What are the recommended first-line treatments for head lice in children and adults according to UK guidelines?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Recommended first-line treatments for head lice in children and adults according to UK guidelines include:

  • Use of insecticidal lotions or sprays containing permethrin or malathion as first-line pharmacological treatments.
  • Mechanical removal by wet combing with a fine-toothed comb as an alternative or adjunct to insecticidal treatments.
  • Repeat treatment after 7 days to ensure eradication of newly hatched lice.
  • Non-chemical treatments such as dimeticone-based products may be recommended especially in cases of resistance or intolerance to insecticides.
  • Advice on avoiding unnecessary treatment of contacts and environmental cleaning is also part of management.

These recommendations are consistent with UK public health guidance and NICE best practice for managing head lice infestations.

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