Use our expert guide to work out whether your child has head lice or nits, and how to keep them away
The key to keeping nits and head lice at bay is spotting them, treating them and then making sure you follow up treatment by staying alert.
Read on for how to identify whether your child has head lice, how you can tell whether it’s nits or dandruff, and the five key things every parent needs to know to keep their children free of nits and head lice.
Head lice and nits: what to look for
Head lice and nits are, unfortunately, a common experience for kids. Our 2021 survey of 1,362 parents revealed that 68% with children aged under 12 have used a head lice treatment in the past year. Our gallery, below, makes for grim viewing – but take a look and discover exactly what to look for, and how to spot nits and head lice.
How to spot nits and lice
Head lice are very common in children. Our picture gallery shows you what to look for.
Nits are actually the eggs, not the lice.
The first sign of head lice may be spotting tiny white specks (the nits) in your child’s hair.
Another sign may be that your child scratches their head a lot. This isn’t always the case though.
If you spot any nits (the head lice eggs, which appear as white specs in the hair), or your child scratching, the best thing to do is to thoroughly check your child’s hair and treat as soon as you spot live head lice.
Three things you need to know about nits
- Head lice need effective treatment to get rid of them successfully, and they’re nothing to be embarrassed about.
- Head lice are the small brown lice you see on the hair, despite many of us calling them nits.
- A nit is the egg case, which sticks to the base of the hair shaft, rather than the live louse. The white specks you can spot in a child’s hair are the empty egg cases, and are usually the first indication that your little one has unwanted visitors and needs a bit more of an inspection.
Head lice and nits are unwanted visitors, but very common ones for most children. Don’t despair – we can help.
Four steps to stop head lice and nits coming back
1. Check hair regularly
The days of the nit nurse are long gone, so regularly checking your child’s hair is the best way to spot the first signs of head lice and treat them effectively.
If your child has them, do tell your child’s school, child minder or nursery, so they can alert other parents and ask to get their children treated as soon as possible, to help stop the spread of head lice.
If you don’t, you run the risk of your newly lice-free child being re-infected by someone they gave the lice to. How to spot nits and head lice – not sure what to look for? Head to our picture gallery to see what nits and head lice look like, or use our questionnaire below to see whether it’s dandruff or nits.
2. Follow the rules on when to treat
Treat head lice as soon as you see a live one. Check all the family and treat anyone who has lice.
And remember, if you choose to use a medicated product, use it only when you see live head lice. Do not use a medicated product as a preventative method, otherwise head lice can build up a resistance.
3. Repetition is key
We’ve said it before and we’ll say it again – repeat, repeat, repeat.
Always follow up any treatment method as directed by the instructions on the product you’re using. Even with treatments that are claimed to kill head lice after one application, the Department of Health suggests checking for lice again after three to five days, and again 10 to 12 days after using the treatment. This is because not all the eggs may be killed by the first application.
If you choose the conditioner and nit comb method, repeat this at regular intervals until all the nits and lice have gone. Regularly combing through your child’s hair and checking will help to prevent a re-infestation.
In a 2021 survey of 1,362 parents, 45% of parents used a nit comb and conditioner. Head lice treatment and brands – find out what’s on offer, plus money-saving tips
4. Don’t let embarrassment get in the way
Head lice are extremely common – they’re nothing to be embarrassed about. They’re spread when children (or adults) put their heads together and the lice walk across. This means any games that involve children playing close to each other, sleepovers, or even something as simple as them taking some phone selfies can mean head lice are able to move from the host to someone new.
Failure to carry out a follow-up treatment can also increase the rate that head lice spread, as the child will go back to playing with their friends in the belief that they’re clear, when in fact they still have head lice and pass it on to more people.
Head lice treatments
There are four main types of treatments for getting rid of head lice and nits. We explain the pros and cons of each below.
You can use a nit comb to detect lice in the hair, and to get rid of an infestation. It’s one of the cheapest nit treatments available – basic nit combs start at around £2 – and they’re easy to use. You simply cover the infected hair in conditioner (so the lice will lose their grip and it’s easy to pull the comb through) and start at the roots, pulling the comb all the way to the tips of the hair. After each stroke, check the comb and clean it on a tissue to see if there are any lice on it.
You need to comb the hair for at least 30 minutes and repeat four more times over the following two weeks to ensure all the head lice are removed, and to capture any head lice that may hatch between combing sessions. A general rule is to continue combing until you haven’t seen any full-grown lice for three sessions.
This treatment is quite time-consuming. And, depending on your child and their hair type, it may be tricky trying to keep them still long enough to do a thorough job.
Battery-operated combs can be used on dry hair. These kill lice on contact, but there is limited evidence to show they really work. They are much more expensive than basic nit combs, costing around £15.
Pros No resistance concerns, reusable, no insecticides, also used to detect lice
Cons Fiddly, takes about two weeks, metal combs can hurt, electric combs not proven to be effective Nits truths and myths you need to know – find out whether hair straighteners kill nits, whether you can use mayonnaise as a treatment, and more.
Watch our video of how to comb through hair using a nit comb and conditioner Play Video
2. Synthetic chemical insecticides
Insecticide products, typically sold in chemists, contain chemicals designed to kill head lice by various methods. Some poison the lice, while others will paralyse their nervous systems.
You should use this type of head lice treatment only if you have found a live head louse in the hair, rather than as a preventative measure because you’ve received notification of an outbreak at your child’s school.
This is because the product can build up on the scalp, exposing the head lice to a non-lethal dose – which means lice can become resistant, and the product will no longer work when your child actually gets infected.
Always read and follow the instructions exactly. And even if a product is claimed to be able to treat head lice in one application, current advice is to check hair a week later to see whether you can spot any head lice that may have hatched, and follow up with another treatment anyway.
Some treatments are described as ‘alcoholic lotions’ and are flammable, so don’t use a hair dryer on anyone who has been treated with one. Always read the instructions to check.
Pros Easy to apply, various trials have shown they work
Cons Can be prone to resistance, varying effectiveness in clinical trials, some smell horrible
3. Physical action to kill lice
Some products kill lice by physically coating them in liquid and drowning or dehydrating them. These types of products include Hedrin and Full Marks Solution and are becoming the most popular form of medicated treatment.
Because these products kill lice through a physical action, head lice cannot become resistant to them. Some don’t kill the eggs (nits), though, so it’s vital that the treatment is repeated after a week to kill any lice that have hatched since the first application.
Pros No insecticides, resistance unlikely, odourless
Cons Trials have shown degrees of efficacy but more evidence is needed, reapplication is needed a week later
4. Natural and herbal products, and essential oils
Natural and herbal remedies include products such as tea tree oil or green-tea shampoo.
Some remedies involve mixing, say, tea tree oil to a specific ratio. Depending on what you use, the smell can be very strong and you need to be careful to get the ratio right.
Natural over-the-counter products include Puressentiel Anti-Lice Treatment Lotion, Nitty Gritty solution or tea tree shampoo.
Pros Resistance less likely, easy to apply
Cons Little clinical research into efficacy of treatments, potential side-effects not known
How should I treat head lice in mixed-race and Afro hair?
We spoke to Dee Wright, founder of The Hairforce, a professional head lice removal company with eight clinics in the UK, about how to treat children and adults with mixed-race and Afro hair.
Step 1 – Part, don’t detangle, the hair
Part the hair down the middle first. Do not try to detangle the entire head of hair at the outset, because as you brush it the curls will disappear and the hair will get fluffier, making it harder to control.
These types of hair are highly absorbent, so don’t be surprised to find you will be using a lot of conditioner as you work.
Step 2 – Keep sectioning only
After you have created the middle parting you need to create a number of smaller sections – the smaller the sections the more manageable it will be for you, bearing in mind that they need to be big enough to get the nit comb through.
For very curly or Afro hair we would recommend dividing the hair into 12 sections – six either side – before you set about nit combing.
Step 3 – Now detangle
Once the sections are created, you then need to detangle each one. As soon as it’s detangled, plait it to keep it under control and out of your way.
Step 4 – Nit combing
Once you have detangled and plaited them all, you can start nit combing each one. Unplait, apply some conditioner and get nit combing. When you finish nit combing that section, replait it and move on to the next section.
African and Afro-Caribbean hair
African and Afro-Caribbean hair has a flattened-oval hair shaft, while mixed-race and Caucasian hair has a more circular hair shaft. The head lice indigenous to Caucasian hair aren’t adapted to the flattened-oval hair shaft, so the lice aren’t able to take up home as effectively in African or Afro-Caribbean hair.
Dreadlocks are notoriously difficult to deal with if they’re infested with nits and head lice. The density of dreadlocks makes it impossible to nit comb, and if you cannot nit comb the nits out, eggs will hatch, allowing the infestation to pick itself back up again.
You need the top of the dreadlocks to have grown down and be at least 5 to 6 inches (13 to 15cm) down the head, so you can get to the scalp and the roots of the hair. When lice lay their eggs, they lay them near to the base of the hair shaft, so that’s where the fresh eggs can be found. Because you can’t nit comb, you would need to pick out the head lice and the eggs. Therefore, treatment by professional lice removal experts might be your best option.
Head lice and nits Reviews
Best nit and head lice treatments for 2022
Do cheap nit and head lice treatments work? Are nit combs or lotions most effective? Discover the best head lice treatments as rated by parents
We surveyed 2,010 UK parents with a child aged under 12, who have all had the unpleasant task of ridding their children of head lice, to discover the top brand of head lice treatment.
There’s a wide variety of treatments available, including lotions, creams, sprays and leave-in mousse products. Many no longer contain pesticides (which lice can build up a resistance to), and instead work by coating the lice in liquid and drowning or dehydrating them.
Read on to find out which ones are most popular with parents for effectiveness, ease of use, smell and value for money.
Which are the best head lice treatments?
Star ratings below are calculated from survey respondents rating various aspects from one to seven stars, which are then converted into one (worst rating achievable) to five (best rating achievable) stars.
Below are the most common treatment methods that parents use for ridding their child of pesky head lice.
Nit comb method
Just under half of parents (45%) surveyed in 2021 said that the last time their child had nits they used a comb with conditioner.
The parents in our survey rated Acu-Life the best brand for removing head lice. It’s rated highly for the four key areas (effectiveness, ease of use, smell and value for money), and it’s a brand known for its distinctive blue plastic-handled nit combs with metal teeth.
A nit comb costs only a few pounds, and you can often use it in conjunction with another product such as a medicated or herbal treatment, or conditioner. If you already have conditioner in your home, the latter method can be a cheap way to tackle head lice, but it can be time-consuming.
Check out our video on how to use the nit-comb-and-conditioner method effectively.
Does your child have very curly or Afro hair? Follow our tips on how to treat head lice in those with mixed-race or Afro hair.
More than half (65%) of parents we surveyed in 2021 said they used a nit comb with solution.
Medicated treatments from Boots, Superdrug, Full Marks, Hedrin, Nitwits and Lyclear all made it into the list. One of the benefits of these treatments is that they’re often much quicker to use than the combing method – some take only 10 minutes.
There are various treatment options, ranging from creams and lotions that you use like a shampoo, to easy-application sprays, or a product that can be used as a leave-in mousse.
Why repeat treatment is so important
The key to making a medicated treatment work is to apply a follow-up treatment.
Even with treatments that are claimed to kill head lice in one application, there is a possibility that some eggs (nits) could survive if the product isn’t properly applied to cover all nits and lice. If they do survive, the cycle starts all over again, and you have another infestation to deal with.
Current advice when using ‘once-only’ treatment is to check your child’s head a week later to ensure you have got rid of any lice or eggs that you might have missed, but we reckon checking and applying an additional treatment a week later is the safest way to know you’ve killed all the head lice.
In our 2020 survey, parents weren’t that impressed with herbal or natural treatments, such as tea tree oil, and were less likely to use them. However, they fared better in the 2021 survey, with Puressentiel, a popular herbal brand, getting four stars for ease of use, smell and value for money, and three stars for effectiveness.
Herbal treatments may work better when used in combination with a nit comb. However, many parents prefer to use herbal treatments as a preventative measure, rather than to actually get rid of lice, as it’s thought products such as tea tree oil repel lice.
There is limited evidence of the efficacy of herbal products, and not much information on any side effects. If you prefer not to use a medicated product, we recommend using conditioner and a nit comb.
Treatment by hair type
Our 2021 survey found some significant differences when looking at head lice treatment by the child’s hair type.
Nearly half of those with straight hair (49%) used a nit comb with conditioner, and around the same amount (48%) of those with coiled/Afro hair used this method, whereas only 38% of those with curly hair used a comb and conditioner.
When it came to a nit comb with head lice solution, fewer people with coiled/Afro hair (54%) used it than those with other hair types – for example, 69% of those treating wavy hair used a nit comb with head lice solution.
Our research also found that almost one in 10 (9%) of those with coiled/Afro hair used neither a nit comb with conditioner nor a nit comb with head lice solution.
On the whole, a nit comb with head lice solution was more popular (65%) than a nit comb with conditioner (45%) for all hair types.