Head lice pediculosis — symptoms, treatment, talk to a doctor online

What is head lice?

Head lice are small wingless insects that live on human scalps and feed on blood. Most common in school-age children but anyone can get them. Spread through direct head-to-head contact or rarely shared items.

They don't transmit disease but cause intense itching and social disruption. Treatment with OTC pyrethroids works for most; resistant lice need prescription options.

Do I have head lice? Common signs

If most of these describe what you're experiencing, telehealth may be a good next step:

Intense scalp itching Tickling sensation of moving hair Small white nits (eggs) glued to hair shafts close to scalp Tiny tan/brown moving lice if you look closely Sores from scratching Sometimes lymph node swelling Often noticed at school screening or by parent

Here's how it actually works

Tell us what's going on5-minute online intake covers your symptoms, history, and any photos.

A clinician reviewsLicensed in your state. Reviews your case and asks anything needed.

Rx to your pharmacyIf treatment is appropriate, the prescription goes to the pharmacy you choose.

What causes it

Pediculus humanus capitis — head lice. Spread by direct head-to-head contact (most common), occasionally by shared hats, brushes, pillows.

Is it contagious?

Yes. Common in close-contact settings (school, sleepovers).

Resistance to OTC pyrethroids is widespread — if regular Nix isn't working, you need a prescription option.

Can it be treated online?

Head lice are well-suited to telehealth. Persistent cases after multiple OTC treatments, infants under 2, pregnancy, or extensive secondary infections may benefit from in-person care.

How head lice is treated

OTC: permethrin (Nix), pyrethrin (Rid) — apply, leave on, repeat in 7–10 days. Rx options (for resistance): spinosad (Natroba), ivermectin lotion (Sklice), malathion (Ovide), benzyl alcohol (Ulesfia). Wet combing every 3–4 days removes nits. Treat household contacts with active lice.

Self-care while you wait

Apply treatment per package — full coverage, leave on full time
Comb out nits with fine-tooth (nit) comb
Repeat treatment in 7–10 days
Wash bedding, towels, hats in hot water, dry on high heat
Soak combs/brushes in hot water
Bag non-washables for 2 weeks
Check household contacts
No need to fumigate house

When to skip telehealth and seek emergency care Significant secondary skin infection, severe allergic reaction to treatment — see clinician.

How long does it last?

With effective treatment, eliminated in 1–2 weeks.

Frequently asked questions

Can I get lice from pets?

No — head lice are human-specific.

Should I send my kid to school?

Most schools follow 'no-nit' policies but CDC and AAP say kids can return after first treatment.

How can I prevent recurrence?

Teach kids not to share hats/combs, avoid head-to-head contact when possible. Regular checks during outbreaks.

Are mayonnaise or olive oil effective?

Limited evidence. Some people use as suffocation method overnight — works variably.

Will dyeing hair kill them?

No reliable evidence. Don't substitute for actual treatment.

This page is for general information only — not a substitute for individual medical advice. A licensed clinician reviews every intake submitted through PrescriberNow before any prescription is issued. If you're experiencing a medical emergency, call 911 or go to the nearest emergency room.

Head lice
(pediculosis)