Permethrin is a synthetic pyrethroid similar to naturally occurring pyrethrins. Permethrin kills live lice but not unhatched eggs. Permethrin can kill newly hatched lice for several days after treatment. You may need to treat again on day nine to kill any newly hatched lice before they can produce new eggs.
Use heat. Wash any items used or worn by the person in hot water, and dry them on high heat. Lice and nits die when exposed to temperatures higher than 130 F for more than 5 minutes.
Pediculicides or medications that kill lice are the strongest measures to get rid of a lice infestation. Of the various pediculicides, ivermectin lotion has emerged as one of the strongest solutions to get rid of lice. A single application can kill the lice without any need for nit combing.
Using an effective head louse treatment, with all infested individuals treated at the same time, to prevent re-infestation from others. In most cases, nits will require re-treatment in 7 to 10 days. No treatment is 100% effective at killing the nits. Removing nits from the head by combing with a metal nit comb.
Spinosad 0.9% topical suspension is used to treat head lice and scabies infestations. This medicine is available only with your doctor's prescription.
Start by wetting the hair and lubricating it with hair conditioner or olive oil. Comb the entire head from the scalp to the end of the hair at least twice during a session. The process typically should be repeated every 3 to 4 days for several weeks — at least two weeks after no more lice are found.
Spinosad suspension is used to treat head lice (small insects that attach themselves to the scalp) in adults and children 6 months of age and older. It is also used to treat scabies (mites that attach themselves to the skin) in adults and children 4 years of age and older.
If wet combing has not worked or is not suitable, you could try a medicated lotion or spray. These kill head lice in all types of hair, and you can buy them from pharmacies, supermarkets or online. Head lice should die within a day. Some lotions and sprays come with a comb to remove dead lice and eggs.
Permethrin lotion, 1%
Brand name* product: Nix. Permethrin is a synthetic pyrethroid similar to naturally occurring pyrethrins. Permethrin kills live lice but not unhatched eggs. Permethrin can kill newly hatched lice for several days after treatment.
“Super lice” are head lice that have developed resistance to the pesticides in traditional over-the-counter head lice treatment products. It is a term coined by the media in 2015 after published research showed head lice were developing resistance to the pesticides used in over-the-counter lice treatments.
Olive Oil smothers and kills active head lice, making nit removal easier and moisturizing the hair and scalp. Part hair and apply the oil directly onto the scalp. Massage into the entire scalp making sure to saturate the hair. Apply a shower cap.
Monisha et al. (2018) showed in a cohort study on the efficiency of 0.1% permethrin shampoo in comparison with 0.5% Ivermectine lotion in head lice infestation after treatment with topical permethrin and 0.1% Ivermectine lotion 0.5%, the presence of active nits were significantly reduced in the Ivermectine group (33).
Chronic exposure of adult virgin females to low doses of spinosad leads to mitochondrial defects, severe neurodegeneration, and blindness.
Overall, spinosad is highly effective compared to permethrin at eliminating head lice infestations under actual use conditions. Spinosad has a high efficacy rate after one treatment application, generally does not need to be reapplied, and does not require nit combing to eradicate lice and nits.
You can treat head lice with medications (pediculicides) that are either over-the-counter or by prescription. Some medicines kill lice and eggs; retreatment is usually not required for these. Other medicines kill lice but are not effective at killing eggs and so retreatment is recommended.
Spinosad Topical Suspension 0.9% (spinosad) Topical Suspension 0.9% is a prescription medication for head lice that is approved for use in children 6 months of age and older.
Ivermectin topical has an average rating of 7.6 out of 10 from a total of 398 ratings on Drugs.com. 70% of reviewers reported a positive effect, while 18% reported a negative effect. Spinosad topical has an average rating of 7.5 out of 10 from a total of 15 ratings on Drugs.com.
Spinosad (Natroba) dosage forms
The average cost for 1 bottle of 120ml of 0.9% of Spinosad (Natroba) is $102.00 with a free GoodRx coupon. This is 63.27% off the average retail price of $277.72.
Spinosad is sold under the brand names, Comfortis, Trifexis, and Natroba. Trifexis also includes milbemycin oxime. Comfortis and Trifexis brands treat adult fleas on pets; the latter also prevents heartworm disease. Natroba is sold for treatment of human head lice.