How do you get rid of head lice?
If you find a live head louse, you should aim to get treatment 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 – see our FAQ on whether or not to keep a child off school because they have head lice.
There are several treatments for head lice. 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 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. If you’re using wet combing to remove head lice, you’ll need to do it every four days for two weeks. It’s important to keep wet combing your hair until you haven’t seen any full-grown lice for three consecutive sessions.
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. Wet combing should be done in four sessions spaced over two weeks – on days one, five, nine and 13. But it 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.
Checking treatment has worked
Whichever treatment you use, you should check it’s worked by looking for lice with a detection comb. The advice about this varies. But it may be worth checking two or three days after you’ve finished the treatment and checking again after another seven days.
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.