Treat drug-resistant super lice. No pesticides needed.

The rise of “super lice”

Upon finding lice, parents often head straight to the drug store. The American Academy of Pediatrics (AAP) warns that many over-the-counter products contain chemicals that lice have evolved resistance to. This has created a new strain of drug-resistant “super lice.”

  • 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.

Before treating, be sure to check all family members using a lice comb. Remember that lice can be very difficult to see—especially in the early weeks of an infestation—and your child may not itch until they’ve had lice for weeks. 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.

The essentials of treating (and cleaning)

  • 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). See reasons above and product tips below. Follow all package directions.

    We also recommend combing regularly post-treatment, and a follow-up treatment around 10 days after the initial treatment. 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. To use effectively, wet hair and coat in your treatment product (while actively treating) or conditioner (when performing a simple check - the conditioner helps the lice/nits slide off). 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 that show how to comb effectively.

  • 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.

  • 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.

  • 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.

Image of lice comb, head lice, and nit (egg)

Images: Center for Lice Control, Cleveland Clinic

The treatment 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

Treat lice - nontoxic, safe and effective

  • 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.

  • 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.

  • 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

Best lice comb, combs out lice and nits

  • 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.

  • 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.

  • 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.

Clean After Lice

Handheld vacuum for cleaning after lice infestation

  • 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.

  • If you’re willing to spend a bit more, we love this handheld vacuum from Shark, which is powerful yet sleek.

  • 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.

    Lastly, 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.

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