How to prevent/control Head Lice Infection: Guidelines from HSE
Guideline for the control of Head Lice infection in children
Prevention of head lice infection:
The following measures can help to reduce head lice infection in children and parents should be advised to undertake them:
(i) Wet comb children’s hair once a week, using a detection comb. This will help to identify a head lice infection at the earliest possible stage and reduce the number of people in the family, or who are close to the child, who will get infected
(ii) Also, wet comb children’s hair, if prolonged (>1 minute), close (head to head) contact with an infected person has occurred , or when members of a household have been named as contacts
(iii) Use an effective detection comb; this should be plastic, with rigid, flat-toothed, plastic teeth, set not more than 0.3mm apart. These are available to purchase in all pharmacies
(iv) There is a commercial ‘Bug buster’ kit available with special fine-tooth combs and instructions for use and a DVD. This may be a useful support to parents. It may also be useful to staff for demonstrating to parents, or reiterating, correct technique for wet combing.
(v) Avoid the use of repellent sprays, alternative preventive products or electronic combs, as there is no evidence to support their use
(vi) Encourage children not to share hair brushes, combs, hats or hair accessories.
(vii) Do not use treatment products as a preventive measure; they should only be used when infection is present i.e. a living, moving louse is seen. The treatments are safe, but should not be over-used. They can make the scalp flaky and itchy.
How to carry out Detection wet combing
Treatment of head lice infection: Recommendations
(i) Products need to contain sufficient active agent and have sufficient contact time with the child’s head to allow the active agent to work
(ii) Dimethicone/ Cyclomethicone /Mineral oil treatments are now considered as first-line treatment. These products have a physical, rather than chemical effect on the lice. They are sold under a few different product names
(iii) Shampoo and mousse formulations are not recommended as they contain low concentrations of the active ingredient, or don’t allow for sufficient contact time.
Recommended Products of Choice, currently on sale in Ireland (these are not available on Medical Card)
Full Marks Solution
Active Ingredient : Isopropyl myristate Dimethicone
Application Time :10 minutes
Repeat : 7 days
Age Restriction :2 years of age and upwards
Full Marks Spray/ Solution
Active Ingredient :Isopropyl myristate 50% Cyclomethicone
Application Time :10 minutes
Repeat :7 days
Age Restriction : 2 years of age and upwards
Hedrin Once Spray Gel
Active Ingredient :Simethicone 4% plus Penetrol
Application Time :15 minutes
Repeat :7 days
Age Restriction :6 months of age and upwards
How to use treatment products
Treat everyone in family who is infected, at the same time; this is so that untreated people don’t infect the treated people again
Pharmacist will advise on which product to use
There will be instructions with the product on how to put on the treatment and how long to leave it on for – each of the products are slightly different
Hair should be dry
The hair should be parted near the top of the head and the lotion or solution put onto the scalp and rubbed in. The hair is then parted further down and the application of the product repeated. Work through hair section by section until all of scalp has lotion on it
The lotion does not need to be put any further down the hair than where a ponytail band would go
Repeat one week later – even if the instructions recommend one application only. The reason for this is that no treatment is guaranteed to kill un-hatched eggs and these hatch out over about one week
Check hair about 2 days after the repeat treatment
Once treatment is complete and has got rid of the lice, it is important that the weekly wet combing, to check the hair, continues.
If treatment does not get rid of infection, a second treatment is recommended following check of compliance with treatment. A third course of treatment should not be started without consulting with GP.
Guideline – Responsibility for the control of head lice:
Parents:
Prevention of head lice infection:
The following measures can help to reduce head lice infection in children and parents should be advised to undertake them:
(i) Wet comb children’s hair once a week, using a detection comb. This will help to identify a head lice infection at the earliest possible stage and reduce the number of people in the family, or who are close to the child, who will get infected
(ii) Also, wet comb children’s hair, if prolonged (>1 minute), close (head to head) contact with an infected person has occurred , or when members of a household have been named as contacts
(iii) Use an effective detection comb; this should be plastic, with rigid, flat-toothed, plastic teeth, set not more than 0.3mm apart. These are available to purchase in all pharmacies
(iv) There is a commercial ‘Bug buster’ kit available with special fine-tooth combs and instructions for use and a DVD. This may be a useful support to parents. It may also be useful to staff for demonstrating to parents, or reiterating, correct technique for wet combing.
(v) Avoid the use of repellent sprays, alternative preventive products or electronic combs, as there is no evidence to support their use
(vi) Encourage children not to share hair brushes, combs, hats or hair accessories.
(vii) Do not use treatment products as a preventive measure; they should only be used when infection is present i.e. a living, moving louse is seen. The treatments are safe, but should not be over-used. They can make the scalp flaky and itchy.
How to carry out Detection wet combing
- Buy the detection comb in a pharmacy
- Wash the hair with regular shampoo
- Put on lots of any conditioner – this makes the lice really wet and keeps them still
- Slot the teeth of the comb into the hair at the roots and draw the comb down to the ends of the hair
- Have plenty light; daylight is best
- Check the comb for lice each time
- Continue until you have worked through each section of hair and checked the whole head
- Rinse off the conditioner and repeat the combing while the hair is still wet
- if moving lice are found, check all family
Treatment of head lice infection: Recommendations
(i) Products need to contain sufficient active agent and have sufficient contact time with the child’s head to allow the active agent to work
(ii) Dimethicone/ Cyclomethicone /Mineral oil treatments are now considered as first-line treatment. These products have a physical, rather than chemical effect on the lice. They are sold under a few different product names
(iii) Shampoo and mousse formulations are not recommended as they contain low concentrations of the active ingredient, or don’t allow for sufficient contact time.
Recommended Products of Choice, currently on sale in Ireland (these are not available on Medical Card)
Full Marks Solution
Active Ingredient : Isopropyl myristate Dimethicone
Application Time :10 minutes
Repeat : 7 days
Age Restriction :2 years of age and upwards
Full Marks Spray/ Solution
Active Ingredient :Isopropyl myristate 50% Cyclomethicone
Application Time :10 minutes
Repeat :7 days
Age Restriction : 2 years of age and upwards
Hedrin Once Spray Gel
Active Ingredient :Simethicone 4% plus Penetrol
Application Time :15 minutes
Repeat :7 days
Age Restriction :6 months of age and upwards
How to use treatment products
Treat everyone in family who is infected, at the same time; this is so that untreated people don’t infect the treated people again
Pharmacist will advise on which product to use
There will be instructions with the product on how to put on the treatment and how long to leave it on for – each of the products are slightly different
Hair should be dry
The hair should be parted near the top of the head and the lotion or solution put onto the scalp and rubbed in. The hair is then parted further down and the application of the product repeated. Work through hair section by section until all of scalp has lotion on it
The lotion does not need to be put any further down the hair than where a ponytail band would go
Repeat one week later – even if the instructions recommend one application only. The reason for this is that no treatment is guaranteed to kill un-hatched eggs and these hatch out over about one week
Check hair about 2 days after the repeat treatment
Once treatment is complete and has got rid of the lice, it is important that the weekly wet combing, to check the hair, continues.
If treatment does not get rid of infection, a second treatment is recommended following check of compliance with treatment. A third course of treatment should not be started without consulting with GP.
Guideline – Responsibility for the control of head lice:
Parents:
- The primary responsibility for the identification, treatment and prevention of head lice in a family lies with the parents
- Parents cannot be expected to diagnose current infection, or to distinguish it from successfully treated previous infection or other conditions, without adequate instruction and support by health professional
- Parents should be given clear, consistent, evidence-based information from all those involved in supporting them in the control of head lice infection: pre-school service providers, teachers, pharmacists, GPs and practice nurses, area and school public health nurses and community medical officers
- Wet combing their children’s hair weekly to help identify a head lice infection at the earliest possible stage
- Inspecting hair for head lice, using an effective detection comb, once a week
- Inspecting hair for lice if head to head contact with an infected person has occurred or when members of a household have been named as contacts
- Promptly treating (at the same time) any members of the family who have head lice (living, moving lice present)
- Only using treatments when an infection is present and never as a preventive measure
- Asking pharmacist for advice in selecting a treatment, so that only an effective treatment will be used
- Informing all contacts, both children and adults, to look out for signs of infection, to inspect hair and to treat with head lice lotion if living moving lice are discovered
- Contacting the pharmacist, GP, practice nurse, area or school public health nurse, if advice or support is needed