Head Lice

Signs and symptoms of head lice

Many people with head lice have no symptoms. Lice become more active at night and can cause tickling, restlessness and difficulty sleeping, especially in young children.

Some people start to have an itchy scalp after becoming allergic to the saliva of the lice. There may still be itching up to 10 days after lice have been removed. Sores or redness on the neck or scalp can be a sign of head lice.

Other health conditions can cause these problems, so you should not assume a child has head lice if you have not seen any lice or eggs (nits).

How to find head lice

• Look for adult lice
• Look for eggs (nits)
• Use the comb-and-conditioner method

Looking for adult lice

Look for lice behind the ears, and at the back of the head near the ears. Adult and young lice are hard to see, because they move away from light and they can change colour to stay hidden on different colour hair.

Looking for eggs (nits)

Eggs are white, smaller than a pinhead, and attached to the hair shaft very close to the scalp. If you find eggs more than 1.5 cm away from the scalp, they are probably dead or hatched. Hatched eggs are usually a dull yellow.

Comb-and-conditioner method

To find lice and nits Use white hair conditioner and a fine-tooth nit comb. The conditioner blocks the breathing pores on the lice and stuns them. The slipperiness of the conditioner makes them easy to find and remove.

1. Apply conditioner from scalp to the ends of the hair.

2. Comb it through the hair with an ordinary wide-tooth comb.

3. Divide hair into sections.

4. For each section, comb the hair from the root to the ends using a fine-tooth nit comb.

5. After each section, wipe the comb on a piece of white tissue, looking for lice.

6. Put used tissues in a plastic bag and tie the top, so lice can’t get out.

7. If you find something and are not sure whether or not it’s a louse, use adhesive tape to stick it to a piece of paper and show your pharmacist, doctor, or general practice nurse.

8. After you finish, clean the combs and soak them in hot water (at least 60 degrees) for at least 30 seconds to kill lice.

As a treatment If you are using this method to remove head lice, you must aim to remove all lice and eggs. This takes a lot of effort. You will need to spend 20–30 minutes every 2 or 3 days. Do not stop until you have not found any lice or eggs for at least three sessions. This could take up to 2 weeks.

How to remove head lice

The main options for removing head lice are:

• insecticidal head lice treatment

• comb-and-conditioner method to remove eggs and lice.

Heat treatment (using a hairdryer on hot setting) may also work, but is unproven. Be very careful not to burn the hair or scalp.

The most effective treatment may be a combination of insecticidal and other methods. Before starting treatment, talk to your pharmacist or doctor if:

• you are not sure if there are head lice

• there are any sores on the scalp

• the child is less than 6 months old

• you are pregnant or breastfeeding.

More tips to eradicate head lice

Until you have killed and removed all the head lice on family members, it’s sensible to wash bedding, towels and hats or put them through a clothes dryer on hot for 15 minutes. Head lice can become resistant to insecticidal treatment. If you are still seeing new lice after carefully following instructions, try a product with a different active ingredient or try the comb-and-conditioner method.

Insecticidal head lice treatment

Insecticidal treatment for head lice should not be started until you have seen lice or eggs (nits). If you have only found dead or hatched eggs, you do not need to use treatment. If you are not sure, ask your pharmacist or doctor for advice. If you have seen lice on one person, treat the whole family at the same time to prevent re-infestation.

Several different insecticidal head lice treatments are available. Ask your pharmacist for advice about choosing a product. Follow the instructions carefully, including:

• how much to use

• how long to leave the treatment on

• whether the treatment should be rinsed off or not

• whether it is safe for young children, pregnant women or people with health conditions

• whether you must wait before using hair dryers or straighteners after treatment

After using insecticidal head lice treatment, comb through the whole head of hair with a fine-tooth nit comb and check the comb after each sweep. Wipe the comb on a tissue and check that lice are dead by waiting 5 minutes to make sure.

No insecticidal treatment can be guaranteed to kill all lice and eggs in one treatment. You will need at least two treatments 7–10 days apart. The first treatment kills adult lice. The second treatment kills young lice that have hatched since the first treatment.

How to prevent head lice

• Check regularly and treat if you find head lice
• Tie long hair back in plaits
• Don’t share hats or hairbrushes

Additional resources

New South Wales

Queensland

South Australia

Victoria

Western Australia

Australian Capital Territory

Tasmania