Our Paediatrician Expert, Dr Lexi Frydenberg gives us the lowdown on all things head lice and nits, what they are, how you get them and how to get rid of them. Head lice and nits (eggs) are part of nearly every child’s life and can be so frustrating for both the child and us as parents.
It is important to know that head lice and nits are really common. They are uncomfortable and annoying but do not pose a health risk to your child. Head lice do not carry diseases and are not a sign of poor hygiene or cleanliness.
If your child has returned to school or childcare and starts scratching their head, or if you've been informed of a head lice outbreak at their centre, they've likely contracted head lice and nits. This article will detail how to conduct a head lice check and explore various treatment options.
What is Head Lice?
Head lice are tiny, wingless parasites that infest human scalps and feed on the blood from the skin. Despite being minuscule, they can be a major nuisance and cause a great deal of discomfort. The Latin name for head lice is 'Pediculus Humanus var. capital, and they can be incredibly difficult to spot with the naked eye due to their size.
Head lice are equipped with hook-like claws that enable them to grasp onto individual strands of hair, where they lay their eggs, known as nits. If left untreated, head lice can multiply rapidly and spread to other people, making them a common problem in schools and childcare centres.
Head lice vs nits
There is often confusion between head lice and nits, but they are not the same thing. Nits are eggs laid by head lice and can be easily mistaken for dandruff or hair debris. Unlike head lice, nits are attached to individual hair strands, usually close to the scalp, and remain firmly attached even after hatching. This means that even if the head lice have been removed, the nits can still be present.
How do you get head lice?
Head lice are spread through head-to-head contact in a matter of seconds and tend to spread from head to head when people play, cuddle or work, or sit closely. Lice can’t fly, jump or swim, so the only way to catch lice is by direct contact-crawl or if they swing from one hair to another.
Adults can also catch lice, but it is more common among kids and their families. It's important to note that head lice cannot be spread through clothing, hats and helmets.
How do you know if you have head lice?
Itching and scratching of the scalp/hair may be a sign you or your child has head lice. Keep in mind there can be many other reasons your child is itching their head including sweat or eczema etc. Some people who have head lice do not have an itchy head at all.
You may also be able to see head lice crawling in your child’s hair but it can be hard to see lice or nits with the naked eye.
What do head lice look like?
Adult head lice are typically dark brown in colour, while newly hatched lice tend to be smaller and lighter in colour, often a lighter brown. Nits, or lice eggs, on the other hand, are attached to individual hair shafts and are usually greyish-white in colour and about the size of a grain of salt.
Although lice can be challenging to spot with the naked eye, some lice kits come equipped with a magnifying glass to aid in the search. However, once you know what to look for, head lice and nits are often easy to identify, especially when using a fine-toothed comb to comb through the hair
How to check for Head lice and nits?
Head lice can be hard to find. The best place to look for head lice and nits is close to the scalp, behind the ears and at the back of the neck. Though there are many different treatments, the best way to get rid of head lice is by putting hair conditioner on the hair (using a lot of conditioners can make it easier to comb). The hair conditioner slows the head lice down so they can be trapped in the comb.
Step 1: Separate the hair into sections.
Step 2: Comb the conditioner through the section of hair with an ordinary comb or brush.
Step 3: Next, it is time for the head lice comb.
Step 4: Once you have combed a section of hair with the head lice comb, wipe the comb with a white wet wipe or paper towel to see if there are lice or nits.
How to treat head lice
Conditioner method for head lice
Step 1: Find lice or nits using the above method.
Step 2: Separate the hair into sections and gently comb each section one at a time. Use a head lice comb with fine-toothed metal. If your child has thick hair, you may need to use a plastic one with slightly wider spaces between the teeth.
Step 3: Continue combing and checking each section and getting rid of any lice or nits in the hair with the white wipe or paper towel. Repeat the combing for every section of the hair at least 4-5 times.
Step 4: When you have finished, rinse the conditioner out and dry the hair
Repeat these head lice treatment steps 1-4 every second day for 10 days to ensure the head lice and nits have been successfully removed.
This method focuses on removing adult head lice from hair and breaking the egg-laying cycle (as the eggs take 7-10 days to hatch after being laid).
Head lice treatments
Some chemical head lice treatments are available from chemists or supermarkets. It is important to read and follow the instructions carefully. The active ingredients in these treatments are often insecticides - Ie. Chemicals that are used to kill or control insects.
Examples of chemicals are:
Permethrin
Pyrethrin
Malathion
These chemicals have been shown to be safe and effective for treating head lice. Make sure you only use specifically labelled head lice treatments and follow instructions. It's important to note that Australian products must comply with certain safety standards (TGA approved). Do not use on babies and infants under six months of age and take extra care if treating infants under 12 months of age or children with allergies, asthma, sensitive skin or scalps.
If you use a head lice lotion, apply it to dry hair. If you use a shampoo, apply it to wet hair (but use as little water as possible). It is important to cover all parts of the hair, especially close to the scalp. It is also recommended to take special care to cover your child's eyes with a towel to avoid getting treatment into their eyes.
Once the head lice treatment has been in the hair long enough (according to the instructions), comb through the hair again with a fine-tooth comb.
It is also recommended to clean your infected child's pillowcase in hot water (60 degrees).
Unfortunately, no topical insecticide treatment kills 100% of the eggs, so treatment usually involves at least two applications, seven days apart (this will kill the eggs that didn’t die the first time around). Some lice may be resistant to an insecticide and may still be alive after the treatment. Either wash out and retreat with a different insecticide or try the conditioner and comb method.
Head lice policy in schools
Your child may be asked to stay home from school until treatment has finished. Your child can return to school when all live headlice have been removed. There is no need for your child to stay away from school if there are only a few remaining eggs, but it is important to continue with treatment over the following 10 days to make sure all the eggs and hatchlings have been removed.
This article was written by our Paediatrician Expert Dr Lexi Frydenberg. For more expert articles and expert videos from Dr Lexi Lydenberg check out our Parenting Portal or to learn more, secure your spot at one of our upcoming parenting education masterclasses.
Further Resources:
Fact sheet:
•https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/head-lice-nits#bhc-content
• https://raisingchildren.net.au/guides/a-z-health-reference/head-lice
Podcast:
RCH Kids Health Info Podcast-Nits, Worms and other gross things kids get.
Disclaimer: The information in this article is provided for educational purposes only and is not intended to substitute advice provided by your doctor or other healthcare professionals. The author of this information has made a considerable effort to ensure the information is in-line with current guidelines, codes and accepted clinical evidence at time of writing, is up-to-date at time of publication and relevant to Australian readers. The opinions and thoughts expressed in this article reflects the view of the author only and not the broader medical profession or her places of work. The author accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in this information. We recommend you always consult a qualified health practitioner for individualised advice.