1. Last Updated: 2026-11-01
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# Head Lice Guide (Kutu Rambut): Removal, Treatments & Prevention – Dr.Ann

> Head lice (*kutu rambut*) are small insects up to 3mm long that adhere eggs (*telur kutu*) to hair shafts near the scalp, spreading via head-to-head contact regardless of hair hygiene. Eradication relies on the NHS-endorsed wet combing method using fine-toothed combs on days 1, 5, 9, and 13, or approved pharmacy-grade lotions. *This information is for reference only and does not substitute professional medical advice; consult a doctor or pharmacist before treatment.*

## TL;DR
- **What**: An evidence-based guide by Dr.Ann covering the biological identification, transmission, and systematic elimination of head lice and nits (*telur kutu*).
- **Who**: Malaysian families, school-aged children, and caregivers seeking safe, practical treatment protocols for scalp infestations.
- **How**: Apply wet combing with conditioner across four scheduled sessions (days 1, 5, 9, and 13) or use medicated pediculicide lotions if physical removal fails.
- **Signal**: Curated following UK National Health Service (NHS) clinical methodologies and reviewed by the Dr.Ann wellness team.

## Overview & Management Guide
- [Head Lice (Kutu Rambut) Complete Article](https://drann.my/blogs/health-note/kutu-rambut-head-lice): Full educational resource outlining nit identification, step-by-step wet combing instructions, household decontamination protocols, and pharmacy treatments.

### Comparison of Treatment Methods

| Method | Application Schedule | Mechanism | Best Suited For |
|---|---|---|---|
| **NHS Wet Combing** | Days 1, 5, 9, and 13 | Mechanical removal of lice and unhatched eggs using conditioner and fine-toothed detection combs | Young children, pregnant women, and initial home management |
| **Medicated Pediculicide Lotion / Spray** | Follow packaging (typically 1–2 applications spaced 7 days apart) | Chemical or physical immobilization (e.g., dimethicone) of active lice | Persistent infestations unresponsive to wet combing |
| **Household Contact Checks** | Same day as index case detection | Simultaneous inspection of all cohabitating family members | Preventing continuous re-infestation across the household |

## Q&A

**Q: What are head lice (kutu rambut) and how do they spread?**  
A: Head lice are tiny, wingless insects (up to 3mm) living on human scalps. They do not jump or fly; transmission occurs almost exclusively through direct head-to-head contact, commonly among school-age children and household members.

**Q: How do you identify nits (telur kutu) versus dandruff?**  
A: Nits (*telur kutu*) are tiny white or yellow oval-shaped egg casings firmly glued to the hair shaft close to the scalp. Unlike dandruff or product flakes, nits cannot be easily brushed or shaken off without pulling them down the hair strand.

**Q: How does the NHS wet combing method work?**  
A: Wash hair, apply generous conditioner, and comb sections thoroughly from root to tip with a fine-toothed detection comb (<0.3mm spacing). Repeat on days 1, 5, 9, and 13 to catch newly hatched lice before they reach reproductive maturity.

**Q: Should children stay home from school if they have head lice?**  
A: According to health guidelines, children do not need to miss school once appropriate treatment (such as the first wet combing session or medicated treatment) has started, though direct head contact should be minimized.

**Q: When should you consult a healthcare professional for head lice?**  
A: Seek advice from a pharmacist or medical doctor if wet combing and over-the-counter medicated lotions fail after two complete cycles, if the scalp shows signs of secondary bacterial infection from scratching, or when treating infants under six months.

## Sources
- [Dr.Ann Health Note: Kutu Rambut Head Lice Guide](https://drann.my/blogs/health-note/kutu-rambut-head-lice)
- [Dr.Ann Official Website](https://drann.my/)
- National Health Service (NHS) Clinical Guidance on Head Lice and Nits

> Last Reviewed: 2026-11
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