Covid-19 Coronavirus

Head Lice

Although head lice infection is an infectious condition, most of the problems associated with the infection are due to society's reaction to it rather than the organism itself. The word 'infection' has been used in an attempt to reduce the stigma associated with the word 'infestation.'

The Policy for the control of head lice on the Isle of Man has been developed based on guidance provided nationally by an expert group. The National Group of experts reviewed all the evidence available with regard to head lice and the Policy for the Control of Head Lice on the Isle of Man draws heavily on this and is, hence evidence based.

Head lice

  • Head lice are small insects (about the size of a grain of sugar when fully grown) that live very close to the scalp.
  • Nits are not the same as lice. Nits are the eggs which stick to the hair.
  • You only have head lice if you find a living, moving louse (not a nit).
  • Anybody can get head lice - adults and children.
  • Head lice don't care if the hair is dirty or clean, short or long.
  • A lot of infections are caught from close family and friends in the home and community, not at school.
  • Head lice can walk from 1 head to another if the heads are pressed together for some time. They do not fly, jump or swim.
  • Regular hair care may help to spot lice early.
  • The best way to stop infection is for families to check their heads regularly using detection combing.

How to detect head lice

You will need: A head lice detection comb (These are available from your pharmacist – ask for help if there are none on display.)

  1. Wash the hair well and towel dry until damp, but not dripping. Add conditioner to the hair as this makes the hair easier to comb.
  2. Ensure that there is good lighting – daylight is best.
  3. First, comb the hair with an ordinary comb. Then, using the detector comb, begin at the top of the head and making sure that the comb is touching the scalp, slowly draw the comb towards the end of the hair.
  4. Check the teeth of the comb carefully.
  5. Repeat steps (3) and (4), working your way around the head from the top of the scalp to the ends of the hair. This should take 10 to 15 minutes.
  6. If there are head lice, you will find 1 or more on the teeth of the comb.
  7. If you find lice, or something which you are unsure about, stick it to a piece of paper with clear sticky tape and take it to your general practitioner or local pharmacist.

The best way to stop infection is to do detection combing regularly.

Frequent use of head lice treatments 'just in case' does not prevent Head Lice.

How to treat head lice

Do not treat unless you are sure you have found a living, moving louse.

Head lice shampoos and mousses are not effective treatments. You will need a special lotion or liquid. Ask your General Practitioner or local Pharmacist to recommend the correct treatment for you to use. Occasionally, a bug busting pack or treatment can be prescribed by your local GP.

In a well-ventilated room:

  • Apply the head lice lotion or liquid to dry hair.
  • Part the hair near the top of the head, put a few drops of lotion or liquid on to the scalp and rub in. Part the hair again a bit further down the scalp and rub in some more of the lotion or liquid. Do this again and again until the whole scalp is wet. You don't need to take the lotion or liquid any further down the hair than where you would put a pony tail band. Head lice live within 2 inches of the scalp. Take care not to get the lotion or liquid in the eyes or on the face.
  • You should use at least one small bottle of lotion or liquid per head; more if the hair is thick (the length of hair doesn't matter).
  • Let the lotion or liquid dry on the hair naturally. Keep well away from naked flames, cigarettes or other sources of heat. Do not use a hair dryer.
  • Leave on the hair for 12 hours or overnight. Then wash and rinse as normal. It can be helpful to comb the hair daily to remove any remaining debris.
  • Repeat the entire treatment 7 days later, using a second bottle of the same lotion or liquid.
  • Check the head 2 days after the second treatment. If you still find living, moving lice, ask your Pharmacist or General Practitioner for advice.
  • To remove the nits, comb the hair, add conditioner while wet and use a head lice detection comb

 The problem hasn't gone away. Did you..

  • use enough lotion or liquid?
  • apply it correctly?
  • use a second treatment 7 days after the first?
  • check all your close family and friends?
  • let it dry naturally?
  • leave it on for 12 hours?
  • check adults as well as children?
  • treat all infected contacts at the same time?

Remember: It doesn't matter how many nits you have, or how itchy your scalp is - if you can't find a living, moving louse, you don't have lice.


Nit on hair


Female lays about 6 eggs in a night.  She cements these to the base of the hair shaft within 1cm of the scalp. These eggs are grey in colour.





Headlice size


Eggs hatch in 7 to 10 days.  The empty egg/nit turns pearly white and remains glued to the hair shaft as it grows out. Their continued presence after treatment is not a sign of treatment failure.






The lice feed 6 times a day by piercing the skin and sucking blood. This is the process that makes scalps itchy.

The female adult lice then start the laying process all over again.



If you have any questions or queries relating to headlice or are experiencing treatment problems, please contact your Primary Health Care Team, Practice Nurse, School Nurse, Health Visitor or Local Pharmacist who can provide further help.

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