Head lice and nits
Head lice are tiny insects that live in hair and feed on blood from the scalp. They are very common in children, and having them has nothing to do with dirty hair. They pass on through head-to-head contact. Nits are the empty egg cases left behind once the eggs have hatched.
- Spread by
- Head-to-head contact
- Only treat
- If you find a live louse
- School
- No need to stay off
What to look for
- An itchy scalp — although many people do not itch, especially at first
- A tickling feeling, like something moving in the hair
- Small, adult lice, about the size of a sesame seed, that are grey-brown
- White or yellowish specks stuck to the hair, close to the scalp (eggs and empty egg cases)
How to check for lice
The best way is to comb the hair using a plastic detection comb (fine-toothed lice comb). Wash the hair with ordinary shampoo, apply lots of conditioner, then comb through the whole head from the roots to the tips, in sections. Wipe the comb on a white tissue after each stroke and look for live lice. Check everyone in the household who may have been in close contact.
Finding an egg case does not mean there are live lice — you only need to treat if you find a live louse.
Treatment
- Medicated lotions or sprays, which kill the lice. Most need to be applied twice, seven days apart, to catch any newly hatched lice — follow the pack instructions carefully. Choose the type that suits you, and ask us for advice.
- Wet combing, without chemicals: use conditioner and a detection comb every few days, for about two weeks, until no live lice are found for several sessions in a row. It takes patience but is very effective.
- Only treat people who have live lice, all at the same time.
- Check again a few days after treatment. If you still find live lice, ask us about switching to a different type of treatment.
What you do not need to do
- You do not need to keep your child off school or nursery.
- You do not need to wash all the bedding and clothing in hot water — lice do not survive long away from the head. Wash a pillowcase or hat if you like.
- Preventative lotions, sprays and repellents are not recommended.
How PRX Pharmacy can help
We can recommend the right lotion, spray or comb for you or your child, and explain how to use it. Tell us if the person being treated is pregnant, breastfeeding, has asthma, eczema or a scalp condition, or is a baby under 6 months — some products are not suitable.
When to get medical help
Contact your GP practice or call 111 the same day if:
- • It is a baby under 6 months old
- • The scalp is sore, has weeping sores, crusts or pus, or the glands in the neck are swollen (this may be an infection)
- • There are still live lice after two full treatments with different products
- • The person has a scalp condition such as eczema or psoriasis and treatment is causing irritation
If you are ever worried and unsure, ask us or call 111. Trust your instincts — it is always better to ask.
This guide is general information written by the PRX Pharmacy team. It does not replace advice from a pharmacist or doctor who knows your medical history.
Last updated 24 September 2026. Clinically reviewed by Milan Patel, Pharmacist on 24 September 2026.
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