What treatment is available?

People with a confirmed head lice infestation and any affected household members should receive treatment on the same day. The options for treatment are:

• Wet combing

• A physical insecticide 

• A chemical insecticide

Which treatment people or parents/carers use will very much depend on their preference, what they’ve already tried and cost. They may need some guidance and advice to choose the right treatment for them.

Before we look at each type of treatment in detail here are some general considerations for treatment from NICE:

• Shampoos should not be recommended because they are diluted too much and have insufficient contact time to kill the lice

• For pregnant or breastfeeding patients, young children aged 6 months to 2 years and patients with asthma or eczema the first line treatment is wet combing or dimeticone 4% lotion

• Patients/parents/carers should be provided with enough treatment to complete a treatment course. Long or thick hair may require more than one bottle of product
• Patients/parents/carers should be directed to read the instructions that come with their treatment product to ensure it is used correctly

The NHS states the following treatments should not be recommended due to lack of evidence that they work:

• Products containing permethrin

• Head lice “repellents”

• Electric combs for head lice
• Plant oil treatments such as tea tree oil, eucalyptus oil and lavender oil herbal remedies