How do you get rid of head lice?

If you find a live head louse, you should aim to treat them as soon as possible. Check everyone who lives in your household and treat anyone who has them at the same time.

Children can still go to school if they have head lice.If your child has head lice, they’ll probably have had them for several weeks. Lots of other children at their school may also have head lice. So, keeping them away from school is unlikely to stop head lice being passed on.

There are several head lice treatments. You can either use a medicated lotion or spray or do wet combing (‘bug busting’).

Lotions and sprays

• You can buy lots of different head lice treatments from a pharmacy without a prescription. These products contain an insecticide and you put them directly onto your hair. You should only use an insecticide treatment if you find live lice. Dimeticone gels, lotions or sprays. Dimeticone is a physical insecticide – it kills the lice by coating them so they can’t breathe.
• Isopropyl myristate and cyclomethicone solutions or sprays. These are also physical insecticides. They kill the lice by dissolving their outer wax coating.
• Malathion. This is currently the only chemical insecticide recommended for use in the UK. It works by poisoning head lice.

If you’re using dimeticone products, stay away from fires and flames (including lit cigarettes) until you’ve washed the product out of your hair.

Products containing the insecticide permethrin are no longer recommended. This is because head lice are becoming resistant to this insecticide.

You’ll need to put the insecticide on your hair and scalp and leave it for a certain amount of time. This can be as short as 15 minutes or as long as overnight depending on the product. So, read the product packaging first. You then need to wash the product out using normal shampoo. You’ll usually need to put the treatment on twice with seven days between the applications – this kills any new lice that may have hatched.

Some insecticides aren’t recommended for:

• children under two years old
• pregnant or breastfeeding women
• people with eczema or asthma

Instead, these people should use wet combing or dimeticone 4% lotion. Check with your pharmacist which products are best for you.

Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Wet combing or 'bug busting'

• Wet combing involves removing lice by regularly combing wet hair with a plastic, fine-toothed head-lice-detection comb. In each session, you should comb through the hair twice. Each session may take around 10 minutes for short hair and around 20 to 30 minutes for long, curly or frizzy hair. You’ll need to do wet combing every four days for two weeks – on days one, five, nine and 13.
• Use a detection comb again on day 17 to check for live head lice – if you don’t find any, the wet combing has worked.

Wet combing is suitable for everyone. Some people prefer it to using an insecticide because it doesn’t involve any chemicals. It’s also relatively cheap because you can use the comb again and again. You can use one comb to treat all members of your family who have head lice. But wet combing doesn’t always work as well as an insecticide. It can also take up a lot of time if several people in your family need to be treated.

Electronic combs aren’t recommended for detecting or treating head lice. Some experts worry they’re not safe if you don’t use them properly. Battery-operated combs may not reach your scalp very well. So, they don’t seem to be any better than a traditional comb.

Checking treatment has worked

Whichever head lice treatment you use, you should check it’s worked by looking for lice with a detection comb. The advice about this varies. Some advice recommends checking 10 days after you’ve finished the treatment, and other advice recommends checking every week for a month afterwards.

If you find any nits (egg cases), this doesn’t necessarily mean the treatment hasn’t worked. If you find live lice, the treatment may not have worked or you may have caught head lice again. You’ll need to repeat the same treatment, making sure you’re following the right instructions for the product.

Head lice can become resistant to the insecticide malathion. So, if malathion hasn’t worked for you, you should try either a physical insecticide or wet combing.

It’s important to check everyone in the household for head lice again at the same time – and treat them if you find any live lice.