When recommending a head lice treatment, bear in mind that multiple family members may need to use it, so check all ages, especially of younger children, and remember to enquire about pregnancy and asthma (some products contain solvents which may not be suitable for people with asthma). Ask the WWHAM questions and refer to your pharmacist when necessary.

Check that your customer buys sufficient product (a small bottle for short/shoulder length hair or a larger bottle for longer/thicker hair) for every infected person to use at the same time and make sure that they understand how to use the product correctly. Are they, for instance, aware of how long the treatment should be left on the hair, and if they should reapply it? 

Physical insecticides

These contain ingredients such as cyclomethicone, isopropyl myristate and dimeticone, which kill lice by physical means (e.g. by blocking the tubes that lice use to breathe or by causing dehydration). Lice cannot become resistant to these products.

Physical insecticides are effective against live lice, but while some also target unhatched eggs, others require a second application after seven days to kill any lice that may have hatched since the first application. They are available in a range of formulations – lotion, mousse, solution, shampoo or spray gel. These products need to be applied thoroughly to cover all of the hair. Point out to customers any cautions relating to slippery surfaces or whether they may be flammable. OTC brands include Hedrin, Lyclear, Full Marks Solution and Vamousse.

Chemical insecticides

These products contain chemicals that kill head lice, such as malathion (the active ingredient in Derbac-M). However, head lice have been known to develop resistance to them. As with all head lice treatments, customers should follow the manufacturer’s instructions carefully and repeat the application after seven days if indicated.

Wet combing

Wet combing is the systematic combing of hair with a comb specifically designed to remove lice and/or eggs. Due to the nature of their life cycle, this needs to be done over two weeks, on days one, five, nine and 13. Detection combing should be done again on day 17 to check all lice have been removed.

There are also products available that are designed to help with removal of eggs from the hair, such as Hedrin Stubborn Egg Removal kit.

Alternative options

Products based on natural ingredients, such as Puressentiel Anti-Lice treatment lotion, are also available.