Lice eggs (nits) cling to hair shafts with waterproof glue, so winning the battle demands a mix of mechanical removal, targeted lotions, and smart follow‑up. This guide lays out a timed plan that blends proven combing techniques with treatments cleared by health agencies, letting families clear heads fast while keeping re‑infestation at bay.
Know Your Opponent
A female louse lays up to eight eggs a day, each positioned within 6 mm of the scalp where warmth speeds hatching. These pale, oval capsules turn cocoa‑brown before they hatch in about nine days. A fresh nit grips the strand so firmly that rinsing or ordinary brushing rarely moves it. That stubborn bond explains why quick action must target both live insects and their eggs.
First 24 Hours At A Glance
| Task | Why It Matters | Timing |
|---|---|---|
| Confirm live lice or viable eggs with a bright light and fine comb | Guarantees treatment only when needed | Hour 0 |
| Wet comb every section after conditioner | Physically lifts eggs from the shaft | Hour 1–2 |
| Apply an over‑the‑counter pediculicide | Kills hatchlings missed by the comb | Hour 3 |
| Soak brushes at 130 °F | Stops hidden lice from crawling back | Hour 4 |
The checklist above handles both the insect and its home turf, setting the stage for a clean scalp by the end of day one.
Core Method – Wet Combing
Why Combing Works
Wet combing removes live lice and nits without chemicals; conditioner stuns the bugs while a 0.2–0.3 mm‑spaced metal comb slides eggs off the hair.
Tools You Need
- A metal nit comb with flat‑faced teeth
- Plain shampoo and plenty of thick conditioner
- Bright lamp plus white paper towel to spot debris
Step‑by‑Step Routine
- Wash the hair, leave it dripping, then coat each section with conditioner.
- Starting at the nape, place the comb flat against the scalp and pull to the end in one motion.
- After every stroke, wipe the comb on paper and crush anything that moves.
- Work the whole head in four directions – down, up, left, right – to reach hidden eggs.
Frequency
Repeat wet combing every two to three days for two weeks, or until no eggs remain.
OTC Lotions That Speed Up Egg Clearance
Many households find that a single comb‑only approach drags on. The following active ingredients can cut the timeline once eggs loosened by combing face a well‑timed chemical hit.
Pyrethrin And Permethrin 1 %
These chrysanthemum‑derived agents stun nerve cells in lice. Apply to damp hair, leave ten minutes, then rinse. A second dose on day nine targets late hatchers.
Tip
Always pair with combing; permethrin does not dissolve the nit glue, so stranded eggs survive unless physically removed.
Ivermectin 0.5 % Lotion
The FDA cleared ivermectin for non‑prescription sale; it paralyzes larvae before they emerge, so nits die without needing combing.
Single‑Use Edge
Data show one ten‑minute application leaves nearly 75 % of users lice‑free at day seven with no second dose.
Product Selection Pointers
- Check age limits on the box (pyrethrin safe from two years; ivermectin from six months as label states).
- Use the full volume per weight chart to avoid sub‑lethal dosing that breeds resistance.
- Keep lotion out of eyes and off eyebrows.
Prescription Back‑Ups When Nits Hang On
If two full OTC cycles plus disciplined combing fail, resistance is likely. A clinician may offer next‑line treatments.
Spinosad 0.9 % Suspension
Spinosad over‑activates insect nervous systems, killing both lice and eggs in ten minutes, and studies put cure rates above 80 % after one round with no combing needed.
Malathion 0.5 % Lotion
This organophosphate kills with dual contact and fumigant action. It stays active after rinsing, but it is flammable, so users must avoid heat‑styling tools until hair is fully dry.
Oral Ivermectin (Off‑Label)
Pediatricians sometimes recommend a two‑dose oral schedule spaced a week apart when topical routes fail; the AAP report supports this path only under medical supervision.
Comparing Treatment Paths
| Agent | Kills Eggs? | Comb Still Needed |
|---|---|---|
| Permethrin 1 % | No | Yes (repeat day 9) |
| Ivermectin 0.5 % | Yes | Not required but speeds clearance |
| Spinosad 0.9 % | Yes | No |
Tidy The Environment
Lice live only one to two days off a host, yet stray hairs with viable eggs can fall on bedding. Wash pillowcases, hats, and scarves used during the two days before treatment in hot water and high heat drying.
Seal unwashable items in plastic for two weeks – longer than any egg can remain viable without a blood meal. Vacuum floors, car seats, and sofas, and soak combs in 130 °F water for ten minutes.
Smart Habits That Block Re‑Infestation
- Tie back long hair during school and play dates.
- Run a detection comb through wet hair weekly in peak seasons such as summer camp.
- Discourage shared helmets or hairbrushes.
- Alert close contacts so they can check promptly.
When To Call A Clinician
Persistent live lice after two full medication cycles, scalp infection signs such as oozing sores, or children younger than six months need medical review. The AAP clinical report outlines scenarios that warrant prescription agents or oral therapy.
Up‑to‑date treatment charts are posted on the CDC head‑lice page, and practical combing advice appears on the NHS care site. Consumer product details, including ivermectin safety notes, sit on the FDA label repository.
Quick Reference Recap
Start with a wet‑combing session under bright light, move straight to an OTC lotion the same day, and comb again every third day. Keep laundry hot, tools soaked, and heads checked. Change to an egg‑killing prescription only if lice survive two full OTC rounds. Follow this rhythm and stubborn eggs lose every advantage.