Head lice - Treatment 

Treating head lice 

Head lice and clothing

Healthy head lice don't deliberately transfer onto clothing, bedding or soft toys.

Their life span is about three weeks and when they fall from the head they're dying and unable to breed.

Hot washing or fumigation isn't necessary to control head lice.

Promptly dispose of any lice that fall from the head on to clothing or bedding.

Head lice can be difficult to treat due to the time-consuming and precise nature of treatment and high re-infestation rate.

In the past, traditional insecticides were used to treat head lice infestations but head lice would often develop resistance to them.

Therefore, these types of treatments have virtually been replaced with silicone and oil-based preparations which have a physical rather than a chemical action on lice.

After a head lice infestation has been confirmed you can treat the lice at home by wet combing the hair with a head lice comb or by using a lotion or spray that's designed to kill head lice (see below).

However, neither will protect against re-infestation if head-to-head contact is made with someone with head lice during the treatment period.

Wet combing

The wet combing method involves removing the head lice by systematically combing the hair using a special fine-toothed comb.

The comb's teeth should be spaced 0.2-0.3mm apart. Lice can be crushed or trapped between the teeth of nit combs with a tooth spacing of less than 0.19mm and remain unseen. 

You can buy a fine-toothed comb from your local pharmacy or you can order one online.

Lotions or sprays don't need to be used for wet combing. However, to be effective, wet combing needs to be carried out regularly and thoroughly. The method you should use is described below. 

  • Wash the hair using ordinary shampoo and apply plenty of conditioner, before using a wide-toothed comb to straighten and untangle the hair.
  • Once the comb moves freely through the hair without dragging, switch to the louse detection comb. Make sure the teeth of the comb slot into the hair at the roots, with the bevel-edge of the teeth lightly touching the scalp.
  • Draw the comb down to the ends of the hair with every stroke, and check the comb for lice.
  • Remove lice by wiping or rinsing the comb.
  • Work methodically through the hair, section by section, so that the whole head is combed through.
  • Rinse out conditioner and repeat the combing procedure.
  • Repeat the procedure on days three, six, nine, 12 and 15, so that you clear young lice as they hatch, before they have time to reach maturity.

How long it will take to comb your child’s hair will depend on the type of hair they have and its length. For example, short, straight hair can be quickly prepared and can be fine-toothed combed in a few minutes. Longer, curlier hair will take longer to comb.

Lotion or sprays

Using a lotion or spray is an alternative method of treating head lice. However, to be effective they need to be used correctly. Your pharmacist will be able to recommend an over-the-counter lotion or spray and advise you about how to use it correctly.

A lotion or spray should only be used if a living (moving) head louse is found. Crème rinses and shampoos aren't thought to be effective and therefore aren't recommended.

Ensure you have enough lotion or spray to treat everyone in your family who's affected. Use enough to coat the scalp and the length of the hair during each application.

Follow the instructions that come with the lotion or spray when applying it. Depending on the product you're using, the length of time it will need to be left on the head may vary from 10 minutes to eight hours.

The normal advice is to treat the hair and repeat the treatment after seven days. Some products also supply a comb for removing dead lice and eggs.

Some products may be capable of killing eggs as well as lice, although there's no certainty of this. Check for baby lice hatching from eggs three to five days after using a product and again 10-12 days afterwards.

At least two applications of lotion are needed to kill lice over the hatching period because the lotions don't always kill louse eggs.

If the lice appear unaffected by the product, or if the problem persists, seek advice from your school nurse, health visitor, pharmacist or GP.

Cautions

Always read the instructions on the pack or leaflet that comes with a head lice treatment, particularly in relation to the following groups:

  • young babies (under six months old)
  • pregnant women
  • people with asthma or allergies

If you're still unsure, seek advice from a healthcare professional before using the product.

It's recommended that pregnant women use either wet combing or 4% dimeticone lotion, which is licensed for use during pregnancy and breastfeeding.

Afro hair

Afro (frizzy) hair or hair that's tightly curled can make treating a head lice infestation particularly difficult.

There's no evidence that keeping your child's hair short, or plaiting or braiding it, will make it easier to treat.

Afro hair should be treated in a similar way to straight hair. Methodically combing small sections of hair at a time with a lice comb, and/or using a lotion or spray, will usually prove effective.


Page last reviewed: 03/07/2014

Next review due: 03/07/2016

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The 11 comments posted are personal views. Any information they give has not been checked and may not be accurate.

GiGi14 said on 25 June 2014

Please read the whole of this..

My 24 yr old daughter constantly had lice/nits throughout primary school, it was a nightmare with her lovely blonde long curly hair. Parents who could not be bothered to sort their kids hair out and learn how to keep on top of it.. book sharing...so I started wet coming 0.5cm sections of hair and got to the stage of scrutinizing and scraping eggs off with my nails until it was all clear.. time consuming and frustrating.. irritating and causing upset. Left conditioner on and scraped her hair back into plaits and only set free on weekends and holidays.

Then came hair straighteners.. so with my now 15 year old daughter..who had them twice.. I used tea tree oil shampoo and conditioner.. leaving the conditioner on, scraped through with a nit comb for live lice and then burned the ' .............' that got rid of them... burning the eggs with the straighteners every 2 days.. unpleasant but such a good feeling to know the eggs could not possibly survive being ironed!

Now we are on to my partners 9 & 6 year old daughters.... yaay.. more lice... including my own head
T - gel, another great way of clearing them.. they don't like the smell.. apparently geranium oil too... its all come flooding back.. so wash with T-gel, leave conditioner on, and straighten the hair - though I did purchase Sainsbury's own lice shampoo for myself once they'd gone home until the summer holidays £5!!!! and not too bad either.. I think it has helped..

So, to summarise:

Wash hair with medicated shampoo
Condition with tea tree conditioner
Leave conditioner in and go through sections with nit comb
rinse comb after each scrape
leave to dry or blow dry
Use straightening irons on small sections to burn the eggs...
Scrape hair back and plait if possible every day whilst at school
hair spray another dislike of the bugs...



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Baileywoo said on 16 October 2013

I have been battling headlice on my daughter for 12 years, with very few breaks. I agree we are at the mercy of those parents who don't bother. The fashion for girls to have long hair and the trend for sleepovers all conspire against us! I can get rid of the live lice but the problem we have are the nits ie the eggs. They stick really well to hair and at the moment my daughters hair is covered. I have been combing them for days and having little impact. They look awful and make it seem as though she is infested when actually there are no lice, dead or alive, in her hair at the moment. Any tips?

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corinne0407 said on 04 August 2013

Desperately seeking advice.... Myself and my husband are first time parents, our daughter (8 months soon) is with a childminder during the day whilst we go to work. Twice now i have found live lice in her hair and have informed the childminder on both occasions (who might i add is very apologetic and very embarrassed poor love). What i need to know is can i treat my daughter with these insecticides or is the best solution to just keep up the wet combing? which she hates :(
Please help!!!!!

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john55 said on 09 January 2013

Mm these blighters must be able to smell hair. I combed them out of my daughters head into the empty but dry bath. There must have been about a dozen or so. I left them there attending to my daugther first thinking that I could easily flush them away later and watching them only move slowly. When I returned to commit the act of genocide 20 minutes or so later I found that they had all returned to one single strand of hair that was close by in the bath and they were actively running up and down it. Amazing, so don't think that these little devils can't get back on, I have seen it with my own eyes !!

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emily10towers said on 08 June 2011

Head lice will only let go of hair when they are to weak or damaged to hold on and although they will stay alive away from human for several hours they cannot transfer to another person in this way. They will only transfer from prolonged head to head contact.

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esiuol1965 said on 24 January 2011

I agree! my son (9) had never had lice before and wanted to see what they looked like. we "bug busted" for half an hour in the bath.I fished one out of the sink thinking it would be unrecognisable and very dead. He was fascinated and it was intact though lifeless. We put it in a bug pot and left it. More than a day later my daughter noticed it was crawling about and is still going strong!!! We are amased as we have avoided them so far as a family so far.
Another bug busting session tonight and all bedding on the washing line after a hot wash.

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mimi54 said on 14 December 2010

There were nits at my daughter's school and now we all have them in the family.I did not dream that it was so hard to treat them as the medicated shampoos do not kill them all and the lice remain alive.I've paid £25 for different shampoos so far and fear the problem is still unresolved.I have yet to do the wet combing properly as first attempts at it hardly worked as well.It's a nightmare! Then my daughter told me her little friends have told her they've had them,too and moms treated them. I notified the teacher about my daughter and she said that the problem was they were now ,new guidance,not allowed to tell the parents if they see their child has nits or put up a poster notifying all the parents of the existing problem. So,parents can choose not to treat their children (their human right,apparently),which makes the struggle of the parents like us almost pointless as recurrance is inevitable.If true,it is more than ludicrous and even frightening.

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mumof2NewMalden said on 16 October 2010

I would also like to add that head lice stay alive for many hours, even in uncosy conditions! I have used the wet combing method and when rinsing the nit comb, have left a live head louse that has not gone down the plug hole, in the sink. Many hours later, it was still alive... I guess the thing is that on the whole the little blighters make sure they don't let go of the hair, so effectively it is only hair to hair transfer by which they find pastures new.

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sue463 said on 16 October 2010

My 8 year old has just been treated painstakingly ,but eventually successfully ,for headlice. I read your pages after the infestation and treatment and found them useful and informative but you failed to mention the presence of the dark greyish coloured droppings from the louse which can be found in large quantities on bedding, clothes, and in the hair , and can sometimes be the first indication of an infestation

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User328887 said on 24 September 2009

That's what I came on here to say - my school uses the text from this page as advice sent home to parents. I combed several live lice out of my son's hair one night before bed onto a piece of white paper. In the morning I looked again at the paper and there were three lice still alive and moving around. I think advice not to wash sheets may need revision, as the lice seem able to lay in wait, even without being warm and cosy, for at least twelve hours according to my experiment.

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mumof8 said on 25 May 2009

A warning about not needing to wash clothing etc. I found a live head louse on my 6 year old daughter's pyjama top at bedtime. The top had been folded and placed under her pillow that morning and it was obviously nice and cosy for the louse.

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Head lice on combs

Inspect brushes and combs that are used during treatment and remove any lice before the next stroke.

Head lice will die after a day or two if they're unable to feed on human blood.

Be aware that head lice can be flicked from dry hair during vigorous combing. If they land on someone they'll try to climb up to their head. 

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