What To Do When Head Lice Comes Home: Here’s Help For Busy Florida Families

As a busy parent you know what your typical week looks like. There are dropoffs and pickups, practices and homework, and dinner each and every day. Now imagine a note comes home from school with these words – “a case of head lice has been reported in your child’s classroom.” It adds just one more thing to your busy life. And dealing with lice is a problem no one ever wants to face.

Here are three important things to keep in mind:

1. Head lice can be solved more easily today than in the past.
2. It’s not your fault your child got lice!
3. The annoying issue of head lice affects many families in your community and around the country every year.

GET THE FACTS

Here are the most important and up-to-date facts to know about head lice:

• Over 98% of head lice in the United States are now resistant to the active ingredients in common over-the-counter (OTC) treatments like Nix and RID.
• Lice resistance works like most other resistances, in a way where repeating a product or process that has stopped working will not change the end result.
• Natroba™ (Spinosad) is an option to consider. It’s a prescription head lice medicated shampoo that kills both lice and their eggs in a single application, with no nit combing required for most patients.
• It is FDA-approved for adults and children as young as 6 months and is covered by many major insurance plans, including Medicaid.

Drugstore Boxes Fail Families and Here’s Why

To treat lice, most parents start by reaching for Nix or RID, familiar boxes they see on the drugstore shelves. These two commonly used products and their active ingredients, permethrin and pyrethrin, have been used on lice for more than 20 years. So it makes sense to try these options, but what is important to know is that head lice have adapted. The most recent nationwide survey, published in 2016, collected lice from 48 states and found that more than 98% now carry a genetic change that lets them shrug off those ingredients.

Reaching for a second or third box of the same product will not change the result. If you followed the box instructions exactly and the lice came back – that is not your fault, it’s the resistance of the lice to the active ingredients.

When these over-the-counter boxes fail, a lot of parents will schedule a visit at a professional lice removal clinic. For some families that is the right call. But I found I had to considered both the cost and also the time the clinic visit took. Plus lice clinic visits are typically cash-pay and at the time of service. These clinics do not bill insurance or Medicaid. The visits take time and one visit often turns into several. The average cost per person is typically in the hundreds of dollars.

Good News: There’s a Different Treatment You Can Turn To

There is another treatment that many parents do not know about.

It’s Natroba™ (Spinosad) – a prescription medicated shampoo that treats head lice by working in an entirely different way.

Its active ingredient, spinosad, comes from a tiny soil organism and belongs to a different medicine family than the old drugstore compounds. Which means that lice that survive the older treatments like Nix have no built-in way to resist Natroba™ (Spinosad). To date, there is no documented resistance to spinosad among head lice in the United States.

And there’s more good news. Natroba™ (Spinosad) kills both lice and their eggs in a single 10-minute application. No nit combing is needed for most patients. Natroba™ (Spinosad) does its work on the surface of the scalp and is not absorbed into the body. It is FDA-approved for adults and children as young as 6 months, and it is covered by many major insurance plans, including Medicaid.

In two head-to-head clinical trials, roughly 86.7% of people who used Natroba™ (Spinosad) were lice-free two weeks later, compared with 42.9% of those who used Nix (permethrin 1%).

Get Started Quickly, From Home

Here is what I appreciate most about Natroba™ (Spinosad) – you do not have to sit in another waiting room to begin treatment. At natroba.com you can meet a licensed provider by telehealth, in minutes, right from home. If that provider decides Natroba™ (Spinosad) is right for your child, the prescription can be picked up same day at your local pharmacy of choice, including Walmart, or delivered discreetly to your home.

An Easier Way Back to Normal

Just a few steps make this whole process easier:

1. First, confirm it really is lice – a wet fine-tooth comb is still the most reliable check.
2. Next, treat everyone in the household who needs it on the same day. Staggered treatment is a common reason lice return. Finally, wash recently used bedding and clothing in hot water, at least 130°F, or seal it in a bag for two weeks. There’s no need to fumigate your home, because lice that fall away from the scalp do not survive long.
3. Lastly, if an over-the-counter (OTC) product already failed you, resist buying another product that uses the same ingredient, because it will most likely fail too.

Skip the Aisle. Skip the Clinic. Skip the Wait.
Head lice is a major inconvenience, but it is solvable. Learn more at natroba.com where you can also get prescribed for same day pharmacy pickup or delivery. Or ask your doctor about Natroba™ (Spinosad).

Sarah Galbraith Laucks develops educational health and wellness content for parents and families.

This article is educational and is not medical advice. Always consult your healthcare provider for what is best for your individual needs. Sarah Galbraith Laucks is a sponsored content creator, and this article was created in partnership with Cipher Pharmaceuticals, the maker of Natroba™ (Spinosad).

IMPORTANT SAFETY INFORMATION

Indication

Natroba™ (Spinosad) Topical Suspension is a pediculicide indicated for the topical treatment of head lice infestations in adult and pediatric patients six (6) months of age and older.

Warnings and Precautions

Natroba™ (Spinosad) Topical Suspension contains benzyl alcohol and is not recommended for use in neonates and infants below the age of 6 months. Intravenous administration of benzyl alcohol has been associated with serious adverse reactions and death in neonates and low birth-weight infants.

Adjunctive Measures

Natroba™ (Spinosad) Topical Suspension should be used in the context of an overall lice management program:

• Wash in hot water or dry-clean all recently worn clothing, hats, used bedding, and towels.
• Wash personal care items such as combs, brushes, and hair clips in hot water.
• A fine-tooth comb or special nit comb may be used to remove dead lice and nits.

Adverse Events

The most common adverse events (occurring in ≥1% of subjects) for head lice treatment were application site redness (3%), eye redness (2%), and application site irritation (1%). Use Natroba™ (Spinosad) only on dry scalp and dry hair. Repeat treatment only if live lice are seen 7 days after the first treatment. See full Prescribing Information and Patient Information.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. You may also contact Cipher Pharmaceuticals US LLC at 1-855-628-7622.

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References

1. Natroba (spinosad) topical suspension, 0.9% [prescribing information]. Cipher Pharmaceuticals US LLC; 2025.
2. Stough D, Shellabarger S, Quiring J, Gabrielsen AA. Efficacy and safety of spinosad and permethrin creme rinses for pediculosis capitis (head lice). Pediatrics. 2009;124(3):e389-e395.
3. Gellatly KJ, Krim S, Palenchar DJ, et al. Expansion of the knockdown resistance frequency map for human head lice (Phthiraptera: Pediculidae) in the United States using quantitative sequencing. J Med Entomol. 2016;55(3):653-659.
4. Data on file. Cipher Pharmaceuticals US LLC.
5. Centers for Disease Control and Prevention. Clinical Care of Head Lice. Updated January 31, 2025.