Quick answer
What is head lice?
Head lice are tiny insects that live on the scalp and lay eggs (nits) attached to hair. They cause itching but do not spread disease. Treat with wet combing or medicated lotions from a pharmacy. Check and treat all close contacts — family members who share a bed or hairbrush. Children can return to school after treatment has started.
Head lice are common and treatable
Head lice are small insects that live on the human scalp and feed on blood. They are very common in children — especially of primary school age — but anyone can get them. They cause itching but do not spread disease and are not a sign of poor hygiene. Lice spread through head-to-head contact, not from sharing hats or beds (though this is possible rarely).
How to spot head lice
Live lice — about the size of a sesame seed (2 to 3mm), brown or grey, move quickly through hair. Hard to see.
Nits — empty or hatching egg cases, pinhead-sized, white or grey, firmly glued to individual hair shafts close to the scalp. Nits further from the scalp are usually already hatched or dead.
Itching — caused by reaction to lice bites. May take weeks to develop after first infestation.
Detection combing — a fine-toothed metal or plastic comb — is the most reliable way to find lice.
Treatment options
Wet combing (bug busting) — recommended first-line by many experts:
- Wash hair and apply plenty of conditioner
- Comb through with a normal comb to detangle
- Switch to a fine detection comb
- Comb from roots to ends, wiping the comb on tissue after each stroke
- Repeat every 3 to 4 days for at least 2 weeks to catch newly hatched lice
Medicated treatments from pharmacies:
- Dimeticone 4% (Hedrin and others) — silicone-based, coats and smothers lice
- Isopropyl myristate — works similarly
- Malathion — traditional insecticide, resistance possible in some areas
Follow product instructions exactly — usually two applications a week apart. Check whether the product kills eggs or requires repeat treatment.
Do not use treatments on children under 2 without pharmacy or GP advice.
Treat the whole household
On the day you start treatment:
- check all family members — treat anyone with live lice
- tell close contacts — grandparents, friends who share beds
- notify school or nursery — so other parents can check (confidentially)
Treat everyone affected on the same day to prevent ping-pong re-infestation.
What you do not need to do
Extensive cleaning is not necessary:
- lice die within 1 to 2 days off the scalp
- wash pillowcases and hairbrushes on a hot wash if you prefer
- vacuuming carpets is optional, not essential
- do not treat pets — human head lice do not live on animals
School and nursery
NHS guidance says children should not be excluded from school for head lice. They can return after treatment has started. “No nit” policies have no medical basis — nits may persist after successful treatment.
When treatment fails
If lice persist after two complete treatment courses:
- check technique — wet combing must be thorough and repeated
- try a different product with a different active ingredient
- ask a pharmacist to check for live lice (not just nits)
- see a GP if still unsuccessful — prescription treatments exist
Preventing head lice
No product prevents lice completely. Loose hair tied back reduces contact risk. Regular detection combing during outbreaks at school helps catch infestation early.
Tea tree oil and other “repellents” have limited evidence.
Head lice vs nits only
Finding nits alone does not always mean active infestation — they may be old egg cases. Look for live lice before treating. If unsure, ask a pharmacist to help with detection combing.
Common questions
- How do I know if my child has head lice?
- Itching of the scalp is the main symptom. On inspection, you may see live lice (small brown insects about 3mm long) or nits (tiny white or grey egg cases glued to hair shafts near the scalp). Lice move quickly and are easier to spot in bright light.
- What is the best treatment for head lice?
- Wet combing — applying conditioner to wet hair and combing with a fine-toothed detection comb every 3 to 4 days for 2 weeks — works well. Medicated lotions or sprays (dimeticone, isopropyl myristate) from pharmacies are an alternative. Always follow the product instructions.
- Do head lice jump or live on bedding?
- No — they cannot jump or fly. They spread by direct head-to-head contact. They survive only 1 to 2 days off the scalp, so extensive house cleaning is unnecessary. Wash pillowcases on a hot wash if you wish.
- Should my child stay off school with head lice?
- No — NHS guidance says children should not be excluded. Treat as soon as lice are found and inform the school so other parents can check. "No nit" policies are discouraged.
- Can adults get head lice?
- Yes — usually from children in the household. Treat all close contacts checked and found to have lice on the same day.