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Help combat head lice

16 May 2024

Once a week take a peek

An easy-to-use guide for parents to fight back against head lice.

Know your enemy

mature louse

Head lice, or Pediculus humanus capitis, are small wingless insects that live on human head or hair. They are common, particularly in children. They are very well adapted to grasp human hair shaft. They cannot fly, jump or swim and are spread by head to head contact.

Head lice feed on human blood, several times a day. A head lice infestation is not the result of dirty hair or poor hygiene and it can effects all types of hair irrespective of its condition or length. Head lice effects only humans and cannot be passed on to animals.

Female head louse lays eggs close to the scalp on the hair shaft. Eggs hatch after 5-7days leaving empty egg shells (nits) glued to the hair shaft. These eggshells are more noticeable as hair grows and carry them away from the scalp.

Nymphs that emerge from egg shells take 7-8 days to grow to adult sized lice. They may take another 7 days to start breeding and hence it is important to remove them to stop them spreading.

Each louse can live for approximately five weeks, but during that lifetime a female can lay up to 120 eggs. The head lice life cycle lasts between 32 and 35 days.

Together we can fight them

Head lice are a normal part of childhood - research carried out at Australian primary schools found that around 21% to 33.7% of children have an active lice infestation at any given time.[1]

As a parent you probably know what a hassle it can be to treat head lice and just how frustrating it can be when your child comes home scratching their head. But, you’ve got the power to stop head lice in their tracks! 

By following a simple three step process, Check-Treat-Complete, you can fight back.

All it takes is three simple steps

three simple steps graphic

1. CHECK

  • Check your child’s hair once a week
  • Use a detection comb to trap head lice, preferably white in colour so they can easily be seen
  • If you find live lice, consult your pharmacy for treatment advice
  • If head lice are spotted, take a close look at all the family, including yourself, and ask close family and friends to check as well

2. TREAT

  • Only treat if live lice are identified
  • Use a clinically proven treatment. Those with a physical mode of action present no known risk of lice resistance
  • Leave the treatment on for the recommended time for maximum effect - leaving it on for longer will not make it more effective

3. COMPLETE

  • Check that all head lice have gone within 2-3 days of the final application to complete the treatment
  • If the pack instructions specify that a second application is required, repeat the treatment seven days after the first application to kill any nymphs which have hatched since the first treatment was applied
  • Continue to check for head lice on a regular, weekly basis

How to CHECK

You should check your child’s hair regularly, ideally once a week – a good way to remember this is ONCE A WEEK, TAKE A PEEK.

1.

Checking for head lice shouldn’t be considered a big deal, it’s just a normal part of a family’s personal hygiene routine like brushing teeth or washing hair

2.

It’s best to check for head lice using a comb made for the purpose, ideally white so they can be easily seen and with teeth no more than 0.3mm apart in order to trap head lice 

3.

Combing through the hair when wet, or after applying a conditioner, may make the process more comfortable 

4.

Good lighting is important and so is comfort to ensure your child stays still. Perhaps distract them with the TV or a book

How to diagnose head lice

To diagnose a case of head lice you need to find them alive. This is when you need to use a treatment. They move fast and are small, so they can be tricky to find!

If head lice are spotted, take a close look at all the family, including adults.

Sizing up head lice

Head lice range in size from a full stop to a sesame seed.

Where to peek

  1. Close to the scalp
  2. Behind the ears
  3. The back of the neck
  4. The top of the head
  5. Under the fringe

What to peek for

Adult lice are 2-4 mm long, immature lice are even smaller.

Live lice remain close to the scalp.

Nits are dead or empty egg shells - if you have already treated for head lice then simply remove these by hand or by combing.

Your home is a lice free zone

Head lice do not survive away from the head. Therefore, there’s no fear of lice spreading to clothes, furniture or bedding, so excessive cleaning is not needed. If live lice are found on one member of your family, simply check everyone’s hair and then treat as necessary.

Myth:

Only those with dirty hair get head lice

Fact:

Having head lice has nothing to do with personal hygiene

Should your child stay home?

No. If children are checked for head lice on a weekly basis and live lice are found, they can attend school, child care and all other activities as usual. However, treat straight away and ask them to avoid head-to-head contact with other children until all the lice are gone.

How to TREAT

If you find live lice, don’t worry. Head lice are nothing to be embarrassed about. You can deal with them quickly and easily if you take the right action.

There are FOUR types of head lice treatment:

1. Cheap conditioner & a fine-tooth comb

Using cheap conditioner and a comb is the recommended method to remove lice and nits, however it can be time consuming and requires commitment from the parent or carer, and co-operation from the child. But this method is proven to be effective. It is recommended that the correct equipment, particularly a fine-tooth comb, is used to increase the chances of success. See the step-by-step guide at the end of this article.

2. Non-pesticide

Non-pesticide treatments work in a different way from conventional pesticide treatments. By coating the outside of the lice, they either disrupt their ability to manage water or attack the waxy cuticle on the louse, causing them to die. These physical modes of action mean there is theoretically no chance for the lice to build up a resistance. There are three main ingredient options currently in use, dimeticone, octanediol and isopropyl myristate.

3. Pesticide

Pesticide based treatments have been around for many years but there is evidence that head lice already have, and continue to, develop resistance to some of them. There are two main types which work by poisoning the lice.

4. Alternative treatments

Alternative treatments and herbal options are available although their effectiveness varies.

Myth:

Head lice can jump from one head to another

Fact:

Head lice can only transfer from a child’s head through moderately prolonged head-to-head contact 

Applying treatment

Treating head lice is straightforward, quick and easy if you get it right.

There are two treatment options for head lice.

You’ll need:

  • a bottle of cheap hair conditioner
  • a towel
  • a thick tooth comb
  • a fine tooth comb
  • a roll of paper towels.

Steps:

  1. Sit your child on a chair or stool in front of you. Wrap a towel around their shoulders to catch conditioner spill. (You may want to put a video or TV show on, as this process can take a while.)
  2. Apply a cheap, pale coloured conditioner generously to your child’s hair. Work it through to coat every strand of hair. For long hair, it may be easier to tie one side of the hair off, and work in sections.
  3. Head lice breathe through small openings along their abdomens. By coating the hair and therefore the louse in something thick and slimy, these openings close over, shutting down the louse’s breathing for about 20 minutes – long enough for them to stay still and be combed out.
  4. After you’ve applied the conditioner, use a large comb to part small sections of the hair, starting from the nape and working upwards toward the crown.
  5. When the hair is detangled and manageable, use a fine lice comb and run through each section several times. Eggs are often found behind the ears and toward the back of the head. By combing from the bottom of the back of the head up, towards the top and front of the head, you’re more likely to find the head lice.
  6. After each comb out, wipe the conditioner on the paper towel. If your child has head lice, you will see them on the towel (they’re a little like small, brown, chia or sesame seeds.)
  7. Keep combing each section of hair until no further lice or eggs appear on the paper towel. Often you will see lots of old egg casings that may take a while to remove.
  8. Once you have combed and re-combed each section of hair, either re-plait or tie it back if it’s long enough.
  9. Head lice often congregate on the crown of the head, so it’s not until you reach these last sections of hair that you’ll find adult lice. However, heads that are severely infected will have adult lice everywhere.
  10. Repeat at least twice over the next few days, until you can’t find any more in the conditioner. You’ll never be able to get all the head lice and eggs out the first time. However, in the days after your first treatment, the eggs will hatch and you’ll be able to catch the crawling nymphs (young lice).

A.

When applying treatment, cover the full length of hair and ensure treatment is left on for the recommended time – following on-pack instructions carefully 

B.

Treatment should only be applied if a living, moving louse is found – never ‘just in case’. Ask your pharmacist for advice on protecting against head lice

C.

Keep lotion out of eyes and off the face – do not use the hair dryer and keep away from flames, stoves, and other sources of heat

D.

Reapply following the prescribed interval if necessary

COMPLETE the job

Once treatment has been applied, more action may be required to ensure the problem is dealt with.

  • Check your child’s hair a couple of days after treatment to ensure that all the head lice have been killed
  • If necessary reapply your chosen treatment method
  • If the pack instructions specify that a second application is required, repeat the treatment seven days after the first application to kill any nymphs (small baby lice) which have hatched since the first treatment was applied
  • Continue to check for head lice on a regular, weekly basis - ONCE A WEEK, TAKE A PEEK 

Removing those stubborn NITS

Despite what a lot of people think, it’s head lice eggs that are called nits - not the actual head lice. To make them stick to the hair shafts, lice produce a strong glue as they lay the nits. Sometimes after treatment, the empty eggshells can stay stuck to the hair until the glue weakens over time. You may therefore wish to use a fine-tooth comb to help remove the empty eggshells after treatment.

If the problem won't go away

If you still find live lice after you finish the treatment, either it’s failed or there has been a re-infestation. If the treatment failed you’ll usually find lice of all life stages, but a re-infestation will usually consist of a few adult lice. You’ll need to treat again.

If using a chemical treatment make sure:

  • You read the instructions carefully and follow them exactly
  • You use enough treatment to cover the whole head and full length of hair
  • You leave the treatment on for long enough
  • You complete the treatment course
  • Ask your pharmacy for advice if required 

How to protect against head lice

There is no product available that prevents head lice. However, tying long hair back and checking weekly for lice, using the conditioner and comb method, can help prevent the spread.

Related articles

Back at school? Here is how to keep kids free of head lice
Head lice may be small but they can cause big worries for parents and carers of school aged children says University of Sydney medical entomologist Dr Cameron Webb.

Head lice: Busting the myths so we can nab those nits
The beginning of the school year inevitably brings a barrage of permission slips, notes and newsletters. Excursions, canteen menus, uniform policies ... and head lice. It's enough to make any parent's scalp crawl.

References

  1. Head lice in pupils of a primary school in Australia and implications for control

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