Head lice

What are head lice?

Head lice are harmless, tiny, wingless insects about the size of a sesame seed that live and breed on the human scalp. They can be found anywhere on the scalp but they’re commonly found in areas where it’s warmest, such as around the ears and the back of the neck.

Varying in colour from cream to dark brown, these creatures mainly affect primary school-aged children with around 60% of kids having them at any one time.2However, adults can also have them. Head lice are not a sign of poor hygiene and do not carry disease. Fortunately, they can be treated at home.

The life cycle of head lice

After mating, a female louse (singular form of lice) lays around 3 —10 eggs per day, close to the scalp at the base of the hair shaft. These eggs hatch in 7-10 days, and within another 2 weeks, they’re mature enough to lay eggs themselves. A louse usually lays eggs for around 16 days, and after 32-25 days, it dies. This life cycle repeats every 3 weeks.3

Signs and symptoms of head lice

The most common symptom that your child has head lice is itching on the scalp, neck and ears. This is an allergic reaction to a head lice bite.4If you inspect your child’s hair, you may see signs of head lice. These include5:

  • lice eggs (nits) on hair — these appear as tiny white dots on the base of the hair shaft which are firmly attached to the hair and can’t be flicked off, unlike dandruff

  • live lice moving in your child’s hair

  • crusty or scaly spots, caused by scratching

How are head lice spread?

Lice can’t fly and they can’t jump. Instead, they crawl from person to person, when there is close contact between heads. They may also spread through sharing personal items such as:

  • hairbrushes and combs

  • hair accessories

  • hats

  • headphones

  • pillows, towels and upholstery

Risk factors for head lice

Head lice are spread mainly through direct head-to-head contact which means those highest at risk are young children who have physical contact such as hugging or playing closely together.

How to treat head lice

There are two main treatment options for head lice with each method involving the removal of head lice and nits from the hair.

Condition and comb method

Anti-lice insecticide treatments

Condition and comb method

This treatment involves applying conditioner to the hair which stuns the lice making it easier to remove them. You should:

1. Wet your child’s hair

2. Apply lots of conditioner to your child’s hair, taking care to rub it into the scalp and along the hair shaft

3. Leave the conditioner on for at least 15 minutes. Putting a shower cap on will protect clothes and furniture and help suffocate the lice

4. Use a fine-toothed lice comb to remove the conditioner from the hair, ensuring the comb touches the scalp each time. Firmly comb out from the scalp. Remove all traces of conditioner, lice and eggs between each comb stroke.

5. Comb your child’s head thoroughly, at least twice.

6. Rinse.

To ensure you remove all eggs and any new lice that may have hatched from those eggs, it’s recommended you repeat this process every 2-3 days for 2 weeks, or until a full combing doesn’t show any eggs or lice.

Anti-lice insecticide treatments

These treatments in lotion, liquid or cream forms, are designed to kill the lice and eggs. While effective, they can have a strong smell and may cause irritation, so speak to your pharmacist about the product that is best suitable for you.

Any head lice treatment you use should carry an Australian Registered (AUST R) or Australian Listed (AUST L) number on the outer packaging, which indicates that the Therapeutic Goods Administration (TGA) has approved these to be supplied in Australia.

Make sure you carefully follow the instructions on the product. Regardless of the treatment you use, you will still need a fine-toothed lice comb to remove the dead eggs and lice.

One treatment won’t kill all the lice and eggs at once. It’s recommended that you repeat the treatment in 7 days, to ensure you kill any lice that may have hatched from eggs that didn’t die during the first treatment.

When to see your doctor

Most of the time, the head lice treatments outlined above are effective in dealing with an outbreak of head lice. However, you should visit your doctor if:

  • head lice treatment (either method) hasn’t worked

  • your child is itching and scratching a lot and it impacts their daily life

  • your child has sores on their scalp

  • has been treated 3 or more times in a year

In some cases, it may be necessary to see a dermatologist for specialist treatment, which may involve taking medication.

How to prevent head lice

It’s not always possible to prevent head lice but you can reduce the risk of them, and take steps to prevent them from coming back after treating them. To reduce catching head lice:

  • discourage your children from sharing their brushes, combs and other personal items such as hats

  • ensure long hair is tied back

  • encourage children to avoid head-to-head contact at school, especially in the playground or during sports

If there has been an infestation of head lice, as well as treating your child, you should also:

  • check all other family members and treat if appropriate

  • wash all bed linen, stuffed toys and clothing used during the 2 days before treatment in very hot water, and then dry in the hot cycle of a dryer for at least 20 minutes, as this will help kill any live lice that may be present

  • dry clean items that can’t be washed, or store them in an airtight bag for 2 weeks, to kill lice

  • vacuum carpets and upholstery and throw away the vacuum bag

  • soak hairbrushes, combs and other accessories in hot water, or a solution of head lice treatment (check packaging for instructions)

  • check your child’s hair every 3-4 days if they have had close contact with someone who has had an infestation

What about going to school?

In the past children with head lice were kept home from school. However, there is no need to keep your child off school or child care, as long as you have treated their head lice.

It may be a good idea to notify your child’s school or pre-school so that other parents can check their children’s hair to prevent further or re-current cases of head lice. However, be sure to ask teachers to be discreet and not name your child as the one who had the head lice!

Your local MediADVICE pharmacist is available to help you manage your health and we can recommend a range of products to assist in the treatment of head lice. We stock a range of head lice treatments and fine-toothed lice combs, so speak to your MediADVICE pharmacist about your symptoms so we can recommend products and medications that may be suitable for you.

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General advice only – this information should not replace the information provided to you by your health care professional. If symptoms are severe or persist, please speak to your health care professional. Information current as of date of publishing.
References:
[1] Healthline, What Are Lice, and Where Do They Come From?https://www.healthline.com/health/lice-what-are-lice
[2] Victorian Health Department, Pediculosis (head lice),https://www.health.vic.gov.au/infectious-diseases/pediculosis-head-lice
[3] Victorian Health Department, Pediculosis (head lice),https://www.health.vic.gov.au/infectious-diseases/pediculosis-head-lice
[4] Mayo Clinic, Head lice,https://www.mayoclinic.org/diseases-conditions/head-lice/symptoms-causes/syc-20356180
[5] Mayo Clinic, Head lice,https://www.mayoclinic.org/diseases-conditions/head-lice/symptoms-causes/syc-20356180
[6] Mayo Clinic, Head lice,https://www.mayoclinic.org/diseases-conditions/head-lice/symptoms-causes/syc-20356180
[7] Raising Children Network, Head lice,https://raisingchildren.net.au/guides/a-z-health-reference/head-lice
[8] Raising Children Network, Head lice,https://raisingchildren.net.au/guides/a-z-health-reference/head-lice
[9] Raising Children Network, Head lice,https://raisingchildren.net.au/guides/a-z-health-reference/head-lice
[10] Better Health Channel, Head lice (nits),https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/head-lice-nits