How do you get rid of head lice?
If you’ve found a live head louse, you should aim to treat them as soon as possible. Check everyone who lives in the same household and treat anyone else who has them at the same time. There are a number of effective treatments available. You can either use a medicated lotion or spray or do wet combing (‘bug busting’).
Lotions and sprays
There are a number of treatments you can buy over-the-counter at your pharmacist to treat head lice. These are products containing an insecticide that you apply to your hair. You should only treat head lice with an insecticide treatment if you find live lice. Treatments include the following.
- Dimeticone gels, lotions or sprays (eg Hedrin, NYDA and Linicin). Dimeticone is a physical insecticide – it kills the lice by coating them so that they can’t breathe.
- Isopropyl myristate and cyclomethicone solutions or aerosol products (eg Full Marks and Vamousse). This is another type of physical insecticide that kills the lice by dissolving their outer wax coating.
- Malathion (eg Derbac-M). This is currently the only chemical insecticide recommended for use in the UK. It works by poisoning the head lice.
Products containing the insecticide permethrin (eg Lyclear) are not currently recommended as there is evidence head lice are becoming resistant to it.
You’ll need to apply insecticides to your hair and scalp and leave it on for a certain amount of time, as directed in the product packaging. This can be as short as 15 minutes, or as long as overnight for some products. You then need to wash it out using shampoo. It’s usually recommended to apply the treatment twice, leaving seven days between the applications – this kills any new lice that may have hatched.
Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice. Some preparations aren’t recommended for children under two, for pregnant or breastfeeding women, or for people who have eczema or asthma. Wet combing or dimeticone 4% lotion (Hedrin Once) is usually recommended for these groups. Check with your pharmacist which products are most suitable for you.
Wet combing or 'bug busting'
This treatment involves removing lice by regularly combing wet hair with a plastic, fine-toothed comb, head lice detection comb. This is also the best method for detecting head lice – the technique for wet combing is discussed in the section above, Checking for head lice. If you’re using wet combing as a way to remove head lice, you’ll need to do this every four days for two weeks. It’s important that you keep wet combing your hair until you haven’t seen any full-grown lice for three consecutive sessions.
Some people prefer wet combing to insecticides, as it doesn’t involve using strong chemicals. You can also use this method if you have asthma or a skin condition, if you’re pregnant or breastfeeding, and at any age. It’s also relatively inexpensive as the combs are reusable; so one comb can be used to treat all members of your family that are affected. However, wet combing isn’t usually as effective as using an insecticide treatment and it can be time-consuming if you have many members of your family to treat.
Checking treatment has worked
Whatever treatment you use, you should check if it’s worked afterwards, by checking for lice with a detection comb. There’s different advice on when is the best time to do this. But it may be worth checking two or three days after you’ve completed the treatment, and repeating again after another seven days. If you find any nits (egg cases), it doesn’t necessarily mean that the treatment hasn’t worked. But if you find live lice, the treatment may not have been successful or you might have caught them again. You’ll need to repeat the same treatment, making sure that you are following the correct instructions for the product. Head lice can become resistant to the insecticide malathion, so it might be worth trying a different treatment if you’ve already tried this one. It’s important that you check everyone in the household for head lice again.