Head lice

What are they? What are the symptoms? What are the treatments?

What are head lice?

This is a very common infestation of tiny wingless insects on the scalp and along the hair shafts, spread by head to head contact. Head lice are extremely common amongst pre-school and primary school age children, and repeated infestations are common unless all the parents in a group where a breakout has occurred can be persuaded to treat their children, at the same time regardless of whether they think they have head lice or not. Sometimes a child may have only one or two lice, but this number multiplies very quickly if left undetected and untreated.

Head lice feed by sucking very small amounts of blood from the scalp, which results in intense itching. Some people believe head lice can fly or jump, but they can't: they move from head to head by crawling. Another commonly held misconception is that head lice prefer dirty heads. In fact, they are undiscerning creatures and will infest anyone's hair, regardless of how clean it is.

What are the symptoms of Head lice?

The first sign of head lice is usually the itching, and you'll see your child scratching away at her head repeatedly. You might be able to see the lice if you examine her head and hair closely: fully grown they're about 3mm long, but are very good at camouflage. People sometimes refer to head lice as 'nits', but this is the term for the empty egg shells left by hatched lice. They are creamy grey in colour and very well 'cemented' to the hair shaft, so hard to remove. They're most commonly seen near the scalp, where warmth from the head encourages them to hatch. These can be removed by using your nails to pull them down the hair shaft.

What are the treatments and remedies of Head lice?

Treatment is either by wet combing - using a special nit comb and plenty of conditioner on wet hair until all signs of nits and lice have gone- or by using a proprietary over-the-counter lotion or shampoo. Some are chemical, others natural. You shouldn't use any chemical treatment on children under two years old. You may find the best solution for your child through trial and error, or ask your pharmacist what is best to use as some headlice have developed resistance to some of the treatments in some areas. Prescription treatments, including oral medication, are available if the lice are very resistant to other treatments.

This guide 

The information in this Bounty A-Z of Family Health is not a substitute for an examination, diagnosis or treatment by a doctor, midwife, health visitor or any other qualified health professional. If in doubt, always speak to a doctor.

Bounty will not be held responsible or liable for any injury, loss, damage, or illness, however this occurs or appears, after using the information given on this website and in particular the A-Z of Family Health.

Further help

For health advice and information 24 hours a day, 365 days a year, the NHS offers call and web services. You can also visit NHS websites for services, health information and health news at nhs.uk 

  • England – call 111 from any landline or mobile phone free of charge, or visit nhs.uk 
  • Scotland – call 111 from any landline or mobile phone free of charge, or visit nhs24.com 
  • Wales – call 0845 4647 , or visit nhsdirect.wales.nhs.uk 
  • Northern Ireland – visit hscni.net


Head lice