Should I use this page, or skip it?
Use this page if you have found live lice or nits and need combing steps, pharmacy products, and school rules. Skip it and call 999 only if the child is otherwise severely unwell — lice themselves are not an emergency. A very sore, oozing scalp needs a pharmacist or GP, not another unproven oil.
This page cannot see live lice for you. A detection comb from a pharmacy can.
What are head lice and how do I spot them?
Head lice are small insects that live on the human scalp. They spread by head-to-head contact, not dirty hair. They itch but do not spread disease. Live lice are hard to see. Nits are eggs or empty cases stuck to hair. The only sure check is finding live lice with a fine-toothed detection comb.
Itching can take weeks to start. Check close contacts even if they do not itch yet. Dandruff flakes off; nits stay glued to the hair shaft.
How do I treat them?
Wet combing is a first option: wash the hair, apply plenty of conditioner, comb from roots to ends, then repeat. NHS timing is days 1, 5, 9 and 13, with a check on day 17. If that is not practical, a pharmacy lotion or spray can kill lice — follow the pack, including any second application.
Treat everyone with live lice on the same day. Find a GPhC-registered pharmacy on Pick My Pharmacy. Do not use lotions to prevent lice — they can irritate the scalp.
Do they need to stay off school?
No. NHS advice is that children do not need to stay off school with head lice. Treat as soon as you find live lice. Tell the school so other parents can check. No-nit policies are not recommended — empty cases can remain after successful treatment and are not a reason to exclude.
You do not need a hot wash of all the laundry. Pets do not get human head lice. Combs and brushes can be washed, but heads are the priority.
When is it a GP, 111 or 999?
See a pharmacist if lotions fail or you need help combing. See a GP if the scalp is crusted, oozing or very sore, or lice persist after two properly used courses. Use 111 if you cannot get that advice and the scalp looks infected. Call 999 only for unrelated emergencies — unresponsiveness, breathing difficulty, or a non-blanching rash with fever.
In England, Scotland and Wales call 111 (NHS 24 in Scotland). In Northern Ireland there is no general 111 — use GP out-of-hours on nidirect. See pharmacy, GP, 111 or A&E if you are stuck on the door.
What should I not bother doing for head lice?
You do not need to fumigate the house, treat pets, or wash every soft toy on a boiling cycle. NHS advice is that you do not need a hot wash of all the laundry. Lice spread by head-to-head contact. Combs and brushes can be washed, but treating live lice on heads is what stops the cycle.
Tea tree oil, electric combs and products sold as repellents are not NHS-recommended. Do not use medicated lotions to prevent lice — they can irritate the scalp. Regular detection combing during a school outbreak is more useful than a scented spray.
What if the lotion does not work?
Check technique first — wet combing must cover the whole head and be repeated on the NHS days. If a lotion failed, a pharmacist can suggest a different type. See a GP if the scalp is infected or lice persist after two properly used courses. Empty nits can stick after lice are gone and are not proof of failure.
Treat everyone with live lice on the same day so you do not pass them back and forth. Itching can take weeks to start, so check close contacts even if they do not itch yet.
Who should skip this page?
Skip this page if the child is already floppy, struggling to breathe, or has a non-blanching rash — that is 999, not nits. It is not a scabies body-itch guide, not a threadworms page, and not a reason to keep a well child off school.
Common questions about head lice
- How do I know if my child has head lice?
- Itching is common but the only sure sign is live lice found with a fine-toothed detection comb. Nits are eggs or empty cases glued to hair near the scalp — nits alone do not always mean lice are still alive. Comb wet, conditioned hair from roots to tips. A pharmacist can help you check if you are unsure.
- What is the best treatment for head lice?
- Wet combing works: shampoo, lots of conditioner, then a detection comb through the whole head, repeated on days 1, 5, 9 and 13, with a check on day 17. If that fails or is not practical, a pharmacy lotion or spray can kill lice — follow the pack, including any repeat application. Do not use products to prevent lice.
- Do head lice jump or live on bedding?
- They cannot jump or fly. They spread by head-to-head contact. NHS advice is that you do not need to wash laundry on a hot wash. Pets do not need treating. Hats and pillows are not the main story — combing and treating live lice on heads is what stops the cycle.
- Should my child stay off school with head lice?
- No. NHS advice is there is no need to keep a child off school. Treat as soon as you find live lice and tell the school so other families can check. No-nit policies are not recommended. Empty egg cases can stick after the lice are gone and are not a reason to exclude.
- Can adults get head lice?
- Yes — usually from children in the household. Check everyone who has had head-to-head contact. Treat anyone with live lice on the same day so you do not pass them back and forth. Itching can take weeks to start after the first infestation, so check even if scalps do not itch yet.
- What if treatment does not work?
- Check technique first — wet combing must cover the whole head and be repeated on the NHS days. If a lotion failed, a pharmacist can suggest a different type. See a GP if the scalp is infected or lice persist after two properly used courses. Do not keep stacking herbal oils — NHS does not recommend them.