Picture: Jessica Flemming (owner of The Lice Lounge in MN) and Cathy Baran (owner of Lice Spies in WA)

Head lice recheck appointments are important!  Can you treat a case of head lice in one shot, 100% of the time?  Some companies claim to do so.  Can it be so?

Let’s deconstruct the process a bit, to understand how these critters work.  Twenty years ago, lice were just lice.  They did not don their “super” capes.  They were not yet ordained “super lice.”  Over the counter pesticides were great at treating a case of head lice.  There was a fast, easy potion to rid oneself from these annoying critters.

Over the years, lice started to build a resistance to the pesticides that were once a reliable treatment option.  A few years ago, scientists researched and concluded that head lice resistance to permethrin and pyrethroids were such that the bugs were almost 100% resistance to these products1.  Thus the term, “super lice” came on the scene.

In response to these failing products, new products and methods emerged.  And some of these come with claims of being “one and done.”

Prescription Medications

Doctors today, have a number of prescription medications to choose from for treating a case of head lice.  Is any one of these products 100% effective at killing live lice and eggs (nits)?  No.


Rx Product & Efficacy

Permethrin/  Pyrethroids

  • Lice almost 100% resistant1
  • Linked to abnormal behavior in children, neurotoxin


Malathion (Ovide)

  • Can kill some bugs, but does not kill eggs, increased resistance
  • Extremely flammable2 around common household devices, burns, neurotoxin



  • Can kill some bugs, but does not kill eggs, increased resistance
  • Lindane has been banned in 52 countries worldwide due to toxicity3, but Doctors can still prescribe for head lice and scabies.  Can only be used once in human lifetime.  Extremely toxic, neurotoxin.


Ivermectin (Sklice®)

  • 74% on day 154
  • $$ May not be covered by insurance


Benzyl Alcohol (Ulesfia®)

  • 75.0-76.2% on day 145
  • $$ May not be covered by insurance


Spinosad (Natroba™)

  • 85% after 14 days4
  • $$ May not be covered by insurance


75-85% isn’t bad though, right?  In a case of head lice, yes it is.  Check out our blog article: 6 month head lice battle OTC prescription pesticides to see the results of one of our client’s struggle.

If you do not get out every last 2 eggs in the hair, where one is male and one is female, then the whole cycle starts all over again.  A female louse only needs to be impregnated once in her lifetime to lay 5-10 eggs per day.  That’s every day of her adult life.  This translates into each impregnated female louse has the ability to lay upwards of 200 eggs in her lifetime.  In the span of those 14 days that you are waiting to see if these products worked, that represents up to 140 eggs that one female left behind could lay.

One has to consider the risks and cost of multiple applications of using these prescription medications knowing that products are not “one and done”.  If you choose to treat with one of these products, know that multiple applications will be needed and constant rechecking to make sure the infestation is truly gone.


Heated Air Devices

The most popular heated air device on the market today is the professional AirAlle® device found at salons/clinics, and the new DIY One Cure Lice Treatment Home Kit, both owned by Lice Clinics of America (parent company: Larada Sciences, Inc).  Prior to being branded AirAlle®, the device was known as the LouseBuster.

During clinical trials, the LouseBuster was 94.8% effective at dehydrating, thus killing, bugs and nits when an experienced person was operating the device.6  This is an impressive result.  However, in the case where someone has let’s say, 100 nits, 5 of those nits left behind could be viable.  Leaving behind one female and one male egg will result in the whole cycle starting again. 

It is worth noting that these devices cannot be used on children under the age of 4, or older people that cannot sense heat.

What is key to using this device is the process to remove every last bit of viable evidence in the hair after using the device.  Using the device alone, is not sufficient.  If removal (usually done by a comb out process) is not done, you run the risk of “getting lice back” in two-three weeks, when in fact, you didn’t complete the full treatment the first go around.

Even with the heated air device lice removal option, one should always follow up with a recheck appointment to verify that the treatment was successful.


Head Lice Removal Specialists

Armed with good lice combs and safe, non-toxic products, professional removal specialists rely on complete elimination of all nits and bugs on the head.  The gold standard in the industry is to be trained and certified from the Shepherd Institute7.  This certification is the most rigorous and intensive training that is on the market today.

For us here at Lice Spies, our goal is to achieve 100% eradication with one full treatment.  Most of the time, we meet that goal.  But “we are all humans with human eyeballs”, as Jessica Flemming, owner of The Lice Lounge in White Bear and Duluth, MN often says.

Can we miss something?  Absolutely.  How often do we miss something?  Not often, but the point is, it does happen just like any other option on the market.  No product, tool, device or human is perfect!



What is common to all the products, devices and methods listed above, is the fact that removing every last viable female and male egg from the head is key to a successful treatment.  Some products can help get you to an effective treatment quicker than others, and they are safe for all to use.  Other products come with the risk of some serious side effects that in our opinion, are just not worth it.

No product, tool, device or human has a 100% efficacy rate.  For this reason, we strongly believe in including at least one free follow-up recheck appointment after each full treatment.

Equally as important as checking one’s own work, is to make sure that the client does not get reinfested.  Most people do not know the exact source of who they got lice from, or who they might have shared it with while they had it.  And most of us have to re-enter into the same environment where we contracted lice in the first place.  Chances of reinfestation are very real.  Whatever your choice for treatment, demand a recheck!


Lice Spies are professionally trained and certified through the Shepherd Institute.   We provide safe, non-toxic, natural head lice checks, treatment services, DIY & preventive products at our Edmonds’ clinic. Located on the corner of Edmonds Way/SR 104 and 236th St SW in Edmonds, WA, appointments can be booked online, anytime of day or night at www.licespies.com.  Follow us on Facebook.



[1] Expansion of the Knockdown Resistance Frequency Map for Human Head Lice (Phthiraptera: Pediculidae) in the United States Using Quantitative Sequencing, by Kyle J. Gellatly, Sarah Krim, Daniel J. Palenchar, Katie Shepherd, Kyong Sup Yoon, Christopher J. Rhodes, Si Hyeock Lee, and J. Marshall Clark; Journal of Medical Entomology, 53(3), 2016, 653–659

[2] https://www.cdc.gov/parasites/lice/head/gen_info/faqs_malathion.html

[3] http://www.panna.org/press-release/global-chemical-treaty-adds-lindane-ban-list

[4] https://www.forbes.com/sites/melaniehaiken/2012/11/28/finally-a-new-head-lice-treatment-that-really-works/#5bf579e511c0

[5] https://www.researchgate.net/publication/267911183_The_Clinical_Trials_Supporting_a_Novel_Non-Toxic_Lotion_Benzyl_Alcohol_5_for_the_Treatment_of_Head_Lice

[6] https://bioone.org/journals/journal-of-medical-entomology/volume-48/issue-1/ME10122/Efficacy-of-the-LouseBuster-a-New-Medical-Device-for-Treating/10.1603/ME10122.short

[7] http://www.shepherdinstitute.com/

As the holidays wind down and you return to your normal routines, it’s the perfect time to check for any unwanted house guests that may be lingering in your hair. Catch lice now before a full-blown infestation occurs.

Holiday gatherings are the perfect setting to transfer head lice. Wrestling with cousins, snuggling on the couch in front of the fire, spreading the love… and unfortunately, lice.  Over 98 percent of head lice transmissions are from head-to-head contact. They don’t discriminate, so yes, Grandma and Grandpa are not immune to the pesky critters.

What is the best way to check for lice? Visual checks are good, but depending on your lighting, vision and where you make part lines, lice can be difficult to detect. The best way to check is to run a good lice comb through wet hair. Weekly checks are recommended to prevent major infestations.

How quickly can a case of head lice progress? A female louse only needs to be impregnated once in her lifetime to lay between 5-10 eggs daily for the rest of her adult life, which can be around 20 days. One female louse can lay up to 200 eggs in her lifetime. When those eggs hatch and mature to become reproducing adults in as soon as 14 days from when they were laid, one can see how quickly a case of head lice can become severe. Early detection is key.

Lice Spies are professionally trained and certified through the Shepherd Institute.   We provide safe, non-toxic, natural head lice checks, treatment services, DIY & preventive products. Located on the corner of Edmonds Way and 236th Street Southwest in Edmonds, appointments can be booked online, anytime of day or night, at www.licespies.com.

Thank you Coffee on pixabay.com for the cute image!