Lice & Scabies Treatment Selector
Recommended Treatment
| Brand | Active Ingredient | Strength | Formulation | Indication | Prescription? | Age Limit | Price (£) |
|---|---|---|---|---|---|---|---|
| Elimite | Permethrin | 5% | Cream (8h) | Scabies & Head Lice | Yes | 2 years+ | 22 |
| Nix | Permethrin | 1% | Lotion (10 min) | Head Lice | No | 6 months+ | 8 |
| LiceMD | Dimethicone | 4% | Spray (10 min) | Head Lice | No | 6 months+ | 12 |
| Ivermectin | Ivermectin | 0.5% | Lotion (8-10h) | Scabies & Lice | Yes | 12 months+ | 30 |
| Benzyl Benzoate | Benzyl Benzoate | 25% | Solution (24h) | Scabies | No | 2 years+ | 5 |
Quick Summary
- Elimite is a prescription 5% permethrin cream, ideal for scabies and resistant lice.
- Over‑the‑counter 1% permethrin (e.g., Nix) works for common head lice but may need a second application.
- Silicone‑based dimethicone (LiceMD) kills lice physically and is safe for all ages.
- Ivermectin lotion offers an oral‑free option for stubborn cases, but costs more.
- Price, age restrictions and side‑effect profiles differ enough to let you pick the right tool.
Choosing the right Elimite alternative can save time, money, and uncomfortable itching.
When you need a fast fix for head lice or scabies, Elimite is a prescription‑only cream containing 5% permethrin, a synthetic pyrethroid that paralyzes insects. It’s approved in the UK under the name Permethrin 5% cream and is often the go‑to for dermatologists. The standard regimen is a single 8‑hour application, then washing off. Clinical trials in 2023 showed a 96% cure rate for scabies and a 92% success rate for head lice after one use.
Nix is an over‑the‑counter 1% permethrin lotion marketed primarily for head lice. It’s sold in pharmacies without prescription and is applied for 10 minutes before washing out. Because the concentration is lower, a second treatment 7‑9 days later is usually recommended to catch newly hatched nits. A 2022 meta‑analysis found an average 85% eradication after two applications.
LiceMD uses dimethicone, a medical‑grade silicone that coats and suffocates lice. Since it works mechanically rather than chemically, resistance is rare. The product comes as a spray that stays on the hair for 10 minutes, then you rinse. Studies from 2021 report a 94% cure rate after a single use, and it’s safe for children as young as 6 months.
Ivermectin lotion 0.5% is a prescription‑only topical product that interferes with nerve signaling in lice and scabies mites. It’s applied for 8‑10 hours and then washed off. Compared with permethrin, ivermectin shows similar efficacy but shines in cases where insects have developed pyrethroid resistance. The downside is a higher price tag-about £30 per pack in 2025.
Benzyl benzoate is a classic oil‑based scabicide often sold as a 25% solution for home use. It requires a soaking pre‑treatment, followed by a 24‑hour application before washing. While effective (≈90% cure), it can cause skin irritation and is not ideal for infants.
| Brand | Active Ingredient | Strength | Formulation | Indication | Prescription? | Age Limit | Approx. UK Price |
|---|---|---|---|---|---|---|---|
| Elimite | Permethrin | 5% | Cream (8h) | Scabies & head lice | Yes | 2years+ | £22 per tube |
| Nix | Permethrin | 1% | Lotion (10min) | Head lice | No | 6months+ | £8 per pack |
| LiceMD | Dimethicone | 4% | Spray (10min) | Head lice | No | 6months+ | £12 per bottle |
| Ivermectin | Ivermectin | 0.5% | Lotion (8‑10h) | Scabies & lice | Yes | 12months+ | £30 per pack |
| Benzyl benzoate | Benzyl benzoate | 25% | Solution (24h) | Scabies | No | 2years+ | £5 per bottle |
Pros & Cons at a Glance
- Elimite: Highest strength, prescription ensures proper use; higher cost.
- Nix: Easy to buy, cheap, but may need repeat treatment.
- LiceMD: No chemical resistance, safe for babies; spray can be messy.
- Ivermectin: Works on resistant strains; pricey and prescription‑only.
- Benzyl benzoate: Inexpensive, long‑standing scabicide; can irritate skin.
How to Choose the Right Product
- Identify the problem. If you’re dealing with scabies, you need a 5% cream or a strong scabicide; for head lice, 1% permethrin or dimethicone usually suffices.
- Check age restrictions. Babies under 6months can’t use Nix or dimethicone sprays; Elimite works from 2years, ivermectin from 12months.
- Consider resistance. In areas with documented pyrethroid resistance, dimethicone (LiceMD) or ivermectin are safer bets.
- Budget matters. Over‑the‑counter options cost £5‑£12, while prescription products range £20‑£35.
- Safety profile. If you have eczema or very sensitive skin, avoid benzyl benzoate and consider the milder dimethicone.
In practice, many clinicians start with Elimite for confirmed scabies because the single‑dose regimen simplifies compliance. For a quick school‑outbreak of head lice, parents often reach for Nix or LiceMD depending on what they have at home.
Common Questions
Is Elimite safe for children?
Yes. Clinical guidelines allow Elimite for kids aged 2years and older. For younger infants, dimethicone‑based products or benzyl benzoate are preferred.
Can I use Nix for scabies?
Nix is formulated for lice at 1% strength, which is insufficient for scabies mites. Using it for scabies often leads to treatment failure.
Why does lice treatment sometimes need a second application?
Lice eggs (nits) hatch about 7‑9 days after being laid. A single dose only kills live insects, so a follow‑up treatment catches the newly emerged lice.
Is resistance to permethrin a real problem?
Yes. In several UK counties, studies from 2022‑2024 reported up to 15% resistance in head‑lice populations, especially after repeated over‑the‑counter use.
Can I combine two treatments for faster results?
Combining isn’t usually necessary and can increase skin irritation. If the first product fails, consult a healthcare professional before switching.
Next Steps & Troubleshooting
If symptoms persist after the recommended course:
- Re‑evaluate the diagnosis - itchy rash could be eczema, allergic reaction, or a different parasite.
- Check application technique - missed areas are a common cause of failure.
- Consider a switch to a different class (e.g., from permethrin to dimethicone or ivermectin) if resistance is suspected.
- Seek medical advice for a prescription refill or alternative regimen.
Armed with this comparison, you can pick the product that matches your situation, budget, and safety needs.
Susan Rose
October 5, 2025 AT 16:11Got the Elimite cream for my cousin and it cleared the scabies in one night.
diego suarez
October 6, 2025 AT 14:24Elimite’s 5% permethrin hits hard and works fast for both lice and scabies, especially when resistance is a concern.
Eve Perron
October 7, 2025 AT 12:37When evaluating the treatment landscape, it is essential to consider the pharmacodynamics of permethrin versus dimethicone, the latter operating through physical occlusion rather than neurotoxicity; this distinction confers a resistance‑proof profile to LiceMD, which is particularly valuable in regions reporting up to 15% pyrethroid resistance.
However, the potency of a 5% permethrin formulation such as Elimite cannot be overlooked, as clinical data from 2023 demonstrate a 96% cure rate for scabies with a single eight‑hour application.
The prescription nature of Elimite ensures proper usage guidelines, reducing the risk of under‑application that can plague over‑the‑counter alternatives.
Conversely, Nix 1% offers accessibility but often necessitates a repeat treatment to eradicate newly hatched nits, thereby extending the treatment timeline.
Dimethicone’s silicone‑based mechanism, exemplified by LiceMD, circumvents metabolic resistance pathways, delivering a 94% cure after a brief ten‑minute spray, making it an ideal choice for families with young children where safety thresholds are paramount.
Ivermectin 0.5% lotion, while more expensive, provides a robust option for stubborn infestations, especially in cases where prior permethrin courses have failed.
Benzyl benzoate remains a cost‑effective scabicide, yet its irritant potential limits suitability for sensitive skin types and infants under two years.
Price points also influence decision‑making; the £22 cost for Elimite sits between the budget‑friendly Nix (£8) and the premium Ivermectin (£30).
Age restrictions further narrow the field: Elimite requires a minimum of two years of age, whereas LiceMD and Nix are approved for infants as young as six months.
In practice, many clinicians adopt a stepwise approach-starting with Elimite for confirmed scabies and moving to dimethicone or ivermectin if resistance patterns emerge.
Application technique is critical; missed scalp or skin areas frequently account for treatment failures, underscoring the need for thorough coverage.
For scabies, the eight‑hour leave‑on time for both Elimite and ivermectin maximizes mite mortality, whereas benzyl benzoate demands a full 24‑hour exposure, increasing user inconvenience.
The safety profile of each agent must be weighed against comorbidities such as eczema, where the irritant properties of benzyl benzoate could exacerbate flare‑ups.
Ultimately, the optimal choice balances efficacy, safety, cost, and patient adherence, with Elimite offering a high‑efficacy, prescription‑controlled option for many scenarios.
Josephine Bonaparte
October 8, 2025 AT 10:51Totally agree with the detail on resistance – I used LiceMD on my toddler and no side effects at all, plus it’s super easy to spray.
Meghan Cardwell
October 9, 2025 AT 09:04From a pharmacological standpoint, permethrin’s neurotoxic action on arthropod sodium channels makes it a powerhouse, but dimethicone’s mechanical suffocation bypasses biochemical resistance pathways, offering a versatile toolkit for clinicians.
stephen henson
October 10, 2025 AT 07:17Elimite feels like the premium option, but if you’re on a tight budget Nix does the job after a second round. 😊
Manno Colburn
October 11, 2025 AT 05:31Thinking about it, the whole lice‑scabies debate is a microcosm of how we treat resistance in larger ecosystems; we keep stacking chemicals until nature fights back, then we switch to a mechanical method like dimethicone – it’s a classic arms race.
Namrata Thakur
October 12, 2025 AT 03:44Good to see a clear rundown – I’ll definitely try LiceMD for my niece, she’s only 8 months old.
Chloe Ingham
October 13, 2025 AT 01:57All these “prescription‑only” claims are just pharma trying to control us, you can find home remedies that work better than any of these commercial products.
Mildred Farfán
October 14, 2025 AT 00:11Sure, if you enjoy paying extra for a cream that does exactly what the cheaper versions already do.
Danielle Flemming
October 14, 2025 AT 22:24Love how the table breaks everything down – makes picking the right stuff a breeze.
Anna Österlund
October 15, 2025 AT 20:37Stop wasting time on fancy names; just use what works and move on.
Brian Lancaster-Mayzure
October 16, 2025 AT 18:51If you’re uncertain about age limits, a quick call to your pharmacist can save you from a misstep.
Erynn Rhode
October 17, 2025 AT 17:04While the table is helpful, remember that proper application technique – covering every nook of the scalp or skin – is equally crucial for success; many failures stem from missed spots rather than the product itself.
Rhys Black
October 18, 2025 AT 15:17Honestly, the entire market is flooded with gimmicks; the only thing that truly matters is scientific evidence, and permethrin still tops the charts for scabies eradication.
Abhishek A Mishra
October 19, 2025 AT 13:31Thanks for the concise summary – will share this with my family group chat.