General Practitioner

Head lice made headlines after Labour MP Emma Hardy suggested changes made to NHS guidelines “threatens an epidemic of head lice in our schools” in parliamentary debate at the end of last year. The guidance published by NHS England in March advised GPs to curb prescribing for 35 conditions including head lice, in favour of self-care and treatments which can be purchased from a pharmacy.

In this post for talkhealth, I will be getting into the nitty-gritty of what head lice are, who they affect and how they are spread. I will also be offering my advice on how to best treat head lice and what you can do to lower your chances of getting them in the first place.

What are head lice?

Head lice, otherwise known as nits, are small parasitic insects up to 3mm long. They pose no major health threat, but they feed off blood from the scalp and can make your head feel itchy. Children are most commonly affected by head lice because they are often less protective of their personal space and more likely to engage in physical contact with one another. However, head lice do not discriminate by age and are comfortable living on the heads of adults. Head lice cannot jump, fly or swim so are spread through close physical contact with personal hygiene not being a factor. You are most likely to find head lice on the scalp behind the ears and near the neckline at the back of the head. Head lice are often mistaken for dandruff, but unlike dandruff, head lice are firmly attached to the hair shaft and more difficult to remove.

How can they be treated?

Head lice can be treated without a prescription from your GP. I would recommend treating head lice as soon as they are detected, whether it be a live louse or their eggs. You can do this by wet combing, which involves using a fine-toothed comb through wet hair with conditioner. Lice can crawl fairly fast through dry hair but remain motionless in wet. Comb all hair from roots to the ends and repeat every few days for a couple of weeks to ensure all head lice are removed. This usually takes around 10 minutes for those with short hair but can take up to half an hour for those with long, frizzy or curly hair.

If after two weeks your child is still struggling with head lice, I would recommend using a medicated lotion or spray to kill the lice. This treatment should kill all live lice within a day and might need to be repeated after a week to kill any newly hatched lice.

Can they be prevented?

Some parents believe head lice are associated with having dirty hair, although this is not the case and children with clean hair are just as likely to get head lice. While you can reduce the risk of head lice spreading by avoiding head to head contact, there is not much you can do to completely prevent them. However, if one member of the family has head lice, you should also check everyone else in the house to lower the chances of reinfestation. Preventative medicated lotions and sprays are available, although these can irritate the scalp and I do not tend to recommend these to my patients.


Dr Sufian Ali is a GP for the MedicSpot private doctor servic


Dr Sufian Ali

Dr Sufian Ali is a Medicspot GP based in the West of Scotland, having attended Aberdeen Medical School and completed his GP training in Glasgow. He has enjoyed working in a number of specialities including paediatrics, psychiatry and emergency medicine; while also working in a variety of settings including prisons, remote Scottish islands and Singapore, with Raffles Medical Group. He finds it important to find time to volunteer, he has led and been involved in many volunteer events including national CPR training, mental health workshops, the Special Olympics and medical relief work in developing countries. This varied experience gives him the ability to provide a more holistic and patient centred approach to the care of his patients. He sees medical technology and innovation as the solution to some of the gaps and inefficiencies in primary healthcare provision. He is passionate about using and assisting in the development of digital health to improve patient care.

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