A mother recently claimed to have spent over £1,000 on head lice treatments, due to a chronic infestation at her child’s school. While this is an extreme example, it showcases the need for clear and effective advice, says the NPA

The pharmacy team will often be the first port of call for advice on head lice, particularly as children head back to school this month. Test your knowledge with the following case study to make sure you’re up to speed:

Case study: A customer comes into the pharmacy and informs you that he has received a letter from his daughter’s school warning that someone in her class has head lice. He wants to buy a treatment just in case she has caught them. What should you advise?

Recommendation: It is not advisable to treat the child’s hair ‘just in case’ she has head lice, as this may build up resistance to the insecticides that are occasionally used to treat them. Treatment should only be applied once it has been established that a person has a live infestation.

The customer should be advised to check his daughter’s hair for live lice. Wet combing is the preferred method of detection – this involves washing the hair with ordinary shampoo before applying plenty of conditioner. It is important to wet the hair as lice become motionless when wet, and if the hair is dry, it can produce static electricity, which causes the lice to be repelled from the comb. It should also make the process more comfortable for his daughter, as her hair will be easier to comb if it’s wet.

The hair should be combed as normal to get rid of any tangles. A detection comb should then be used in sections of the hair, from the roots to the tips. If live lice are present, some will be combed out and will appear as small, grey-white or brown coloured specks. It may be useful to comb the hair over a piece of white paper, so the lice show up more clearly. The area at the nape of the neck and behind the ears should be thoroughly checked, as lice prefer these areas. Once all the hair has been checked, the conditioner should be washed out. Advise the customer that this process should be repeated regularly – at least weekly – to check whether his daughter has caught head lice.

Sufferers do not always experience symptoms if they have an infestation. However, advise the customer that some people develop an itchy scalp (caused by an allergic reaction to the lice’s saliva) or a rash on their neck (a reaction to lice droppings), which may indicate that they have head lice. If the customer discovers lice, advise him to check the rest of his family’s hair (including his own) and return to the pharmacy for advice on how to treat the infestation.

NPA members can access a free e-learning module created to help medicines counter assistants assess their knowledge of over-the-counter medicines and common conditions seen in community pharmacy. To access, visit: npa.co.uk/assessandlearn