How to Treat Lice at Home | A Step-by-Step Plan

Finding lice in your child’s hair is stressful, but the fix is straightforward: choose the right treatment, follow the application steps exactly, and stay consistent with combing. The CDC has clear guidance that works for most households, and the whole process takes about three weeks from start to finish. Here’s the complete plan.

Which Lice Treatment Should You Use?

The medicine you choose depends on what’s available and whether you need a prescription. The FDA currently lists permethrin and pyrethrins with piperonyl butoxide as over-the-counter options. MedlinePlus also names malathion lotion, spinosad suspension, and ivermectin lotion as head-lice medicines — some of these are OTC, others need a prescription.

The table below compares the most common treatments so you can match one to your situation.

For most families, an OTC option like permethrin works well. If you’re not sure which product to start with, our best at-home lice treatment picks compare the top-rated options side by side.

How Do You Apply Lice Medicine Correctly?

Application steps differ by product, so read your specific label first. The CDC emphasizes following the medicine’s directions exactly — and skipping the conditioner before treatment, since it can reduce how well the product works.

For permethrin lotion, the CDC outlines this sequence: wash the hair with regular shampoo, skip conditioner, towel-dry until damp, apply the lotion to the scalp and hair, leave it on for 10 minutes, then rinse in a sink and comb out tangles.

For pyrethrin shampoo, apply to dry hair and scalp, leave on 10 minutes, lather, and rinse. MedlinePlus notes that if live lice still appear a week later, a repeat treatment may be needed.

Whichever medicine you choose, use only one lice product at a time unless a clinician says otherwise. Apply it to scalp hair only, and avoid treating people who show no signs of live lice or nits near the scalp.

What Comes After Treatment?

Treatment kills the lice, but it doesn’t remove the nits. The CDC recommends using a fine-tooth comb to remove dead lice and remaining eggs after treatment, then continuing to comb every 2–3 days for 2–3 weeks to catch anything that hatches.

You’ll also need to handle your home environment. The CDC recommends washing clothes, bedding, and items used in the past 2 days in hot water at 130°F with high-heat drying. Items that can’t be washed can be sealed in a plastic bag for 2 weeks. Soak combs and brushes in hot water at 130°F for 5–10 minutes, and vacuum floors and furniture.

A common mistake is reapplying medicine too soon. If lice are still moving slowly 8–12 hours after treatment, the CDC says not to reapply immediately. If they seem as active as before, talk to a healthcare provider before treating again.

FAQs

Do kids need to stay home from school?

No. The CDC states that children do not need to leave school early once treatment starts. They can return after the first treatment is complete, though you should check your school’s specific policy. Head lice don’t spread disease, and the risk of transmission drops significantly once live lice are treated.

Can I use conditioner before lice treatment?

No. The CDC advises against using conditioner or a shampoo with conditioner before lice treatment because it can coat the hair and reduce how well the medicine penetrates. Wait until after treatment is complete before using conditioner again, and follow the specific timing for your product.

Are fumigant sprays safe for killing lice?

No. The CDC warns against using fumigant sprays or fogs for head lice because they can be toxic if inhaled or absorbed through the skin. They’re also unnecessary — the combination of proper medicine application, nit combing, and washing bedding handles the problem safely.