How can you choose the right anti-lice treatment for your children as they go back to school?

Every new school term brings the same question: which head lice treatment should you choose for your child, and which one actually works? Head lice is one of the most common infestations in primary schools. It says nothing about a family’s hygiene and can be sorted out in a matter of days — provided you follow the correct protocol at the right intervals.

In practice, it all comes down to three steps: a dimethicone-based suffocating treatment as the first line of defence, combing through damp hair strand by strand with a nit comb, followed by a second application 7 to 10 days later to eliminate any lice that have hatched from the nits in the meantime. Vegetable oils, essential oils, bicarbonate of soda or laundry treatments are used as a supplement — never as a substitute. Here’s how to choose a lice treatment and, above all, how to make sure you use the right method.

Can you prevent head lice before the start of the new school term?

No product can make a child completely immune to head lice. The only effective form of prevention is regular checking: combing through damp hair with a nit comb once a week during the first few weeks of term helps to detect an infestation before it spreads.

Short answer: no product can protect a child from head lice, and the French National Health Insurance reminds us that anti-lice treatment is never a preventative measure. The only prevention that works is early detection: check the head once a week, whilst the hair is damp, using a fine-toothed comb, paying particular attention to behind the ears and the nape of the neck.

Lice are transmitted through direct head-to-head contact: in the playground, the classroom, the canteen, or during Wednesday activities. They do not jump or fly. This is why preventing head lice mainly relies on simple measures: tying back or plaiting long hair, and not sharing hats, scarves or hair ties. The same rules apply on holiday: see ‘Summer head lice: different ways to avoid them on the beach ’ and ‘5 natural tips for tackling head lice’.

As for preventive anti-lice products, their effect is short-lived at best. Using them continuously merely delays the inevitable, puts a strain on your budget and increases the risk of insecticide resistance. It’s better to save your money for a treatment applied correctly as soon as the first lice are spotted.

Key takeaway: you don’t prevent head lice with a product; you spot them early. A child treated within twenty-four hours of the first lice being discovered is far less likely to pass them on to their classmates, and this helps prevent the cycle of repeated re-infestations in the classroom.

Which anti-lice treatment should you choose?

Dimethicone suffocates the louse physically, without using an insecticide, and lice do not develop resistance to it. Always allow for two applications, seven to ten days apart: the first does not kill nits that have already been laid.

Short answer: a dimethicone lotion or spray as the first-line treatment, a nit comb used systematically alongside it, and a second application 7 to 10 days after the first. Natural methods may help, but their effectiveness varies and they never replace the need for combing.

Contrary to popular belief, current products are not applied continuously over several days: they are used as a single treatment, the duration of which is specified in the leaflet, followed by a repeat treatment seven or ten days later. It is this second treatment, which is often overlooked, that makes the difference between an infestation that is brought under control and one that flares up again.

Method	How it works	What we know	Good to know
Dimethicone (lotion, spray)	Mechanical suffocation of the louse and nits	First-line treatment; no known resistance	A short treatment, followed by a second application after seven or ten days
Nit comb	Mechanical removal of lice and nits	Used on its own, effective in about half of cases	Essential as a complementary treatment, on damp, detangled hair
Essential oils (tea tree, lavender)	Natural insecticidal and repellent action	Encouraging results in a randomised trial, on a par with a suffocating treatment	Always diluted; avoid use in young children and pregnant women
Vegetable oils (coconut, olive)	Partial suffocation; helps the comb glide through the hair	Limited data; particularly useful for loosening nits	Safe, but time-consuming and messy
Insecticides (pyrethrins)	Neurotoxic effect on the louse	Resistance is common; 25 per cent success rate in the trial cited below	To be used only when other treatments have failed, on the advice of a doctor or pharmacist

Natural alternatives:

Nowadays, parents are increasingly turning to natural methods to get rid of head lice. These are safe in the vast majority of cases, but not very effective in the long term. Nevertheless, you can use them to help ensure these parasites are completely eradicated.

• Coconut oil:

This can help to remove lice and nits easily. How does it work? Simply apply a mask to your child’s hair and gently massage the scalp. Once the vegetable oil has been thoroughly applied to each strand, cover the head with cling film or a shower cap to prevent air from getting in. The result: the insects and their eggs suffocate within an hour (or so) of application. Once this time has elapsed, all you need to do is wash their hair with shampoo and remove any residue using a lice comb.

NB: You can substitute coconut oil with olive oil if you have some.

• Bicarbonate of soda:

Bicarbonate of soda is known to eliminate nits. What’s more, it’s very easy to use. Simply sprinkle the bicarbonate of soda powder directly onto the scalp, massage it in for several minutes, and then rinse it out. Of course, make sure the children’s eyes are firmly closed to prevent the powder from getting into them. In fact, if you’re worried this might happen, you can also dissolve the bicarbonate of soda in warm water. In this case, dip the anti-lice comb into the mixture and run it through the hair. Feel free to dip it into the mixture as often as possible for best results.

NB: Bicarbonate of soda will loosen nits very easily. However, it will be less effective against lice that are clinging to the hair.

• Tea tree and lavender essential oils:

Tea tree and lavender essential oils have gained popularity in the treatment of head lice infestations thanks to their effectiveness, which has been demonstrated by scientific studies. A landmark study, published in*BMC Dermatology*(Barker and Altman, 2010), examined the effectiveness of a treatment based on these essential oils compared with a traditional chemical-based anti-lice treatment.

The study assessed the effectiveness of a formulation containing tea tree oil and lavender oil. The participants, all of whom had head lice, were treated either with this natural solution or with a conventional treatment. The results were impressive: the essential oil-based solution showed a success rate of 97.6 per cent (41 out of 42 children), compared with 25 per cent (10 out of 40) for the pyrethrin-based product. However, one detail is almost always overlooked when this study is cited: the third arm of the trial, a so-called ‘asphyxiating’ product from the same family as dimethicone lotions, achieved exactly the same result as the essential oils (97.6 per cent, or 40 out of 41 children). This trial therefore does not suggest that essential oils are more effective than asphyxiation: it shows that both are significantly more effective than insecticides.

Properties of essential oils

1. Tea Tree Oil: Known for its natural antimicrobial and insecticidal properties, tea tree oil is one of the natural remedies studied for treating head lice, although its effectiveness does not match that of a standard treatment. Further reading: Tea tree essential oil, the ‘Green Gold’ of the fifth continent.
2. Lavender Oil: Renowned for its calming and repellent effects, lavender oil complements the action of tea tree oil by repelling lice and soothing the scalp irritated by lice bites.

Application and precautions

When using these essential oils, certain precautions must be taken:

• Dilution: Essential oils must be properly diluted in a carrier oil (such as coconut or sweet almond oil) to avoid the risk of skin irritation.
• Sensitivity test: It is advisable to carry out a patch test before applying the mixture to the whole scalp to check for any allergic reactions.
• Method of Application: Apply carefully, ensuring that the entire scalp and hair are thoroughly covered, and leave on for an adequate period before rinsing.

Warning: tea tree essential oil may contain allergens. It is also contraindicated for children under 7 years of age.

Dimethicone: why it’s the first choice

Although dimethicone is not a natural remedy in the traditional sense, it represents an important alternative in the treatment of head lice infestations. Dimethicone is a type of silicone commonly used in cosmetic and medical products due to its non-toxic properties and safety profile.

Mechanism of action

The mechanism of action of dimethicone against lice is primarily physical. This substance works by creating a thin, impermeable layer around the lice and nits. This barrier prevents the lice from maintaining their water balance, leading to their death by dehydration. Unlike traditional insecticides, dimethicone does not act through toxic chemical mechanisms, which minimises the risk of lice developing resistance.

Clinical efficacy

Several clinical studies have demonstrated the efficacy of dimethicone in treating head lice infestations. A study published inthe *British Medical Journal* found that dimethicone-based formulations were significantly more effective than conventional permethrin-based treatments. In these studies, dimethicone successfully eliminated lice and nits, with reported cure rates ranging from 70 per cent to over 90 per cent, depending on the trials and protocols. This variability is largely due to compliance with the second application, seven to ten days after the first.

One of the main advantages of dimethicone is its safety. Unlike chemical pesticides, it is non-toxic and can be used safely on children and adults, including those with sensitive scalps. Furthermore, as a non-chemical treatment, it presents a minimal risk of skin irritation and allergic reactions.

Wet combing: the mechanical method, step by step

Wet combing is a widely recognised mechanical technique for combating lice and nits. This simple yet effective method involves using a fine-toothed comb specially designed to detect and remove lice and nits from the hair.

How the method works

The wet combing process involves moistening the hair, which makes the lice less mobile and therefore easier to catch with the comb. Nits, which are firmly attached to the hair, are also more easily dislodged when the hair is wet and conditioned with a conditioner or a specific product.

Wet combing procedure

1. Moistening the Hair: Wet the hair with water and apply a generous amount of conditioner or a detangling product. This makes it easier to run the comb through the hair and temporarily immobilises the lice.
2. Dividing the Hair: Separate the hair into sections for thorough combing. This ensures that every strand of hair is carefully examined.
3. Combing: Use a fine-toothed nit comb to comb through each section from the roots to the tips. After each pass, clean the comb to remove any captured lice or nits.
4. Rinsing: Once you have finished combing, rinse the hair thoroughly to remove any conditioner and any remaining residue.

Effectiveness and recommendations

Studies have demonstrated the effectiveness of wet combing, particularly when carried out regularly and thoroughly. For best results, it is recommended to use this method every three to four days for at least two weeks to ensure that all lice and nits have been removed.

Which anti-lice products should you choose from the chemist?

Short answer: a dimethicone-based product suitable for the child’s age and a nit comb. The rest comes down to ease of use: spray or lotion, short or long application time, and whether a comb is included or not.

Nowadays, there are many high-quality products available that can eliminate lice and nits quickly and effectively. Here are a few of them, but please note that it is advisable to consult your doctor before use. As children are more vulnerable, it is better to be safe than sorry.

• Pouxit Flash spray:

Pouxit Flash spray is part of the Pouxit range. It ranks among the best anti-lice products available on the market as it kills the parasites quickly and is gentle on the scalp. How does it work? It suffocates lice and nits by blocking their respiratory and excretory openings. What’s more, it’s very easy to use: simply spray the product directly onto the child’s hair. Wait a few minutes, then rinse. All instructions and recommendations are printed on the box to ensure completely safe use.

NB: anti-lice and anti-nit treatment for adults and children over 6 months.

• Paranix Extra Strong 5-minute treatment:

Part of the Paranix range, Paranix Extra Strong anti-lice lotion is a high-quality treatment that also offers protection against possible re-infestations. Gentle on the scalp, it is used just like a normal lotion. Simply apply it to the child’s hair, wait a few minutes, then rinse thoroughly.

NB: anti-lice and anti-nit treatment suitable for children aged 6 months and over.

Spearmint lavender essential oil: what to expect

The effectiveness of spike lavender essential oil in eliminating lice is not fully supported by clinical evidence. Although it has antiparasitic properties, precautions must be taken before use. Further reading: Spike lavender essential oil. Dilute the oil in a vegetable oil before applying it to the scalp, carry out a skin sensitivity test and avoid contact with the eyes. Consult a healthcare professional for appropriate advice on treating head lice.

When should you see a doctor?

Short answer: when the diagnosis is uncertain, or when live lice are still present after two properly carried out treatments.

Medical or pharmaceutical advice is useful in the following situations:

• you are unsure whether it is head lice: dandruff, hair shafts and scabs on the scalp can easily be mistaken for nits;
• live lice remain after two full courses of treatment, including a second application;
• scratching lesions are extensive, oozing or secondarily infected, or the lymph nodes in the neck are swollen;
• the child is under six months old, or the person concerned is pregnant or breastfeeding: in such cases, the choice of product should be made in consultation with a healthcare professional;
• the eyelashes or eyebrows are affected: no anti-lice product should be applied to these areas.

A persistent infestation is far more often the result of an incomplete treatment regimen — a missed second application, insufficient quantity, or failure to check those around the affected person — than of an ineffective product.

Head lice: what to do at home

As mentioned earlier, head lice are spread through contact. However, it is difficult to prevent this at school during daily group activities. The best thing we can do to minimise the problem is, first of all,to tie back or plait long hair — cutting it short is never necessary. Secondly, it is essential to teach our children to avoid sharing items that have been in direct contact with hair. Typical examples include hair ties, scarves and hats. These items can indeed carry nits and lice.

The list of items likely to harbour lice and nits also includes pillows and bed linen. Throughout the course of the anti-lice treatment, it is therefore essential to isolate these items in a separate room and seal them in one or more airtight bags. As these insects only survive for one to two days away from their host, forty-eight hours of isolation is sufficient to eliminate them. Do not hesitate to follow the same procedure for items of clothing such as jumpers and gloves, which come into close contact with the hair when worn. Then, after a few days, you can wash them at 60° to remove any remaining parasite residues.

Furthermore, before using the products recommended above, it is always important to seek professional advice. This is because some of them may contain allergens, particularly for very young children (aged 3 to 4). Please feel free to ask any questions you may have to ensure you use the anti-lice treatments correctly and achieve the best possible results.

Frequently asked questions about head lice

How long does it take to get rid of head lice?

Allow around ten days. Live lice are eliminated after the first correctly administered treatment; the second treatment, seven to ten days later, eliminates any nits that had hatched and survived. In the meantime, combing the hair every two or three days helps to check for any remaining lice.

Does the whole family need to be treated?

No: check everyone in the family, but only treat those found to have live lice. Treating someone who doesn’t have them as a preventative measure is pointless and increases the risk of resistance.

Is an anti-lice shampoo enough?

Rarely. The contact time for a shampoo is short and it is diluted by water: it is a useful addition to a treatment, but a suffocating lotion or spray remains the main treatment, along with the nit comb.

Do you need to wash all the laundry in the house?

No. Only items that come into direct contact with the head need to be washed: pillowcases, hats, scarves, collars, hair ties and brushes. Washing at over 50 °C, or leaving them in a sealed bag for 48 hours, is sufficient.

Should the child stay at home?

No, head lice do not justify exclusion from school. However, informing the school and the parents of close classmates greatly reduces the risk of further infections spreading.

Are essential oils safe for children?

They are not harmless: never use them undiluted; always dilute them in a vegetable oil, test on the inside of the elbow first, and avoid using them on young children, pregnant or breastfeeding women, or in cases of asthma or epilepsy. Ask your pharmacist for advice before using them on a child.

Sources

• Assurance Maladie — Head lice: how to get rid of them? (protocol, second application, laundry, when to seek medical advice).
• Barker SC, Altman PM. A randomised, assessor-blind, parallel-group comparative efficacy trial of three products for the treatment of head lice in children, BMC Dermatology, 2010.
• Burgess IF et al., clinical trials on dimethicone lotions, British Medical Journal.