Head lice infestation (pediculosis capitis) is a common problem in paediatric practice. It can cause considerable distress to children and their families and may lead to bullying and social stigmatisation. Therapy with "conventional" topical pediculicides with neurotoxic mode of action-such as malathion, permethrin, phenothrin and carbaryl-is increasingly associated with treatment failure as a result of the emergence of resistance within the parasite population. This review provides an overview of the natural history, clinical symptoms and diagnosis of head lice infestation. It also discusses general management principles and summarises the current data on novel treatment strategies, including wet combing, dimeticone, isopropyl myristate, benzyl alcohol, plant-based compounds and oral medication.