School's back – and so are head lice

What treatments work for getting rid of head lice?

We've looked at the best and most up-to-date research about head lice, to find out what treatments work.

Bug busting. This is an option if you don't want to use chemicals on your child's head. It can work, but it takes a lot of time and patience. You can use conditioner or oil on the hair, to make it easier. You have to carefully comb through your child's hair with a special bug-busting comb to remove the head lice. You need to do this thoroughly, every four days over at least two weeks, to be sure you've got rid of them all, including the lice from the eggs that hadn't hatched the first time.

Bug busting has no side effects, but it's hard to be thorough enough to get rid of all the bugs. In studies, it worked for between 4 and 6 out of every 10 people who used it.

It's important to use the right type of comb for bug busting. Ask your pharmacist for the Bug Busting kit, which includes a special comb and instructions to give you the best chance of getting rid of the head lice.

Chemicals that kill head lice (insecticides). There are several types. The most common are malathion, permethrin and phenothrin. They work best as lotions or liquids which you leave on the hair for a long time (up to 12 hours, depending on the type). Shampoos and rinses don't work as well, because they are not on the hair long enough to kill all the lice. You should repeat the treatment after seven days to kill any newly hatched lice.

Lotions and liquids can work well for about 7 to 8 in 10 people who use them. But they don't always work. That's because, in some parts of the country, head lice have become resistant to certain insecticides. Ask your pharmacist which types of insecticide work best in the area where you live.

Insecticides can sometimes irritate the skin, making it sore or itchy. Some people are worried that these chemicals might have more serious side effects. But there's no evidence that they can be harmful at the low doses used for head lice, when applied correctly.

You can buy insecticides in a pharmacy. The brand names for malathion include Derbac-M, Prioderm, Quellada M and Suleo-M. The brand name for permethrin is Lyclear Crème Rinse. The brand name for phenothrin is Full Marks.

Dimeticone. The latest treatment for head lice is not a chemical insecticide. It's a silicone lotion called dimeticone (the brand name is Hedrin) and you can buy it from a pharmacy. It works by sealing the head lice in a coating, so they can't use water properly. This kills the head lice. Because dimeticone works differently to other treatments, researchers hope that head lice won't become resistant to it in the same way.

There hasn't been a lot of research into this treatment yet. We found only one study, looking at 253 people with head lice. The people in the study were treated with either dimeticone or the insecticide phenothrin. The study found that dimeticone worked for about 7 out of 10 people in the study. This was about the same number as people treated with phenothrin.

Dimeticone might be a good alternative if you don't want to use a chemical insecticide.

Some people who use dimeticone find it irritates their eyes, scalp or neck. But you're less likely to get side effects with dimeticone than with chemical insecticides. Also, unlike other chemical treatments, it doesn't get absorbed through the skin.

What else can I try?

Herbal and aromatherapy oils and sprays are sometimes used for treating head lice. Some of them have a powerful scent which it is claimed can repel or suffocate the lice. But there hasn't been much good quality research looking at them, so we don't know whether they work. One study found that a product containing a mixture of coconut, aniseed and ylang ylang oils worked as well as a spray with a chemical insecticide. But more research is needed to know whether or not these treatments work and whether they have side effects. If you use a spray, there is a risk of inhaling or getting it in the eyes.