Why is Bug Busting wet combing special?

Prescription of the Bug Buster Kit

Data sheet

How well do the different treatments work?

Why the school nurse cannot solve the head louse problem

Why is Bug Busting wet combing special?

To help parents and healthcare providers achieve a lasting solution to the persistent problem of head lice and nits, our charity developed the original Bug Busting wet combing method.

Reliable detection, even when there are only a few lice present, and even in really curly hair, became possible. The unique, bevel-edged teeth of the Bug Buster and Nit Buster combs work brilliantly with gentle shampoo and hair conditioner. For treatment, there is no dependence on louse-killing formulated products.

Instead, the Bug Buster Kit instructions explain precisely how you can simply break the life-cycle by periodically removing lice over the hatching period. Simultaneously you learn how to recognize any new incoming lice. No lotion can tell you if you have caught more egg-laying lice between doses.

None can guarantee complete egg-kill. Since it became available, the UK Department of Health has advised use of a Bug Buster Kit alone as a treatment alternative to lotions, and that these should be combined with wet combing checks after use.

Prescription of the Bug Buster Kit

The Bug Buster Kit is a registered medical device on free NHS prescription for children since September 2002.

The Kit is no longer mentioned by name in the British National Formulary and non medical prescribers’ formularies, because it is an appliance and currently only drugs are listed. This does not affect it’s legitimacy for NHS prescription. On the prescription you are required to write ‘Bug Buster Kit x 1’. Pharmacies can obtain supplies from AAH (pip code: 233-1783) or by ordering from Direct Trade Ltd email:- info@tradedirect.co

Bug Buster Wet Combing Kit Data Sheet, January 2024

BUG BUSTER® KIT for reliable detection and treatment of head lice, and comfortable removal of nits by GOLD STANDARD wet combing

“Wet combing: The Bug Buster® kit is the only head lice removal (and detection) method that has been evaluated in randomized controlled trials*, and it is available on the NHS.”

November 2021 NICE CKS             *Hill et al (2005) BMJ: 311:384-6

Head Lice Device

The Bug Buster Kit contains 3 durable plastic, bevel edge Bug Buster combs, 1 Nit Buster comb, 1 wide tooth comb, a protective cape, and full instructions on the detection and treatment of head lice using the Bug Busting® wet combing method and subsequent Nit Busting to remove unsightly nits.

The Bug Buster Kit works in combination with ordinary shampoo and ordinary hair conditioner – no additional medicated product is required.

It is reusable by a whole family for louse detection and treatment of infestation.

Clinical particulars – therapeutic indications

To detect and remedy head infestation by systematic elimination of head lice, and, if desired, easy nit removal for cosmetic purposes.

Method of administration

Wash hair with usual shampoo, rinse, apply hair conditioner generously, untangle and straighten hair with wide tooth comb. With the slanted edge of the teeth held towards the scalp, pass a Bug Buster comb from roots to tips, section by section, until no more lice are found. Clear the comb of lice between strokes, by wiping both sides on paper towel or rinsing. Typically the time required to cover the whole head ranges from 2 minutes for short, straight hair to 30 minutes for long, frizzy hair. Rinse off conditioner and comb wet hair again with a mini Bug Buster comb and then the Nit Buster comb. Repeat 3 times at half weekly intervals (a total of 4 sessions in 2 weeks). If re-infestation occurs, recognisable by the presence of full-grown lice at session 2, 3 or 4, further half-weekly sessions must continue, until no full-grown lice have been seen at 3 consecutive sessions. A person who is undergoing Bug Busting wet combing will not pass on lice between sessions, but can still catch new lice.

Also used to check the efficacy of any treatment choice 5, 9 and 12/13 days after first application (on day 1).

Marketing authorisation

3 May 2001 Registered medical device, Class 1: CA 006936, Community Hygiene Concern

1 Sept 2002 Drug Tariff, Part IXA (appliance, available on NHS prescription)                                          

18 Dec 2023 Reg. Medical Device, GMDN 17552: UKCA 0000030403, Direct Trade

Jan 2024 Regulation (EU) 2017/745 (MDR): Bug Buster Kit (NL-CA002-2024-78264) CE MD, Direct Trade

Pip code: 233-1783

Net NHS price = £5.23 from October 2022

Support service

Visit www.chc.org/for-parents/ and www.nits.net for advice and to view the demonstration videos

Manufacturer

Produced by Direct Trade Ltd. 85 Great Portland Street, 1^st floor, London W1W 7LT, UK:

R&D by Community Hygiene Concern, registered charity no: 1153824 England & Wales + SC047079 Scotland

Internet: www.chc.org  Email: info@chc.org

UK Distributor: Direct Trade Ltd. Online sales at www.ukhealthbeauty.co.uk

To order wholesale supplies email: info@tradedirect.co

January 2024

How well do the different treatments work?

Listen to the science

Read about Louse Detection Methods & Comb Design 2002 – 2022 here.  Alternative “wet combing” methods are reviewed here

In International recommendations for an effective control of head louse infestations (Mumcuoglu et al 2020) Bug Busting wet combing is recognised as the most sensitive detection method for head lice and the only purely combing method that has been demonstrated to offer an effective cure.

A Bug Buster Kit alone proved four times more effective than neuro-toxic insecticide treatment for head lice in a randomised controlled trial, when parents followed the respective product instructions. The primary findings were reported in BMJ, Online First on 5 August 2005. Most families re-used their original Bug Buster Kit for detection and cure during a whole year (report to the International Congress on Lice, Argentina, October 2006). This independent study, led by Dr Nigel Hill of the London School of Hygiene and Tropical Medicine, was funded by a Big Lottery Fund research grant find out more

Alternative ‘wet combing’ methods are reviewed here

Formulated treatments

In International recommendations for an effective control of head louse infestations (Mumcuoglu et al 2020) the standard is set:

“Only evidence-based effective products that are not harmful to children or the environment should come to market”. (Referenced to ten Bosch L, Habedank B, Siebert D, et al. 2019)  Unfortunately very few formulated products comply with these standards (Combescot-Lang et al. 2015; Vander Stichele et al. 1995). For more information visit our Reviews and Studies page

“For a balanced approach to all methods of eradication – chemical and combing – the best site I found was www.chc.org” Vass A. Website of the week, head lice. BMJ 2001;323:1136

Why the school nurse cannot solve the head louse problem

Bug Busters want to get rid of head lice as much as those campaigning for the return of school nurse inspections in school. So we tested school nurse-style inspection v. parents using a Bug Buster Kit. We confronted epidemic levels of head lice amongst primary schoolchildren (first and middle school, aged 4-13 years).

Visual inspection results

With the parents’ consent, our staff checked 245 pupils in school using the traditional visual method, systematically parting the dry hair with their fingers and looking for evidence of head lice.

• Thirty eight (16%) had some evidence, largely nits, which are the empty eggshells left stuck to the hair when lice hatch.
• Of these cases, only on six heads (2.5%) were lice seen, which proved that the infestations were active. (It was possible that the other 32 heads had in fact been successfully treated.)

Bug Buster Kit results

No indication was given to the children themselves of the results of the inspection. All pupils in school that day were given a fun sticker and a Bug Buster Kit for use at home in the evening.

• Parents reported finding 133 cases of lice on schoolchildren (29.5% of 450 pupils attending the school) and another 47 cases in other age groups.
• Not only did parents identify 180 definite live cases as opposed to six found the school nurse way, they cured them using the Bug Buster Kit combs in wet, conditioned hair according to the instructions.
• Because all families started into the programme together on the same date, it thwarted the constantly circulating lice. Children, parents and teachers had a long rest from head lice, and organised another Bug Busting Day when they eventually crept back.

Why the Bug Busting way is better

• Most cases of head lice consist of only 10 lice or less, but they are still contagious. With the best will in the world, the school nurse cannot diagnose most cases because she has little time to check each child.
• In dry or even damp hair, lice move swiftly away from any kind of disturbance, avoiding detection. Our staff discovered that really wet lice stay still and ordinary shampooing is an excellent way to get them wet. Then ample amounts of any conditioner will keep them still while the hair is easily straightened with a wide-tooth comb and then methodically combed with a Bug Buster comb.
• The Bug Buster comb has been precision engineered to do the job of lifting out lice comfortably and accurately. By wiping both sides of the comb on kitchen paper between strokes you can quickly clean out any lice. They are much easier to see on the paper than on the head.

What the school nurse can do

In the UK, each school nurse is looking after at least 3,000 schoolchildren – she simply has not the time to search through their wet, conditioned hair for head lice. Her role is to make sure that her schools are aware of the Bug Busting head louse detection programme and to arrange support for the few families who cannot learn to use a Bug Buster Kit. Increasingly school nurses may write NHS prescriptions for Bug Buster Kits, which are filled free when children need treatment for head lice. 

From the National Education Union 2019 leaflet Head lice in schools

“Families with recurring or continuing infection need to be supported by health professionals, particularly school nurses. They should be prepared to make a professional assessment of reported cases, provide appropriate information, support and advice to teachers and parents, and undertake home visits if that is deemed to be the most tactful and effective method of dealing with the problems of a particular family.”

Reference

Ibarra J, Fry F, Wickenden C, Olsen A, Vander Stichele RH, Lapeere H, Jenner M. Franks A. (2007) Overcoming health inequalities by using the Bug Busting ‘whole-school approach’ to eradicate head lice. Journal of Clinical Nursing 16: 1955-1965

Read about the discussion on safety standards here

See our Mistaken Advice page