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Head Lice

Dec 05, 2019

Head lice are tiny wingless insects that live in human hair. They are whitish to grey-brown in colour. When first hatched they are the size of a pinhead and grow to 3mm (the size of a sesame seed). They cannot fly, jump or swim and are spread by head-to-head contact. Children are most commonly affected by head lice as they have more head-to-head contact. A head lice infestation is not the result of dirty hair or poor hygiene.

Head lice feed by biting the scalp and it is an allergy to this that causes itching for many people, however not everyone is allergic to head lice so not everyone will experience itching when they have an infestation.


Detection combing is the most reliable method to detect head lice as it is difficult to detect head lice simply by inspecting your child’s head. Use a fine tooth detection comb.

Wet detection combing
This is the most accurate way to detect lice as they remain motionless when wet.
 Wash hair using ordinary shampoo and apply plenty of conditioner. Use 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 of hair is combed through.
 Rinse out the conditioner and repeat the combing procedure in the wet hair.

Dry detection combing
 Use an ordinary comb to straighten and untangle the hair.
 Once the comb moves freely through the hair without dragging, switch to the louse detection comb. Comb the hair from the scalp to the ends, combing each section of hair three or four times before moving on to the next section.
 Look for lice as the comb is drawn through the hair. If you see a louse, trap it against the face of the comb with your thumb. This will stop the louse being repelled by static electricity as the comb is removed from the hair.
 Continue combing the hair section by section until the whole head has been combed through.

If you discover head lice in your child's hair you should check the rest of the family and alert close friends.

You should only treat hair after live head lice have been found. Don't treat "just in case" as it will not protect against re-infestation if head-to-head contact is made with someone with head lice during the treatment period.

Wet combing
This is similar to the wet detection combing but it must be repeated on days 3, 6, 9, 12 and 15 so that you clear young lice as they hatch.

Lotions or sprays
Insecticides are no longer the treatment of choice due to the development of resistance. Silicone or oil based products (e.g. Full Marks, Hedrin) are now recommended as the lice cannot develop resistance to these. It is important to follow the instructions provided carefully. You must ensure that lotion is applied to the entire scalp and length of hair. Depending on the product it may need to be left in the hair for between 10min and 8 hours before being washed out. Dead lice and eggs will then need to be removed using a fine tooth comb. The treatment should be repeated after seven days.

totalhealth pharmacist’s advice
 Regular detection combing is important as not everyone who has a head lice infestation will have an itch, or the itch may take some time to develop.
 Some products are available to help prevent infestations e.g. Hedrin Protect and Go. These are applied at least twice a week and can disrupt the life cycle of the lice. Products containing tea tree may also be useful in preventing infestations.
 If your child has head lice, it is important to notify close friends and your child’s school or crèche.
 Lice can only live on the scalp of humans so there is no need to wash or fumigate clothing and bedding or treat animals.

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