Treating head lice Choosing a head lice treatment

Don't worry: head lice are just part of life

Are head lice normal?

Head lice are a rite of passage that every parent can expect their child to face. Pharmacist Graham Phillips reassures us: ‘It’s just part of life. Don’t worry and don’t get upset – your pharmacist will help you sort it out.’

While you can catch head lice at any age, our survey showed that of members who reported experiencing head lice in the past two years,  usually it was their children who had suffered.

Where to buy head lice treatments

If you want to shift head lice quickly, our survey indicates that over-the-counter products are your best option. Almost half of our members used these products and 59% of them said the lice went away in three days or less.

However, our survey also revealed that no one treatment method is necessarily superior in terms of satisfaction – overall, members were satisfied with whatever type of treatment they used.

These mixed conclusions show there’s no clear winner. Only you can decide which treatment is right for your child, as personal circumstances, including time and hair type, will affect which is best to use. If you are unsure which product to try, speak to your pharmacist.

Types of head lice treatments

When we investigated whether any clinical trials had proven which treatment was best, we found varying results.

Manual combs don't require insecticides

1. Combing

Manual combs can be used to detect lice in the hair, and also to get rid of an infestation. They are the cheapest nit treatment available and are easy to use – you simply cover the infected hair in conditioner (so the lice will lose their grip) and comb through, starting at the root and going all the way to the tips. After each stroke, check the comb for lice and clean it if there are some on it.

This treatment is quite time consuming – you need to comb the hair for at least 30 minutes and repeat four more times over the next two weeks to ensure all the lice are dead. A general rule is to continue until you haven't seen any full-grown lice for three sessions.

You can also buy battery-operated combs, which kill lice on contact and can be used on dry hair.

Pros No resistance concerns, reusable, no insecticides, also used to detect lice
Cons Fiddly, takes about two weeks, metal combs can hurt, efficacy not conclusive for electric combs

Insecticides show varying effectiveness in clinical trials

2. Synthetic chemical insecticides

Insecticide products contain a cocktail of chemicals designed to kill lice. Products include Derbac M, Full Marks Liquid, Full Marks Mousse, Full Marks Lotion, Lyclear Creme Rinse. 

You should only use a chemical insecticide if you have found a live head louse in the hair, otherwise non-lethal doses could build up on the scalp and lead to lice becoming resistant. Always read the instructions and bear in mind that you might need to repeat the treatment a week later.

Pros Easy to apply, various trials have shown they work
Cons Can be prone to resistance, varying effectiveness in clinical trials

Lice can't build resistance to drowning

3. Physical action to kill lice

There is a relatively new breed of products that kills lice by physically coating them in liquid and drowning them or dehydrating them, rather than poisoning them. These products include Hedrin and Full Marks Solution. 

Because these products kill lice through physical action, head lice cannot become resistant to them. They don't kill eggs though, so you'll usually need to repeat treatment after a week to kill any lice that have hatched since the first application.

Pros No insecticides (Hedrin drowns lice and Full Marks Solution dehydrates them), resistance unlikely, odourless
Cons Trials have shown degrees of efficacy but more evidence is needed

4. Natural insecticides and essential oils 

Natural insecticides need more research

Natural insecticide products include Boots Head Lice Remover, Lyclear Sprayaway, Nice’n Clear and Quit Nits Head Lice Remover.

As yet, there’s little evidence for the effectiveness of natural insecticides or essential oils. Plus, Dr Graham Archard, from the Royal College of General Practitioners, told us: ‘Other over-the-counter treatments have very stringent safety tests – you don’t get this with herbal remedies.’

Pros Resistance less likely, easy to apply
Cons Little clinical research into efficacy of treatments, potential side effects not known.