription-strength treatment. 

Are lice contagious?

Lice spreads from person to person through head-to-head contact. They cannot jump or fly but spread through crawling. This doesn’t necessarily mean your head must touch the head of someone with lice to get it. Lice can also spread through personal items such as hats, hairbrushes, or hair accessories. 

Is there prescription-strength lice treatment?

You may need a prescription-strength treatment if you still notice living lice after completing an OTC treatment. Prescription-strength treatments include products with the following active ingredients: 

  • Benzyl alcohol lotion, 5%: The prescription product containing this ingredient is Ulesfia lotion. This product kills lice but not the eggs. Seven days after the initial treatment, a second treatment is needed to kill newly hatched eggs. This product is safe for children six months and older. This lotion is sometimes irritating to the skin. 
  • Ivermectin lotion, 0.5%: This prescription product kills live lice, and while it does not kill the eggs, it does appear to kill the newly hatched lice. It is most effective when applied to dry hair without combing. 
  • Malathion lotion, 0.5%: The prescription product containing this active ingredient is Ovide. This product kills live lice. It also partially kills some eggs. A second treatment is recommended if lice are present seven to nine days after the initial treatment. Only use this product on children six years and older. This lotion can sometimes be irritating to the skin. It is not safe to use electrical heat sources such as hair dryers, curlers, or flat irons on your hair when using this product as it is flammable. 
  • Spinosad 0.9% topical suspension: The prescription product containing this ingredient is Natroba. This product kills live lice along with the unhatched eggs. A second treatment is typically not required. Nit combing is also not required. This treatment is safe for children six months of age and older. 

When using prescription-strength lice products, follow these helpful hints:

  • Never use extra amounts of the treatment than recommended. These products may be dangerous when overused. 
  • Keep these products out of the eyes. Immediately flush with lots of water if they get into the eyes. 
  • Do not use these products more than two or three times with the same medication if it is not working. Call your medical provider if there are still crawling lice after two treatments.
  • Do not use two different head lice products at the same time unless directed to do so by your pharmacist or medical provider.
  • Rinse these products out of your hair in the sink rather than the shower to minimize exposure to your skin. Use warm water rather than hot to decrease absorption into the skin. 

Which prescription is best for lice?

After taking a look at your current symptoms, your doctor will help you decide which treatment is best for you. Many times, two treatments are required to kill all the lice. If after two treatments you are still seeing live lice, call your medical provider. The lice may have developed a resistance to that product, and you may need to try a different one. 

How much does it cost to treat lice?

K Health offers efficient and cost-effective appointments to help keep your costs down. Generally, our fee is less costly than it would be to see a doctor in person. For $73, you can chat with one of our licensed healthcare providers. They will review your symptoms and, if appropriate, send you a prescription for your treatment to the pharmacy of your choice. How much it costs to treat lice depends on if you have insurance and how much your pharmacy charges for the treatment. 

Preventing lice 

Follow these tips to help decrease your chance of getting lice or control the spread. These are also great tips to teach kids who are more likely to get lice.

  • Avoid touching your head to another person’s head while playing or participating in activities such as sports, playing on the playground, at camp, or a sleepover. 
  • Do not share clothing such as hats, scarves, hairbrushes, or hair accessories. 
  • Disinfect brushes and combs used by a person with lice by soaking them in hot water, at least 130° F, for five to ten minutes. 
  • Do not lie on the bed, couch, pillow, carpet, or stuffed animals that have been in recent contact with a person with lice. 
  • Machine wash in hot water and dry with heat all the clothing, bed linens, towels, and other items that a person with lice wore or used during the two days before treatment. 
  • Seal up any fabric items that are not washable into plastic bags and store them for two weeks. 
  •  Vacuum the floor and furniture where the person with lice sat or lay. 

How do I know if I have lice?

If you have had recent exposure to lice or if you are experiencing itching, check your hair for signs of lice, such as tiny crawling bugs or signs of their eggs. The eggs are small white flecks that usually attach to the root of the hair. You may need a magnifying glass to see them.

Stephanie Foley, MD

Stephanie Foley, MD

Neil Brown, MD

Neil Brown, MD

Heather Hylton, MS, PA-C

Heather Hylton, MS, PA-C

Lynn Byars, MD

Lynn Byars, MD

David Morley, MD

David Morley, MD

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