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Standard treatment
Human head lice can be killed by a 1% permethrin or pyrethrin (neurotoxic) or Lindane lice shampoo. Lindane is not recommended for pregnant or nursing women or for children less than 2 years old. The hair must be combed with a fine-toothed comb after treatment to remove the nits.
Combing, or nitpicking is a particularly effective method for removal of lice without the use of any medicine, special shampoos, or meticulous visual inspections.
A special comb can remove nymphs and adult lice, but not their eggs. A white comb will contrast with the vermin to make inspecting and cleaning the comb easier.
The combing treatment requires a measure of patience, though not so much as the chemical treatments which generally require at least three weeks of treatment. Combing, by contrast, takes approximately 10 days.
Three times per day (preferably, right after you wake up, noon and before you sleep), you must 'scan' your hair with the comb completely, three times, and at each pass of the comb, carefully inspect the comb to remove possible adult lice and nymphs (using water, or by blowing at the comb), then continue combing. It may help to wet the hair before combing.*
This technique works because the comb removes the nymphs and the adult lice, but not the nits. Thus, by combing your hair 3 times per day, you make sure you have removed all the adult lice you have on your hair, PLUS all the nymphs which were going to grow up into adults, thus you only have nits (lice eggs) on your head. The next day, some of the nits will have transformed into nymphs, and thus you remove all of the newly-transformed nymphs, before they get the chance to become adults and thus lay eggs (because only adults can lay eggs). Therefore, since the nits take 7-9 days to become nymphs, and you remove every nymph from your head every day, you just wait until the last-laid nit becomes a nymph (that's the ninth day after you have started this treatment), and remove it. Continue for one more day for good measure.
Alternative treatment
Resistance to commercially available anti-lice shampoos such as the above is becoming increasingly common. Pesticides like these can be dangerous to humans and thus raising pesticide levels is out of the question due to concerns about the current level being toxic. Some studies suggest an elevated risk of childhood acute leukaemia following exposure, (see a recent study).
Natural solutions permeate the Internet and in some retail stores. There effectiveness is not always supported by research studies. There is a group of medical facilities that rank treatments. The top three are: Head Lice Cure, Lice Doctor, and Head Lice Remedy
Shampoos based on Neem seed extracts can also be efficient if used properly. (see here.
One alternative to insecticidal treatments, particularly where resistance is common, is to use an electric comb such as the RobiComb. Alternating teeth carry a high voltage (though the developable current is small, and so the device is safe). Fine combing causes any contact with the lice to result in their electrocution. This allows diligent combing to eradicate an infestation.
Another alternative is shampooing with pure essential oils of 2 parts tea tree and 1 part peppermint oil. Repeat the process once every two days applying the oils liberally for 8 days.
Another alternative, called Bugbusting, involves combing wet hair covered with ordinary hair conditioner using special combs: the conditioner immobilises the lice so they can be detected easily. Used properly, this method appears to be as effective in practice as poison; lice cannot develop resistance to it, and it is economical and safe. But the process is tedious, particularly on curly hair, and must be repeated diligently four times over a two week period to cover the full life cycle of the lice. More information about Bugbusting is available from Community Hygiene Concern, a UK registered charity set up to protect people and pets from parasites.
Another alternative that has been proven successful in a research study is the adaptation of Dr. Dale Pearlman, dubbed Nuvo lotion. Novo lotion is Cetaphil, which is applied to the hair, blow dried, and left for eight hours; after several treatments, 96% effectiveness was achieved. This treatment does not require a nit removal comb.
Head lice do not survive in bedding and clothing for more than 24 hours. However, it is a good precaution to wash bedding and clothing which may have come into contact with an infected person in hot water.
A new treatment released recently in the UK called Hedrin® (www.thorntonross.com/hedrin), is now availiable from pharmacies. Hedrin contains Dimeticone, which is a silicone based compund. Hedrin® coats the headlice and prevents them from feeding. As it contains no pesticides it is suitable for people with sensitive skin or asthma. Studies are underway to scientifically prove that it also compromises the eggs.
A major problem with headlice treatment is the incorrect application of the solutions to the scalp. As the lice live very close to the scalp there is no need to coat the entire length of the hair.
Prevention
The human being's first natural line of defense against head lice is their own natural hair oil. This interferes with the louse's ability to cling to hair shafts and lay eggs (which are attached around the hair shaft). The cleaner one keeps one's hair, the more vulnerable they are to human head lice*.
Lice also have a genetic preference to the shape of hair common in their region of origin; African head lice thrive better with oval hair, North American head lice with round hair.
Ponytails and tight braids tend to reduce the likelihood of acquiring a head lice infestation, among those with long hair. Hair lice crawl slowly; they cannot fly or leap. Therefore proximity to people who may be infested is not risky, but one must avoid sharing hats, hooded jackets, and hair decorations.
External links
"Treatment of human head lice"