Head Lice Treatment

There are different types of lice:

• Head lice (Pediculus humanus capitis) are the most common.
• Body lice (Pediculus humanus corporis) live in clothing seams and move to the skin to feed.
• Pubic lice (Pthirus pubis), often called “crabs,” typically spread through intimate contact and may affect pubic hair, body hair, or eyelashes.

Head lice are tiny parasitic insects that live on the scalp and feed on small amounts of blood. They lay eggs (known as nits) that stick to hair shafts near the scalp. They cause intense itching, sleep disruption, and skin irritation. Lice aren’t caused by “dirty hair,” they don’t jump or fly, and pets don’t carry or spread them.

Head lice do not spread disease. However, body lice can transmit bacterial infections that may spread louse-borne typhus (Rickettsia prowazekii), louse-borne relapsing fever (Borrelia recurrentis), or trench fever (Rochalimaea quintana). These are rare but serious diseases.

Lice are spread through close contact or shared personal items:

• Head lice: Head-to-head contact (the biggest cause in schools and households) or sharing brushes, combs, hats, hoodies, helmets, hair accessories, pillows, or towels shortly after use.
• Body lice: Wearing unwashed or shared clothing and bedding.
• Pubic lice: Close/intimate contact and sharing bedding.

Lice can survive briefly off the body but need human blood to live.

Use these clear, at-home prevention steps:

1. Reduce head contact: Avoid head-to-head contact during outbreaks. Consider tying long hair back.
2. Don’t share items: Keep personal hair tools, hats, helmets, towels, and pillowcases to one person.
3. Routine checks: During outbreaks, do quick scalp checks at the hairline, behind the ears, and nape of the neck. Look for moving lice or lice eggs (nits). Use fine-tipped combs for easy nit removal.
4. Clean smart: Wash pillowcases, hats, scarves, bedding, and recently worn clothing in hot water and dry on high heat. Soak combs/brushes in hot water (≥130°F) for 5–10 minutes. Items that can’t be washed can be sealed in a bag for two weeks. Avoid fumigant sprays.
5. Limit re-exposure: Treat affected household members promptly and avoid sharing sleeping spaces until treatment is complete.
6. For pubic lice: Pause intimate contact until prescription medication or appropriate over-the-counter treatment is finished and linens are washed.

Common signs of a lice infection include:

• Itchy scalp or intense itching on the neck and behind the ears 
• A tickling feeling or movement in the hair
• Visible lice or nits on the scalp or hair shafts (nits are tiny, oval, and firmly attached near the scalp)
• Red bumps on your head, neck, or shoulders; skin rash or sores from scratching
• Irritability and difficulty sleeping (lice are more active at night)
• For pubic lice: Itching in the pubic area or body hair
• For body lice: Itchiness where clothing is tight (waist, shoulders)

Not sure if it’s lice or another scalp condition? Our online doctor can help you tell head lice from dandruff, seborrheic dermatitis, or psoriasis and guide the right at-home treatment.

Consider virtual care now if:

• OTC lice removal treatment hasn’t worked or lice keep coming back.
• You see persistent nits after treatment and need to schedule retreatment.
• There are sores, yellow crusting, swelling, or signs of skin infection from scratching.
• You’re unsure if it’s lice or dandruff or you need help choosing between permethrin, ivermectin, or another prescription medication.
• Multiple adults in the home are affected and you need a coordinated plan to get rid of lice and prevent reinfestation.
• You suspect body lice or pubic lice and need discreet guidance and a prescription to treat lice appropriately.

Our clinicians provide discreet, quick online care with same-day prescriptions and clear home treatment steps.

Here’s how care works with 24hrdoc:

1. Virtual visit – Share symptoms, exposure, and photos (if possible). A board-certified doctor confirms the diagnosis and discusses options.
2. Personalized plan – You’ll receive either over-the-counter treatment guidance or a lice prescription medication (sent to your pharmacy the same day).
3. At-home treatment – Start a shampoo or lotion exactly as directed, then follow simple cleaning steps to protect your home.
4. Follow-up – If you still see live lice after the recommended window, we’ll adjust treatment to help you kill lice and nits effectively.

Medications we may recommend:

• Permethrin (1%): A widely used first-line OTC lice treatment. Often repeated in 7–9 days to target newly hatched lice.
• Ivermectin 0.5% lotion: A prescription-strength topical pediculicide that can get rid of head lice with a single application (no nit combing required in many cases).
• Other options may be considered when resistance or recurrence is suspected.

Key treatment tips:

• Apply to the scalp and hair exactly as instructed. Don’t rinse early.
• Plan a retreatment on the timeline your clinician recommends (often day 7–9 for certain products).
• Avoid “layering” multiple products the same day.
• Wash bedding, clothing, hats, and towels used in the last 48 hours. Vacuum upholstered furniture and car seats.

We also treat lice at home for body lice and pubic lice with personalized guidance, prescription medication, and practical hygiene steps.

• Affordable, convenient care: Low-cost virtual visits with clear guidance so you get lice treatment online fast.
• Fast relief: Same-day prescriptions and practical steps to treat lice at home.
• Experienced clinicians: Board-certified doctors provide evidence-based care and follow-up support.