What are head lice?
Head lice are harmless, minute, wingless insects roughly the size of a sesame seed that inhabit and reproduce on the human scalp. They may occur anywhere on the scalp but are most often located in the warmest regions, like behind the ears and at the nape of the neck. With colours spanning from cream to dark brown, these parasites predominantly infest children in primary school, with approximately 60% of them affected at any given time. Adults can also host these insects. Head lice are not an indicator of poor cleanliness and they do not transmit disease. Luckily, treatment is available at home. Consult your pharmacist for appropriate, effective treatment options.
The life cycle of head lice
Once mating has taken place, the female louse deposits about 3–10 eggs daily, attaching them close to the scalp at the hair shaft base. These eggs hatch within 7–10 days, and in another fortnight, the new lice reach reproductive maturity. A louse typically continues laying eggs for around 16 days, and it dies between 32 and 35 days after hatching. This life cycle renews itself approximately every three weeks.
Signs and symptoms of head lice
The most frequent sign that a child has head lice is itching on the scalp, neck and ears. This results from an allergic reaction to a lice bite. On examining your child’s hair, you might notice evidence of infestation. These signs include:
- lice eggs (nits) attached to hair, appearing as small white dots firmly fixed at the hair shaft that cannot be brushed off like dandruff
- live lice crawling through the hair
- scaly or crusted patches caused by scratching
How are head lice spread?
Head lice cannot fly or jump. They move by crawling from one head to another during close contact. They can also be passed on by sharing items like:
- hairbrushes and combs
- hair accessories
- hats
- headphones
- pillows, towels, and upholstered items
Risk factors for infestation Because head lice spread mainly through direct head-to-head contact, young children who play or hug closely are most vulnerable. How to treat head lice There are two main treatment options to remove lice and their eggs (nits) from hair:
Condition-and-comb technique
This method uses conditioner to immobilize lice for easier extraction. You should: 1. Wet your child’s hair thoroughly. 2. Generously massage conditioner into the scalp and along each hair shaft. 3. Keep it on for at least 15 minutes, covering with a shower cap helps suffocate lice and protects clothing and furniture. 4. Using a fine-toothed lice comb, comb from the scalp to the tips, ensuring the comb reaches the root each pass and removing conditioner, lice, and eggs with each stroke. 5. Repeat combing of the entire head at least twice. 6. Rinse out the conditioner.
To eliminate newly hatched lice, repeat this procedure every 2–3 days for two weeks or until combing reveals no lice or eggs.
Anti-lice insecticide treatments
Available as lotions, liquids, or creams, these products are formulated to kill both lice and eggs. They can have a strong odor and may irritate skin, so consult your pharmacist for the most suitable choice. All head lice products should display an Australian Registered (AUST R) or Australian Listed (AUST L) number on their packaging, indicating approval by the Therapeutic Goods Administration (TGA). Follow all product directions carefully and use a fine-toothed lice comb afterward to remove any dead lice and eggs. Since a single application may not eradicate all pests, a second treatment is recommended after seven days to destroy lice that have hatched since the first application.
When to consult your doctor
In most cases, the treatments already described will successfully eradicate a head lice infestation. However, you should see a doctor if:
- the chosen treatment fails to remove all lice and eggs
- your child experiences intense itching that interferes with sleep, school or play
- there are open sores or inflammation on the scalp
- infestations have required three or more separate treatments within a single year
If lice persist despite correct home treatment, or if your child develops a severe reaction, a healthcare professional can assess for treatment-resistant lice and may refer you to a dermatologist for prescription-strength medication.
Preventing head lice
While it’s impossible to guarantee lice won’t ever appear, you can take steps to lower the risk of infestation and stop reinfestation after treatment. To help keep lice at bay:
- discourage sharing of brushes, combs, hair ties, hats, scarves or personal items
- keep long hair tied up in a braid or bun, especially during active play
- remind children to avoid head-to-head contact during sports, playground games or group activities
If an outbreak occurs, in addition to treating the affected child, you should also:
- check and, if necessary, treat all household members
- wash bedding, soft toys and clothing worn in the 48 hours before treatment in hot water, then tumble-dry on high for at least 20 minutes to kill any remaining lice
- dry-clean items that can’t be washed, or seal them in an airtight bag for two weeks to starve any lice
- vacuum carpets, rugs and upholstery, then discard the vacuum bag immediately
- soak hairbrushes, combs and headbands in hot water or a lice-treatment solution (follow manufacturer’s directions)
- examine your child’s hair every 3–4 days for two weeks after treatment to catch any newly hatched lice early
What about going to school?
Children no longer need to stay home once treatment has begun. As long as you’ve started an approved lice regimen, your child can safely return to school or daycare. It’s considerate to quietly inform the school or preschool so other families can check for lice, but ask staff to handle this discreetly and avoid identifying your child by name. Regular head checks can then help keep the entire class lice-free.