Head Lice in Spain: Signs, Nit Combs and What to Do
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 5 November 2026
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To check for head lice in Spain, wet the hair, add conditioner and comb it section by section with a nit comb (lendrera) from the roots to the tips. You only know for sure if you find a live louse. Itching or a few nits are not enough. This guide is by Dr. Pedro Yelamo Vera, a GP licensed in Spain (Colegiado No. 484814280).
- The reliable way to find head lice is to comb wet hair with a nit comb and find a live louse.
- Lice spread by head-to-head contact. They cannot jump or fly, and they are not a sign of poor hygiene.
- Spanish pharmacies sell lice lotions and shampoos without a prescription, such as dimeticone or permethrin. Follow the leaflet: most need a second go a few days later.
- Treat only people with live lice, and check everyone at home.
- No lice repellent has clearly been shown to prevent lice.
- See a doctor for babies, in pregnancy, for sores with pus, or if treatment fails.
What are the signs of head lice?
The most common sign is an itchy scalp, mainly behind the ears and at the back of the neck. But not everyone itches, and it can take weeks to start.
- An itchy scalp, or a feeling that something is moving.
- Small red spots on the neck from scratching.
- Lice: small grey or brown insects, about the size of a sesame seed.
- Nits: white or yellow egg cases stuck firmly to the hair near the scalp. Unlike dandruff, they do not blow away.
Empty nits can stay in the hair long after the lice have gone. So nits alone do not always mean live lice.
How do you check for lice with a nit comb?
Combing wet hair is the most reliable check, and much better than looking at dry hair.
- Wash the hair and put on plenty of conditioner. This slows the lice down.
- Untangle it with a normal comb.
- Run the nit comb from the roots, touching the scalp, to the tips.
- Work section by section over the whole head.
- Wipe the comb on a white tissue after each stroke and look for lice.
Check everyone in the house the same day. In Spain a nit comb is a lendrera, lice are piojos and nits are liendres.
How do head lice spread?
They spread by direct head-to-head contact, for example when children play, hug or take selfies together. Sharing combs, hats or pillows is much less common. Lice cannot jump or fly, and pets do not spread them. Having lice has nothing to do with being clean or dirty.
What lice treatments can you buy in Spanish pharmacies?
Spanish pharmacies sell lice lotions, shampoos and sprays (pediculicidas) without a prescription. Ask the pharmacist which suits the person's age.
- Dimeticone (dimeticona) and other physical products: they coat the louse and smother it. Lice do not become resistant to them.
- Insecticides such as permethrin (permetrina): in some places lice have become resistant, so they fail more often.
- Wet combing alone: no product, repeated over about two weeks as the NHS describes. It needs patience.
Always follow the leaflet. It says how long to leave the product on and when to repeat it, because no product kills every egg. Treat only people with live lice, not the whole family just in case. Vinegar, mayonnaise and essential oils have no good evidence behind them.
Do lice repellents work?
There is no strong evidence that repellent sprays, colognes or "prevention" shampoos stop lice. Using lice treatments to prevent them is not advised either.
What helps most is a weekly check with a nit comb, tying long hair back and avoiding head-to-head contact when lice are going round the class.
Does a child with lice have to miss school in Spain?
Usually not. The Spanish Paediatric Association (AEP) and the NHS agree that lice are not a reason to keep a child at home. Spain has no national rule, so each school sets its own. Many ask you to start treatment before your child returns. Tell the school so other families can check their children. US paediatric advice also says children should not be sent home for nits.
You do not need to deep-clean the house. Wash bedding, hats and combs used in the last few days in hot water. Our guide on how long you are contagious covers going back to school for other illnesses.
When should you see a doctor about head lice?
- Babies and very young children: many products are not for them.
- Pregnancy or breastfeeding, or asthma, eczema or another skin problem on the scalp.
- Sores, crusts, pus or swollen glands in the neck. Scratching can lead to a skin infection.
- Lice in the eyelashes or eyebrows.
- Live lice are still there after two treatments done properly.
- The itch does not go: it may be something else, such as scabies.
Call 112 if the face or lips swell, or breathing becomes hard, after using a product.
Frequently asked questions about head lice in Spain
Can you have head lice without itching?
Yes. Many people do not itch, especially at first. That is why combing wet hair with a nit comb is the reliable check.
How do I tell nits from dandruff?
Dandruff falls off when you blow on it or touch it. A nit is glued to the hair, and you have to slide it off with a fingernail or the comb.
Does short hair prevent lice?
No. Short hair is easier to check and comb, but lice can live in hair of any length.
Do adults get head lice too?
Yes, often the parents of children who have them. Check the whole family and treat only those with live lice.
Can a doctor help with head lice by video?
Yes. A doctor can look at the scalp on video, check for infection and advise on treatment for each person's age and health.
Getting a medical assessment
If you are in Spain and worried about head lice or a sore on the scalp, you can book a video consultation with Dr. Pedro Yelamo Vera, a physician registered in Spain. You can also read about rashes and skin problems and itchy skin. A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.
This guide is general information. It does not replace the package leaflet or the advice of your doctor or pharmacist.
Sources
This content is written and reviewed by a licensed physician with reference to the following sources.
