Woman having hair extensions put into her hair.
Hair extensions are attached near the root of the hair and must be properly removed before treatment for lice can begin. A lice comb cannot go through the hair properly and pesticide treatments could react with the bonding agent.

Head lice and hair extensions are two things you do not want to hear in the same sentence. It is already expensive to get the extensions put in and to hear that you have lice with them can be devastating.  Not only are extensions an investment of money but they are also an investment of time, it can take hours to put in hair extensions and no one wants this amount of time and money gone to waste. Over the years, we at Head Hunters have come across a few people with extensions who either needed to be checked or treated and the options are pretty limited.

First, you will have to remove your extensions to be treated. There are diverse ways people install their tracks, but no matter which way they are put in, you must be able to comb the scalp to remove the nits. The extensions should be left out until you are cleared by us with a head check or follow up visit, so they are not installed again and the infestation reoccurs. Manually removing lice most effective way to treat, but if someone were to do a home treatment we would recommend taking care not to get those harsh chemicals on the bondage part of the extensions.  The chemicals from over-the-counter treatments could damage the hair, whether it is synthetic or natural, and regardless of quality.

Once the extensions are removed, isolate them for 48 hours so the lice can die off. This can be done by putting the extensions in a plastic bag, and this bag can also be put in the freezer to accelerate the death of any lice that may be there.  The hair should also be washed before you put it back in. Also inspect the extensions near the roots and make sure they are clear of nits. A nit dies immediately once it is no longer at a temperature of about 90 degrees, so these nits will not hatch but they should be removed for cosmetic purposes. You can use a lice comb to remove any nits from the hair or pinch them off with your finger nails.

Woman with dreads looking to the left.
The hair must be untangled in order to remove head lice with a lice comb. If the dreads cannot be untangled, they will unfortunately need to be cut off in order to effectively treat the head lice issue.

For those with dreadlocks , unfortunately, they will have to be cut off if there is a lice infestation. Unless the locks can be untangled, there is no way to get a lice comb through the hair.  No lice treatment , natural or chemical, will be able to kill the nits and they must be removed with a lice comb. You can attempt to remove live bugs by hand, but if you do not remove the nits, lice will continue to populate generations of lice.  The lice could also climb inside of the locks, so you may think you got rid of them because they can’t be seen but in a few weeks the infestation will have started over again. Once the eggs hatch and current lice continues to grow, you will have all stages of lice and be contagious. Yes, it is a very drastic thing to do, but it is impossible to comb through locks. Oils and sheens do not prevent you from getting lice completely but it had been known to slightly lower your chances only if it is a daily regimen. Once you cut off the locks, you should have no problem getting rid of the lice and a normal lice removal treatment can be completed. 

Before taking the drastic step of cutting your hair or removing hair extensions, it should be 100% confirmed that you do actually have head lice. If a doctor or nurse tells you that you have head lice, ask them to show you the evidence. They should be able to find a nit and remove it for you or take a picture. Nits are dark brown in color when placed on a white napkin and this color comes from the embryo that is inside. If they remove a louse from your hair, it will immediately begin to move if it is set down on a surface and should have visible legs and other features. If what you’re finding isn’t moving, does not have limbs, or you are finding nits that are not brown, have different sizes and shapes, what you are finding may not be head lice. If you are unable to have 100% confirmation you should get a head check from a lice professional and have them show you the evidence if they do find it.