When a child gets head lice, the first question many parents ask is what kind of treatment works best. There are two main choices: over-the-counter (OTC) lice treatment and prescription hair lice treatment.  Both are made to kill lice and help remove nits, but they are not the same in strength or how they work.

What Are Over-the-Counter Lice Treatments?

OTC lice treatments are easy to find at most drugstores. You don’t need a doctor’s visit to buy them. These products often use ingredients like permethrin or pyrethrin. They work by attacking the nervous system of the lice, which causes them to die. Some of these treatments may not kill all the eggs (nits), so a second round is often needed about a week later.

OTC treatments work well for many families, especially if the lice problem is caught early. They are also a good first step before trying stronger options. However, lice in some areas have become harder to kill with these products, which is why they might not work for everyone.

What Are Prescription Lice Treatments?

Prescription treatments are given by a doctor when OTC products don’t do the job. These treatments are usually stronger and may come as a lotion, cream, or pill. They may use different ingredients that work in other ways to stop the lice. Some are made to kill both lice and nits in one use, which can save time and reduce the chance of the lice coming back.

Doctors may suggest prescription treatments if a child has had lice more than once or if the lice don’t go away after using OTC products. These treatments are also helpful for large outbreaks or if someone has allergies to ingredients in common lice shampoos.

Which One Is Stronger?

In most cases, prescription lice treatments are stronger than OTC ones. They are designed for situations where the usual treatments have failed or when a faster solution is needed. But stronger doesn’t always mean better for everyone. Sometimes a gentle start with an OTC product and careful combing is all that’s needed.

Talk to a Doctor If You’re Not Sure

If lice keep coming back or aren’t going away after treatment, it’s a good idea to check with a doctor. They can help choose the best option based on your child’s age, skin type, and how bad the lice problem is.