Head lice keep coming back in our house.

Start tonight, not on Sunday: wet-comb every head in the house, treat everyone who has a live louse on the same day, then repeat the combing on days 5, 9 and 13 and check again on day 17.

Two things usually explain the "it keeps coming back": the effort went into the sofa and the bedding instead of the heads, and the combing stops before the last eggs have hatched. Lice live in hair and move head-to-head. Current NHS guidance says you do not need to hot-wash laundry and there is no need to keep a child off school for head lice.

This is not a diagnosis, and I cannot diagnose from a message. The only thing that confirms head lice is finding a live louse on a wet-combed head.

1) What you have already tried, and what to do instead

2) Avoid list (please park these)

• No insecticide sprays, foggers, or "household mite" products on mattresses, sofas, carpets, or in rooms — no benefit, real exposure for small children and pets.
• No kerosene, petrol, lighter fluid, vinegar, salt, mustard, mayonnaise, flour, talcum powder, or any "herbal lice powder" — these burn, poison, or do nothing.
• No essential oils (tea tree, eucalyptus, lavender) on a child's scalp or near the face, and nothing swallowed.
• Never put a head-lice product on a pet. Human lice do not live on animals; if the pet is itching or has a sore, that is a vet call, not a lice treatment.
• Do not use medicated lotion as prevention — it irritates the scalp and prevention is not possible. Early detection through combing is the lever.
• Do not buy from an online marketplace or use a prescription-type product bought online. Get any medicated product from a pharmacy counter.
• Do not mix two products in one application, and do not use a product on a child whose age the pack does not cover — let the pack and the pharmacist decide.
• Do not share combs, brushes, hats, scarves, or headphones; wash the comb in hot soapy water between people and dry it fully.
• Nothing here changes any medicine anyone in the house is already taking. I am giving no doses: for any medicated lotion, the pack and the pharmacist govern how it is used and whether it is repeated.

3) Tonight's routine (about 10 minutes per short head, 20–30 for long, frizzy or curly hair)

1. Set up once (5 min): a fine-toothed detection comb, conditioner, white tissues, a bright lamp, an old T-shirt for the person combing, a bowl and a towel.
2. Check every head, youngest first while they are fresh. Wet the hair, work in lots of conditioner, comb from roots to ends in 4–6 sections, wiping the comb on a white tissue each time. Look for a moving louse. Nits are attached to the hair shaft near the scalp.
3. Long or curly hair: split it into two halves and do two passes of ~15 minutes, so no single sitting goes past 25 minutes.
4. Comb out what you find. If you and the pharmacist decide a medicated lotion is needed, follow the pack exactly, then comb out the dead lice and nits with the detection comb.
5. Launder the day's bedding, towels, hats, scarves and pyjamas on the normal cycle and dry them well. Anything you cannot wash (stuffed toys, hairbands, a wig or hairpiece) goes into a bag out of use for the next few days.
6. Clean the comb: hot soapy water, rinse, dry. Label one comb per person if you have more than one.

4) Put the dates in the phone now

5) Decision tree

• No live louse found on a wet-combed head? Then nothing is confirmed — keep the day-5/9/13 combing routine, skip all products, and do not spray the house.
• Live louse found? Treat that person and every head in the house on the same day, and start the day 5/9/13 schedule.
• Still a live louse on day 13 or at the day-17 check? Take a medicated lotion to a pharmacist counter and say what you have already done and how you used it. Ask what suits the ages in your house and whether it needs repeating. That is a conversation, not a self-prescription.
• Any red flag in section 6? Stop the home plan and get a clinician today.

6) Red flags — stop the DIY and get clinical or urgent help

Same-day clinic or pharmacist:

• Sores from scratching with yellow crust, oozing, spreading redness, warmth or tenderness, or a fever — a scratched scalp can get a bacterial infection, and that needs looking at, not more combing.
• Swollen glands in the neck, or the person is off their usual self, not eating or drinking, or feverish.
• Hair loss or a bald patch.
• Nits in the eyelashes or eyebrows — the eye area needs a clinician, not a home product.
• The person is a baby, is pregnant, has eczema, or has a weakened immune system — start with a clinician, not with a product.
• Itch and scratch so bad the child cannot sleep or is being kept off school by how miserable they are.
• A full combing cycle completed and live lice are still there at day 17.

Urgent, right now: any swelling of the face or lips, a rash with breathing difficulty, or a collapse after a product was used — that is an emergency; call your local emergency number.

7) What success looks like in 24 hours — without promising a cure

By tomorrow night you should have: every head in the house checked and wet-combed; anyone with a live louse treated that same day; the treated person's wet-combed hair showing no live louse (nits may still be visible — those are eggs, and seeing them is not a failure); the day 5, 9, 13 and 17 dates in the calendar; and the class teacher told once, in writing.

The itch usually keeps going for a while after the lice are gone, so a scratchy child tonight is not proof it failed. The honest test is day 13 and day 17 with no live louse in anyone. If one person in the house is missed, or combing stops at day 5, this often comes round again — that is the whole reason for the fixed dates.

8) Scripts you can copy

*To the class teacher:*
> Hi — [child] has head lice. We are treating everyone at home with wet combing and he/she is not staying off school. We comb again on [dates]. If you notice it on another child, please check and treat at home — that is what stops it circulating. Thank you.

*To the family your child plays with:*
> We are dealing with head lice at home. It spreads head-to-head, not through dirty hair or food. If you check [child]'s hair after a wash and find a small moving louse, please treat everyone in the house the same day — it is much faster than chasing it one child at a time.

*To the pharmacist counter:*
> Head lice in the household. Ages in the house: [ages]. We have been wet-combing on days 1, 5, 9 and 13 and will check on day 17. What product is suitable for these ages, how do you use it, and does it need repeating? We will not use it on the baby unless the pack says it is suitable.

*To the elder relative who is embarrassed:*
> We are checking everyone's hair today as a precaution. It turns up in classrooms and it has nothing to do with cleanliness — it is the same as a cold going round.

*If you want to ask a clinic:*
> Does head lice need a doctor's appointment in our area, or is it something we manage at home with combing and a pharmacy product?

I can set the four reminders (4 Nov, 8 Nov, 12 Nov, 16 Nov) so the dates do not depend on you remembering, and there is a one-page version of this plan you can print and stick on the fridge: head-lice-plan-fridge-sheet-2026-10-31-ba12d847.pdf

Guidance checked today, 31 October 2026, from the NHS page "Head lice and nits" (page last reviewed 22 April 2024).

Source: nhs-conditions https://www.nhs.uk/conditions/head-lice-and-nits/