Head lice guide

Head lice treatment online in Virginia and West Virginia

A photo and symptom review to confirm typical head lice, then an over-the-counter permethrin 1% plan with wet-combing and household steps, for adults and children age 4 and older.

Start online

Start a $59 online review for Head lice.

Head lice are common, especially in school-age children, and they are treatable at home. This visit confirms that the itching and specks are actually lice, then gives an over-the-counter permethrin 1% plan plus wet-combing and household steps. For a child, a parent or guardian completes the visit. It is not for a scalp skin infection, widespread crusting, or lice of the eyelashes, which are directed to in-person care.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

Start this visit See response windows

Quick facts

You must be physically in Virginia and West Virginia at the time of request
Starts at $59
No insurance needed
No app download
Physician review around the clock
Non-controlled prescriptions can be sent to your pharmacy when appropriate
A work or school note can be included when medically appropriate
Response windows: 24/7, every day

Common symptoms

Intense scalp itching, often worst behind the ears and at the nape of the neck
Small tan or brown live lice moving in the hair
Whitish nits (eggs) glued close to the scalp
A recent classmate or household member with lice

May fit online care

Adults & children 4+ (with a parent or legal guardian)
Adult, or a child age 4 or older with a parent or guardian completing the visit
You can see live lice or nits near the scalp, or can upload a clear photo
No pus, spreading redness, or swelling of the scalp
Looking for the right over-the-counter treatment plus a household plan

Look for another care setting

Pus, honey-colored crusting, or spreading redness and swelling of the scalp or behind the ears
Lice or nits on the eyelashes or eyebrows
A scalp rash or sores that are not typical of lice
A weakened immune system

What to have ready

When the itching started and who else at home or school has lice
A clear close-up photo of the hair near the scalp if you can take one
The age of the child being treated
Whether any lice treatment has already been used, and how it went

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer the fit questions, and choose the response window you want. If the concern still fits this service, a physician reviews it and sends a secure update after sign-in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

Your physician

Every visit is personally reviewed by Ankur Fadia, MD — board-certified, cardiology-fellowship-trained, and Alpha Omega Alpha. Licensed in Virginia and West Virginia — your care is never handed off.

Verify Virginia medical license Verify West Virginia medical license Verify board certification

How do I know it is really lice and not dandruff?

Nits are glued firmly to the hair shaft close to the scalp and do not brush off like dandruff. Seeing live lice, or nits within about 1 cm of the scalp, points to an active case. A clear close-up photo helps confirm it.

Do I need to treat more than once?

Yes. Over-the-counter permethrin is applied and then repeated about 9 days later to catch lice that hatch after the first treatment. Wet-combing every few days and washing bedding and clothing in hot water are part of the plan.

When should head lice be seen in person instead?

Please seek in-person care for pus, honey-colored crusting, or spreading redness and swelling of the scalp, for lice on the eyelashes or eyebrows, or if over-the-counter treatment has been used correctly and still failed.