In recent years, a number of non-insecticidal alternative products have been developed and marketed for treatment of head lice. These head-lice products contain chemicals that are not classified as conventional insecticides. Furthermore, they do not require treatment with an insecticidal product prior to their use. An obvious advantage is that these treatments are relatively nontoxic. It is difficult to evaluate the effectiveness of many of these new products because there are few published reports.
Hair Clean® 1-2-3 contains various plant oils, such as coconut, anise, and ylang ylang oil, which aid in removing head lice and nits. However, to ensure long-term success, a second application is recommended 7 days after initial treatment. The enclosed long-toothed, metal nit comb kills the lice due to the physical combing action. This product has been on the market for several years. It has been evaluated in several clinical trials, which suggest promise for head-lice control.
Lice B Gone® contains enzymes of natural vegetable extract that soften the glue that attaches the nits to the hair. The hair then must be combed carefully (preferably with a metal nit comb) to remove all of the head lice and nits. This product typically requires only one application. Clinical trials suggest promise for head-lice control.
Not Nice To Lice® contains enzyme cleaners with protease, which work to "release" the nits. This product includes a cautionary statement that the cleanser can cause eye irritation and should be kept out of the eyes.
Acu-Med® Lice Cure contains tea tree oil, ylang-ylang, eucalyptus, and citronella. This spray helps remove lice eggs from the hair. The kit also contains a long-toothed, metal nit comb that kills the lice due to the physical combing action.
Licefreee® contains natrum muriaticum, a "homeopathic" pediculicide. A second treatment with this gel is recommended 7–10 days after the initial application.
LiceGuard® Head Lice Repellent Spray claims to "help prevent head lice infestations" with a patented CL-1 fragrance. The spray is applied to dry hair every 24 hours.
Electronic devices for insect control or eradication typically are not backed by conclusive research. In general, electronic devices are not effective in controlling insects. The LiceGuard® Robi Comb® has been marketed as an electronic head-lice detector and remover. This device is quite expensive (approximately $40). Clinical tests have not demonstrated the need for the electronic component; the simple mechanical action of the comb may be sufficient.
Products that are not marketed specifically for head lice typically do not have clinical data to support their effectiveness. There are only anecdotal (word-of-mouth) suggestions that some alternative approaches may have value for treating head lice on hair. For the most part, there is no reliable evidence that oil-based treatments, conditioners, or shampoos actually kill head lice on a person's head. However, these products may cause the nits to more readily slide off the hair, and they also appear to slow down the head lice so that they can be more easily removed with a nit comb. Such products are much less expensive than chemical treatments.
Advocates of non-insecticidal treatments suggest that head lice may be affected by soaking the hair of the affected person with olive oil, vegetable oil, or baby oil. A hair conditioner that frequently is mentioned as an alternative treatment is Queen Helene® Cholesterol Hair Conditioning Cream. This hair-care product is quite thick (heavy) and clings to the hair. The suggested procedure is to thoroughly apply one of these oils to the hair, then put a shower cap on the head and leave it on overnight. The next morning, complete the previously described process of nit-picking with a nit comb and your fingers. Follow-up by using a shampoo containing sodium laureth sulfate, which possibly affects head lice. Such shampoos include Herbal Essence®, Suave®, White Rain®, and many others.
Be aware that any of these oil-based treatments typically require repeated efforts with daily nit-picking until nits are no longer seen. Also, it is necessary to continue overnight applications if live head lice are observed. The mechanical action of the comb may be responsible for ultimately providing head-lice control, rather than simply the oil component.
The disadvantages of some alternative, oil-based treatments outweigh their usefulness. Mayonnaise has been recommended as an alternative, but mayonnaise will become rancid by the next morning. (Furthermore, a dog or other pet may lick the mayonnaise, perhaps becoming ill.) Petroleum jelly is very sticky and quite difficult to remove from hair. Also, it is difficult to find the nits because lint, dust, and crumbs readily cling to this sticky substance.
Do not shave the head in a desperate attempt to get rid of head lice. Head-shaving does not get rid of all of the nits, which are attached at the base of the hair shaft and extremely close to the scalp. It is needlessly upsetting to children and can have a long-term impact on their self-image and socialization. It is unnecessarily traumatic, particularly for females, to resort to such a measure. Would you and older female relatives submit to this procedure?