Head lice

Updated 22 April 2016

Treating head lice

Lice can be effectively treated either using insecticidal shampoos or through natural alternatives such as the 'comb-only' technique and the use of Tea Tree Oil.

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When treating head lice, the aim is to remove all lice and nits. This usually requires repeated efforts, because a few adult lice may escape by hiding in clothing or bedding, and eggs are difficult to kill.

The most common treatment for head lice is to kill the adults with an insecticidal shampoo and to clear out the nits with a special fine-toothed comb.

Here are some products you could consider using: 

Dimethicone 4% lotion is a physical non toxic treatment available in pharmacies.
Permethrin 1% shampoo.
Malathion 0.5% lotion and Ivermectin 0.5% lotion are also effective, especially when there is a poor response to primary treatment. 

Of the medications for lice, permethrin is the safest, most effective, and most pleasant to use, and is available over the counter. For best results, follow the directions exactly.

Many people recommend pharmaceutical grade Tea Tree Oil, but ask your pharmacist for advice on other good products to treat head lice. 

The "combing only" technique

If you prefer to avoid the use of insecticides, try a "combing only" technique. Wash the hair with an ordinary shampoo and conditioner and leave wet. With a fine-toothed comb, stroke slowly outward from the roots through one lock of hair at a time.

Lice will land on the back of the comb, get caught between the teeth, or fall off. Space at least 30 strokes over the head. Repeat every three days. Because new-born lice do not lay eggs for the first week, all lice should disappear after about two weeks of combing.

Additional methods for eliminating lice

To eliminate all lice and successfully prevent reinfection, wash all clothing, towels and bed linen in hot, soapy water, and dry them in a hot dryer.

You can also disinfect bedding and other items such as hats and clothing by placing them in a sealed plastic bag for 14 days; the nits will hatch in about a week and die of starvation. Brushes and combs can be disinfected by soaking them in hot, soapy water for 10 minutes.

Brushes and combs can be disinfected by soaking them in hot, soapy water for 10 minutes.

Other family members should be treated too – about 60% of infected children have relatives who carry lice.

Read more:

Causes of head lice

Symptoms of head lice

Preventing head lice

Reviewed by Dr Rowan Dunkley, Paediatrian, Red Cross Children’s Hospital, Cape Town. February 2015