Intended for healthcare professionals

Clinical Review

Information for patients: removal of lice and eggs by combing

BMJ 2003; 326 doi: (Published 05 June 2003) Cite this as: BMJ 2003;326:1258
  1. Zosia Kmietowicz, freelance medical journalist (zkmietowicz{at}
  1. BestTreatments, BMJ Publishing Group, London WC1H 9JR

    Little research has been done into whether combing helps to get rid of head lice, so it's difficult to say whether it works. Success seems to depend on how committed you are to carrying out this treatment.

    What is it?

    Combing wet hair with a special comb is called “bug busting” or “wet combing.” You use a special finetooth comb that can pick out lice. They are supplied with some head lice shampoos. Otherwise, find a comb with very fine teeth: the space between the teeth of the comb should be no more than 0.3 mm (0.01 inch).

    Here's how to remove lice by combing:

    • First comb through wet hair with an ordinary comb to get rid of knots and tangles.

    • Apply conditioner (or olive oil) to make it easier to comb the hair with the finetoothed comb.

    • Comb through every bit of hair, pulling the comb from the scalp to the hair ends. If you find lice, rinse them off the comb and down the sink. Work through the hair until you've gone through it at least twice, flushing away any lice you find. Afterwards, rinse the conditioner out (or shampoo out any oil).

    • Do this every three or four days to make sure that you catch any new lice that have hatched since you last combed the hair.

    • Keep doing the combing until you no longer find any lice for at least two treatments in a row.

    How can it help?

    Combing works for just over a third of people. So for every 10 people who use combing, only four will be clear of head lice after two weeks.

    View Abstract