Head Lice and Nits: Tips & Tricks

Dr Lexi Frydenberg

General Paediatrician

Instagram:@drlexifry

Has your child just started back at childcare/school and come home itching their head?

Have you been told there is an outbreak of head lice at your child’s school or childcare centre and you have been asked to check your child’s hair but don’t know what to do?

Head lice or Nits (eggs) are part of nearly every child’s life and can be so frustrating for both the child and us as parents

Here are some things you need to know about Lice:

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

HEAD LICE vs NITS

Head Lice are very small wingless insects/parasites that are hard to see with the naked eye
Their latin name is Pediculus Humanus var. capitis
They live on the scalp of humans and feed on the skin of their head

Nits are the eggs laid by the head lice
Nits stick to individual hairs, close to the scalp
They remain attached to the hair, even after the eggs have hatched

HOW DO YOU GET HEAD LICE?

Head Lice are spread through head to head contact in a matter of seconds
They tend to spread from head to head when people play, cuddle, work or sit closely
Lice can’t fly, jump or swim so the only way to catch lice is by direct contact-they crawl or swing from one hair to another

Adults can also catch lice, but it is more common among kids and their families
Head lice ARE NOT 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 lice
- Keep in mind, there can be other reasons your child itches eg: sweat, eczema
- Also- some people who have 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
Adult head lice are typically dark brown in colour, while newly hatched lice (young lice), tend to be smaller and a lighter brown colour
Nits (or lice eggs), on the other hand are attached to the individual hair shafts and are usually greyish-white in colour and about the size of a grain of salt
Although lice and nits can be challenging to spot with the naked eye, some lice kits include a magnifying glass to aid in the search
However, once you know what you 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 & 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
The best way to find (and remove) head lice is by putting hair conditioner on to your child’s hair (I tend to use a lot of conditioner to 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 on a wet wipe or paper towel to see if there are lice or nits

HOW TO TREAT HEAD LICE

There are 2 main types of treatment

Mechanical removal – 10 day conditioner method
Head lice lotion or shampoo

Conditioner Method

Use this method every second day for 10 days. 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)

Step 1: Find lice or nits using above method
Step 2: Separate the hair into sections, gently comb each section one at a time with a fine-tooth head lice comb – I like to use a fine-toothed metal head lice comb but 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 onto 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

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 used to kill or control insects.
Examples of chemicals are permethrin, pyrethrin and malathion
These chemicals have been shown to be safe and effective for treating head lice
- Make sure you Use only specifically labelled head lice treatments and follow instructions
- Australian products must comply with certain safety standards (TGA approved) and should display this information
- Do not use in babies and infants < 6 months age and extra care if treating infants < 12 months 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 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 treatments has been in the hair long enough (according to the instructions) , comb through the hair again with a fine tooth head lice comb
It is also recommended to clean your child’s pillowcase in hot water ( 60 degrees)
Unfortunately, no topical insecticide treatment kills 100% of the eggs, so treatment usually involves at least 2 applications, 7 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 re-treat with a different insecticide or try the conditioner and comb method

HEAD LICE POLICY IN SCHOOL

Your child may be asked to stay away from school until treatment has started
Your child can return to school when all LIVE head lice 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

RESOURCES:

FACT SHEETS:

PODCAST

RCH Kids Health Info Podcast-Nits, Worms and other gross things kids get https://megaphone.link/HNAST8469618432

Best of Luck

I would love to know how you go and any tips you want to share

Dr Lexi

xxx

Dr Lexi Frydenberg

General Paediatrician

Disclaimer: The content in this article is not intended to constitute or be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your doctor or other qualified health care professional. Moreover views expressed here are my own and do not necessarily reflect those of my employers or other official organisations.