Lice and Nits Treatment: What to Know

Head lice are small insects that live close to the scalp and feed on blood. Nits are eggs attached firmly to individual hairs, often near the scalp. Empty egg cases can remain after lice have gone, so finding a nit does not by itself prove that an active infestation is present. Live crawling lice are the clearest sign to act on. Itching, especially [Itchy Scalp](/symptoms/itchy-scalp/), may appear after the scalp reacts to bites; some people notice [Itching Worse At Night](/symptoms/itching-worse-at-night/).

Use a fine-toothed detection comb on wet, conditioned hair, working from the roots towards the ends and wiping the comb after each pass. If live lice are found, follow the instructions for the chosen product carefully, including how long it stays on the scalp and whether a repeat application is needed. Some products do not remove every attached nit, so combing can help clear eggs and make later checks easier. Check close household contacts and avoid sharing combs, brushes, hats, or hair accessories until the situation is managed. A pharmacist or [GP Consultation](/treatments/consultations-and-assessment/gp-consultation/) can help when the diagnosis or product choice is uncertain.

Arrange medical advice if the scalp has broken skin, spreading redness, crusting, marked swelling, or discharge, because scratching can damage the skin and allow infection. Seek help when symptoms continue after treatment, live lice remain despite following the instructions, or the person affected is very young, pregnant, breastfeeding, or has a skin condition that makes products difficult to use. A clinician can confirm the finding and discuss [Head Lice Treatment](/treatments/medical-dermatology/head-lice-treatment/).

Ask: How can we confirm that live lice are present? Which treatment suits the scalp and age of the person affected? When should the hair be checked again? What should we do if live lice are still seen? Could the itching or rash have another cause?