Interest in home remedies for head lice is increasing. Head lice are becoming resistant to many medications containing insecticides. Many parents are reluctant to use pesticides on their children, for fear of long range health effects. Also, medication can get expensive, especially if you have to see a doctor to get it. The bad news is, no non-prescription, non-insecticide based treatments are FDA approved for treating head lice. The good news is, some of them may be effective.
Before evaluating any treatments, you should know that head lice are not a serious health problem at all. The main problem is that they cause itching. Now, it is true that the itching can be severe enough to cause distraction in the classroom, and if the itchy area opens up, it could get infected, just like any other skin wound. However, lice are not otherwise a health risk.
Clinical trial proven
Pyrethrins. Pyrethrins are considered standard, first line therapy for head lice. They are insecticides but they are extracted from flowers. If you buy organic vegetables or fruits, they may have been sprayed with pyrethrins. Though not strictly a home remedy, they are available over the counter. This treatment leaves about 20% of eggs alive, so a second treatment should be done in 7-12 days (9 is optimal). Unfortunately, pyrethrins have a high level of resistance in some communities. Also, since pyrethrins come from flowers in the chrysanthemum/daisy family, people allergic to these types of flowers should use something else.
Cetaphil Cleanser. Cetaphil is not at all natural, but it is not more unnatural than most shampoos. It is also extremely gentle. Many dermatologists and most hospitals keep this on hand for people with skin problems. The method used is to massage the cleanser into the hair and scalp, leaving it in for 2 minutes. Then, use a comb to remove excess cleanser before drying with an air dryer. Leave in for greater than 8 hours and remove with your usual shampoo. The treatment is repeated weekly for a total of three treatments. The total cost is probably comparable to a course of brand name over the counter pesticidal treatment. There was one medium sized clinical trial which assessed this remedy as 96% effective, which is significantly higher than the leading pesticidal treatments. The study was criticized as nonrandomized and nonblinded. There has never been a trial to compare how effective Cetaphil is compared to standard insecticidal treatment.
Essential oils. Several formulas may be found at health food stores, and the formulas are not FDA regulated as medications, so it is difficult to make general conclusions about effectiveness or safety. However, more than one trial of more than one formulation (Hair Clean 1-2-3, and NeutraLice (available only in Australia), have demonstrated effectiveness. Major safety concerns include an unknown frequency of allergic reactions.
Petroleum Jelly. This treatment involves using 30 to 40 grams of petroleum jelly (aka Vaseline) massaged into the scalp and hair. The head is covered with a shower cap and the petroleum jelly is left in overnight. One trial noted that this treatment kills both lice and eggs. However, removing the petroleum jelly is difficult and usually requires careful shampooing over the course of a week to 10 days. Although petroleum jelly is relatively nontoxic, and hypoallergenic, having it in the hair may draw more attention than necessary to the patient.
Clinical trial disproven
Isopropyl alcohol, olive oil, mayonnaisse, melted butter. None of these were able to kill lice or nits in a small clinical trial.
Vinegar. This is unable to actually kill lice or eggs. It has also been shown unhelpful in loosening nits from hair once another product has been used to kill the live lice. It cannot be used with permethrin (Elimite, Nix) as it inactivates its residue.
Acetone, bleach, WD-40. These have been suggested for easing nit removal but all are ineffective and also have other toxic effects.
Frankowski, Barbara L., and Joseph A. Bochini. “Head Lice.” Head Lice. Pediatrics, 26 July 2010. Web. 03 Feb. 2014.