“4 Strikes They’re Out” head lice treatment


Head Lice treatment basics

Increasingly head lice are becoming resistant to synthetic insecticide treatments.[1] Many alternative treatments exist, but they are often ineffective or have never been tested for efficacy. Following is a lice treatment that employs four lice treatment methods (suffocation, desiccation and two natural insecticides) into one extremely effective treatment.

What you’ll need

  • "4 Strikes" head lice treatment ingredientsA 400ml bottle of conditioner (a natural, plant-based conditioner is recommended to avoid toxic synthetic ingredients). Alternately you can use an oil like olive or coconut oil, however the consistency will be a bit different and the oil has a tendency to drip down.
  • Diatomaceous Earth[2] (food grade).
  • 2 TBLSP (tablespoons) Neem Oil[3]
  • 1½ tsp (teaspoon) pure essential oil of Tea Tree.[4] Optionally also ½ tsp of Eucalyptus or Anise[5] essential oil (or a ½ tsp mixture of both).
  • Non-reactive bowl (e.g. glass).
  • A plastic bag, plastic food wrap or a shower cap.


  1. In the bowl, pour out all of the conditioner.
  2. Add to this the 2 TBLSP (tablespoons) Neem oil and whisk thoroughly.
  3. Whisk in the pure essential oils. Certain essential oils have been found to be effective against lice[6][7] and additionally the essential oil helps cover the smell of the Neem oil.
  4. Add a teaspoon of diatomaceous earth and then whisk.
  5. Keep adding diatomaceous earth a teaspoon at a time until you reach a thick but still slightly runny consistency. It should have the feel of a spreadable paste.
    "4 Strikes" head lice treatment mixture

    Finished mixture ready to apply

  6. Apply to hair. Starting at the roots, use either fingers or a spoon to apply small amounts to a section of scalp at a time. Gently rub into each section so that it’s completely coated in the mixture.
  7. Keep applying in this way until the scalp is completely covered with mixture. If hair is long and the mixture does not cover the ends, fold sections of hair over and against the scalp using the mixture to paste hair down.
  8. Once hair is completely coated, cover with shower cap, plastic bag or plastic food wrap so that hair is completely covered and there is minimal air exposure.
  9. Leave on for at minimum 60 minutes. 2-4 hours is strongly recommended. Can be left on for up to 6-8 hours.
  10. Remove plastic cap and wash very thoroughly.
  11. Repeat again after 8-10 days.

Makes enough mixture to treat approximately 3 heads (depending on hair length).

Do’s and Don’ts

  • Leave on as long as you can manage (up to 6-8 hours). The longer the treatment is left on, the more likely lice die.
  • Supervise young children carefully.
  • Be very thorough about washing hair after. Diatomaceous earth is very drying to the scalp and hair so it’s essential to remove as much of it as possible after.
  • Use a nourishing/hydrating conditioner or hair oil after the treatment (see above).
  • Brush or comb hair thoroughly after to remove dead lice.
  • Repeat 8-10 days after the initial treatment. It is imperative it’s not done sooner than 8 days or more than 14 days after.
  • Treat the entire family.
  • Use fragrance oils. Pure essential oils must be used.
  • Use pool grade diatomaceous earth. You must use food grade.
  • Leave on overnight while sleeping. Dried mixture could get into eyes and cause irritation or damage.

What to look out for

It may feel like you are applying mud to hair, that’s normal. Small lumps of unmixed diatomaceous earth is also fine. If the mixture is crumbly or won’t spread well, add a little water or oil a bit at a time and whisk until you reach the desired consistency.

Head lice lifecycle chartIf you use an oil instead of conditioner, you may have to shampoo/soap hair several times to remove the oil. Any oil residue will eventually disappear over time and/or with repeated hair washing.

Diatomaceous earth can be irritating or damaging to eyes as can the essential oils. Flush immediately and thoroughly with water if any mixture gets into eyes. Seek medical attention if irritation and/or redness persists.

If you wait to repeat the treatment more than 2-3 weeks after the first, you will need to repeat the treatment for a third time (8-10 days later). This is because eggs that survived the first treatment may have hatched and been able to lay more eggs. The key to this treatment is to break the life cycle of the lice – it is essential that the repeat treatment is applied no sooner than 8 days after the previous treatment but less than 14 days after. 8-10 days is optimal. This gives any viable eggs remaining, time to hatch (and be killed with the second treatment) but not enough time to produce more eggs (17-32 days after hatching).

Further reading

References   [ + ]

1. Clark, J. M., Yoon, K. S., Kim, J. H., Lee, S. H., & Pittendrigh, B. R. (2015). Utilization of the human louse genome to study insecticide resistance and innate immune response. Pesticide Biochemistry and Physiology, 120, 125-132.
2. Bunch, T. R.; Bond, C.; Buhl, K.; Stone, D. 2013. Diatomaceous Earth General Fact Sheet; National Pesticide Information Center, Oregon State University Extension Services.
3. Abdel-Ghaffar F; Semmler M. 2007. Efficacy of neem seed extract shampoo on head lice of naturally infected humans in Egypt. Parasitol Research (2007) 100:329–332 DOI 10.1007/s00436-006-0264-2
4, 7. Di Campli E, Di Bartolomeo S, Delli Pizzi P, et al. Activity of tea tree oil and nerolidol alone or in combination against Pediculus capitis (head lice) and its eggs. Parasitology Research. 2012;111(5):1985-1992. doi:10.1007/s00436-012-3045-0.
5, 6. Mumcuoglu KY, Miller J, Zamir C, Zentner G, Helbin V, Ingber A. The in vivo pediculicidal efficacy of a natural remedy. Isr Med Assoc J. 2002 Oct;4(10):790-3.