The 8 Best Lice Treatments of 2022

RID's Lice Killing Shampoo is formulated with piperonyl butoxide to remove nits

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Nothing makes your skin crawl quite like a case of head lice. Head lice infestations are most common among pre-school children who attend child care and elementary school children due to consistent close contact with others, but adults can get head lice as well—especially from their infected children. One way to remove those pesky insects is by using head lice treatment.

Reviewed & Approved

Formulated with piperonyl butoxide, RID's Lice Killing Shampoo removes louse, nymphs, and nits. We also recommend Nit Free's Terminator if you're looking to eradicate lice using a comb.

Manual removal involves the use of a fine-toothed comb to pick out all adult lice, nymphs (baby lice), and nits (eggs) from the hair and scalp. Chemical removal can require the use of a shampoo, mousse, spray, or treatment gel containing ingredients that either repel, stun, or kill the live lice. The manual removal of nits must follow chemical treatments.

When looking for head lice treatments, consider the ingredients of chemical treatments. Look for piperonyl butoxide and pyrethrum extract. We researched dozens of head lice treatments and evaluated them for ingredients, methods, price, and effectiveness.

Here are the best lice treatments on the market.

Best Overall: RID Lice Killing Shampoo

4.9
RID Lice Killing SHampoo, Proven Effective Head LIce Treatment for Kids and Adults

Courtesy of Amazon

We chose RID's Lice Killing Shampoo as our top pick because it’s powered by a combination of piperonyl butoxide and pyrethrum extract to remove louse, nymphs, and nits. You can apply it safely to dry hair, let it work, and rinse it away easily without leaving any chemical residue behind. Remember to thoroughly comb through the clean hair afterward with a lice comb to remove any remaining nits. It’s also advised that you repeat the treatment a second time within seven to 10 days for optimal effectiveness. This shampoo is safe for use on adults and kids over the age of 2.

Best Comb: Nit Free Terminator Lice Comb

4.6
Nit Free Lice Comb

Courtesy of Amazon

Most experts will agree that you cannot effectively eradicate lice without the manual removal of louse and nit with a fine-toothed comb. With that said, not all combs are created equal. In fact, some say the combs that come with lice treatment kits are rather ineffective.

Instead, invest in a high-quality Nit Free Terminator Comb. Called a “must-have” by experts and users alike, this professional comb is able to get underneath and remove even the smallest of lice eggs thanks to its spiral micro-grooved teeth. The microscopically rounded tooth ends also protect the scalp from unwanted pricking, scratching, and pulling. And because it’s made with durable and corrosion-resistant stainless steel, it can be effectively sterilized between uses.

Best Gel Treatment: LiceMD Head Lice Treatment Kit

LiceMD Head Lice Treatment Kit

Courtesy of Amazon

If you’re struggling with persistent lice, or super lice, this gel treatment from LiceMD is definitely worth a try. It’s pesticide-free, non-toxic, safe, and odorless, and the manufacturer claims that the formula can eliminate lice in as little as 10 minutes. It’s powered by dimethicone, which is less likely to irritate the skin and is very effective in killing louse, as well as preventing a future infestation. Simply apply the gel, comb it through the hair for even coverage, let it sit, and then shampoo it out. The formula includes conditioners, helping to prevent painful tangles in the midst of treatment. LiceMD is clinically proven, pediatrician tested, and safe for use on adults and kids over the age of 2.

Best Spray: Tec Labs Head Lice Spray

Tec Labs Head Lice Spray

Courtesy of Amazon

This expert-recommended spray is a quick and effective lice treatment that doesn’t rely on harsh chemicals to kill louse, nymphs, and nits. Instead, the homeopathic solution is powered by sodium chloride, AKA salt, making it safe for both adults and children as young as six months.

This special formulation also enables you to use it daily during an infestation without the worry of skin irritation. Simply spray it all over your hair until it is fully saturated, let it dry completely, and then use a comb to remove dead louse and eggs. Users report that it works well on both super lice and nits, and they love how it begins working on contact. The spray application also makes it easier to use as a self-treatment.

Best Mousse: Fairy Tales Lice Good-Bye Mousse

Fairy Tales Lice Good-Bye Mousse

Courtesy of Amazon

This foamy mousse uses enzymes rather than chemicals or pesticides to effectively remove louse and nits. More specifically, the formula helps to dissolve the sticky glue that attaches eggs to the hair and breaks down the shell of the louse. The mousse is easy to apply and safe to use repeatedly, if necessary—each bottle contains six to 10 treatments, depending on the length of hair being treated.

Apply pumps of the mousse to damp hair, working it throughout layers in a massaging motion to loosen the nits. After letting it sit for 20 to 25 minutes, comb each section throughout to remove the mousse, louse, and nits. The manufacturer labels this product as safe for kids and does not list any age restrictions on the label.

Best Gentle Method: Cetaphil Gentle Skin Cleanser

Cetaphil Gentle Skin Cleanser

If you or your child has particularly sensitive skin, reach for a classic bottle of Cetaphil Gentle Skin Cleanser and give this method a try. Apply an ample amount of the cleanser to dry hair, massaging it thoroughly to make sure that every bit of hair and scalp is coated. Then grab your lice comb and carefully move through the hair one section at a time, removing the product along with any louse, nymphs, or kits you can find. Finally, blow-dry the hair on high heat to kill any bugs you may have missed. Repeat this treatment again at the one week and two week mark to make sure the infestation is eradicated.

Best All-Natural Method: AmazonFresh Extra Virgin Olive Oil

AmazonFresh Extra Virgin Olive Oil

Courtesy of Amazon

Olive oil is considered a suffocant when it comes to lice treatments, meaning it blocks the airways of louse to kill them. As a bonus, it’s full of vitamins, antioxidants, and healthy fats that help hydrate the scalp and strengthen the hair.

Coat the scalp and dry hair with olive oil until it’s fully saturated. Since it can be a bit messy, it’s best to use some sort of head wrap or shower cap to secure the hair and oil in place. Louse can live for hours without breathing, so leave the olive oil on the hair overnight for best results. Then comb through the hair section by section, removing all louse and nits along with the oil (the olive oil helps loosen nits from the hair). Once all signs of lice are gone, wash your hair as you normally would.

Best Preventative Wash: Lice Shield Shampoo & Conditioner

Lice Shield Shampoo & Conditioner

Courtesy of Amazon

If you want a natural preventative against a lice infestation, go the essential oils route with this two-in-one shampoo and conditioner. Specially developed with an exclusive blend of citronella, rosemary, lemongrass, cedar, and geraniol essential oils, this gentle-yet-effective cleanser repels lice and super lice and nourishes your hair simultaneously. The gentle formula also makes it safe for the entire family. Just apply the cleanser generously to wet hair, massage thoroughly, and rinse. Consider it one of the easiest ways to protect your kids (and yourself) when everyone returns to school, as well as during the inevitable lice outbreak.

Final Verdict

The ideal first line of defense in getting rid of lice is an insect-eradicating treatment like RID Lice Killing Shampoo paired with a high-quality comb like the Nit Free Terminator Comb. If the lice appear to be resistant to this treatment, you’re likely facing off with super lice and will require additional treatment. In that case, experts recommend the LiceMD or Licefreee Spray! Instant Head Lice Treatment. Regardless, you need a good lice-removing comb and patience for the manual removal of louse, nymphs, and nits.

What to Look for In a Lice Treatment

Method and Severity

“Most lice treatments are topical insecticides that either directly kill the louse, or egg, or both. Prescription treatment benzyl alcohol works by smothering the lice. Different products (both over-the-counter and prescription) have different ways of killing the lice based on the mechanism of action of the product. Many treatments need to be reapplied in seven days due to the life cycle of nit to louse. In addition to medication, combing the hair with a fine-tooth comb every three to four days for several weeks may clear the infection, but studies show it may not be as effective as the medications.

“Lice can infect both children and adults at all socioeconomic levels; however, children are more often infected compared to adults. This may be because of the mode of transmission (direct contact or possibly sharing hats). There is no difference in the mechanism of treatment for adults and children, but adults may need more product due to larger head sizes. We also have more safety concerns with younger children who may absorb more product relative to their size.

“Unless there is widespread resistance in the community, over-the-counter preparations made with permethrin are the first-line treatment. In some communities, lice are becoming resistant to that treatment. If a prescription is needed, I prefer benzyl alcohol or spinosad. Malathion is also a commonly prescribed medication, but it smells bad and may be flammable. It is also important to follow the directions for the specific product because they are applied for differing amounts of time, and some are applied on wet hair while others are applied on dry hair.

“When rinsing the hair, we recommend using cool water to limit the risk of absorption. When blood vessels get warm, they get bigger and increase absorption through the skin. Rinsing over a sink rather than a shower or bath also lessens contact with other skin. Many products are irritating to the eyes, so care should be used not to rinse it into the eyes.” — Adam Keating, MD, a pediatrician at Cleveland Clinic Children’s.

Manual vs. Chemical

“For the most part, lice treatment is the same for all age groups. It is important to read the contraindications for any product to check for age restrictions or other vulnerable populations (like pregnant women) and for allergies. Most over-the-counter and prescription lice treatments are safe if the directions are followed appropriately. However, many people do not follow directions. For example, when the product label says to leave it in the hair for one hour, some people rinse it out after 10 minutes.

“As with many things, there are many options for lice treatment, and some are better than others. However, it’s just as important to have good lice comb as it is to use a good lice treatment product. Most combs that are supplied with a treatment kit are not effective. We use and recommend the Nit Free Terminator Comb. It is a “must-have” for successful treatment. For any person that is concerned about any ingredient in a product, it is possible to have a successful treatment using an inert product, such as a conditioner, olive oil, or coconut oil combined with the Nit Free Terminator Comb. Combing (manual or mechanical removal) is also a treatment method on its own.” — Anna Warren, the owner of The Asheville Lice Treatment Center in North Carolina

Ingredients

“Key features of lice treatment include topical neurotoxic agents, oral agents, combination therapy, and mechanical removal therapy. Washing all bedding, sheets, and towels in hot water for at least 30 minutes is also important in the treatment and prevention of reinfestation. Items that cannot be washed can be placed in a Ziploc bag for more than one week as lice cannot survive without blood from a human for longer than 48 hrs. Wash all surfaces. Any other siblings and adults should be treated also if live lice are visualized in the scalp. Also important to note, the removal of nits must be done on a daily basis manually after topical treatments. It is very important to make sure patients are aware of side effects and age recommendations of certain treatment methods. Always be sure to check with your healthcare provider and/or pediatrician for the best advice for your child. All treatment options work similarly but can have more side effects in younger-age children.

“I usually recommend Nix or RID over-the-counter treatments, up to two applications one week apart, as the first line of defense. It is very important to comb wet hair with a fine-toothed comb, removing all nits. If one nit survives, reinfestation can occur. Treatment of all family members in the home, and washing all sheets, towels, and bedding at the same time of treatment is important. If the first treatment fails, I recommend Sklice or Ovide therapy (prescription options). It is important to discuss with your primary medical provider all concerns relating to the safety and efficacy of different treatments of lice.” — Sara Siddiqui, MD, a pediatrician at NYU Langone Health

Frequently Asked Questions

  • What ingredients are in lice treatments?

    Food and Drug Administration (FDA) approved over-the-counter lice treatments contain one of two active ingredients: permethrin 1% lotion, or pyrethrins combined with piperonyl butoxide.

    In addition to OTC products, the following lice treatments are available only by prescription: 

    • Benzyl alcohol 5%
    • Ivermectin 0.5% lotion
    • Malathion 0.5%
    • Spinosad 0.9% suspension
  • When should you go to the doctor for lice?

    If you find active lice 8 to 12 hours after beginning treatment, consider checking in with your healthcare provider. They may recommend a different OTC product or prescribe a stronger treatment.

  • Can home remedies get rid of lice?

    Some people turn to a variety of household products—such as acetone, bleach, petroleum jelly, and WD-40—to treat head lice. There is no scientific proof these remedies work. They may even be dangerous.

  • What is the strongest lice treatment?

    Of the various lice treatments, ivermectin lotion has emerged as one of the strongest solutions to get rid of lice. Research shows a single application can kill the lice without any need for nit combing.

Why Trust Verywell Health

As a seasoned health writer, Alena Hall understands how important it is to know exactly what you’re getting in a wellness product. Over the years, she has reviewed dozens of products, from athletic recovery aids to homeopathic essential oils to ever-trendy CBD topicals, to help readers like you discover products that can help you live your best life.

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4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  4. Pariser DM, Meinking TL, Bell M, Ryan WG. Topical 0. 5% ivermectin lotion for treatment of head liceNew England Journal of Medicine. 2012;367(18):1687-1693. doi:10.1056/NEJMoa1200107