HANDI

HANDI Interventions

Wet combing: head lice

Children
        15. Wet combing: head lice
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Intervention

Manual (condition and comb or wet comb) removal using the Bug Buster® kit, Quit Nits Combing Solution® or other head lice comb.

 

Half of the people infested with lice do not scratch; all people in contact with an affected person should be manually checked for lice.

Figure 1.

Figure 1.

Head lice (Pediculosis capitis)

 

 

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Suitable for insecticide resistant infestations.

Suitable for pregnant and breast feeding women, babies, people with allergies or open scalp wounds and asthma.

Good alternative for people who are reluctant to use insecticides.

Figure 2.

Figure 2.

Nit comb

Nit combs are available from pharmacies and some supermarkets.

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The teeth of the comb should be just wider than the hair. More than one comb may be necessary, starting with a wide-tooth comb and then moving to smaller and smaller combs.

The Bug Buster kit can be purchased online (from the UK) for £6.30 + P&P. It contains four different sized combs, step-by-step illustrated instructions, an explanatory booklet, waterproof cape and stickers.

The Quit Nits Combing Solution can be purchased from most supermarkets and pharmacies. The kit contains two combs and a low irritant formula.

To perform wet combing using the Hill Trial1 method:

  1. Wash the hair using an ordinary shampoo.
  2. Apply ample conditioner to aid straightening and detangling.
  3. Straighten and detangle the wet hair using a wide-toothed comb.
  4. Once the comb moves freely through the hair without dragging, switch to a detection comb.
  5. Make sure the teeth of the comb slot into the hair at the roots, with the deeply bevelled edge lightly touching the scalp, and draw the comb down to the ends of the hair with every stroke.
  6. Check the comb for lice after each stroke, and remove them by wiping or rinsing the comb.
  7. Work through the hair section by section.
  8. Rinse out the conditioner.
  9. Repeat the combing procedure in the wet hair to check for any lice that might have been missed the first time.

The Quit Nits Combing Solution® method is similar to above, except the solution is used instead of conditioner.

All methods advocate repeating the procedure regularly until no further lice are found:

  • Bug Buster – repeat every 4 days for 2 weeks
  • Quit Nits – repeat every 7 days for 2 weeks
  • Any method used needs to be done diligently and pedantically to be effective – the term ‘nit-picking’ really does apply here.
  • Repeated treatments are necessary regardless of the method used.
  • No method guarantees avoiding recurrence.
  • Most state health authorities advocate wet combing.


A DVD is available for purchase with the Bug Buster Kit (£12.20 + P&P) or individually (£8.95 + P&P)
Step-by-step instructions are also available from the NHS Clinical Knowledge Summaries website.

NHMRC Level 2 evidence.

The Victorian Government’s Better Health Channel provides easy-to-read advice on head lice.
The Quit Nits website has information about wet combing in general and much more detail about their Quit Nits Combing Solution.
The NSH head lice instructions are available for print.

  1. Hill N, Moor G, Cameron M, Butlin A, Williamson M, Bass, C. Single blind, randomised, comparative study of the Bug Buster kit and over the counter pediculicide treatments against head lice in the United Kingdom. BMJ 2006: doi:10.1136/bmj.38537.468623.E0
  2. Tebruegge M, Runnacles J. Is wet combing effective in children with pediculosis capitis infestation? Arch Dis Child 2007; 92: 818–820.