Head Lice

What are head lice?

Head lice are tiny insect parasites that live on the human head, feeding on the scalp several times a day. Head lice reproduce by laying their eggs (nits) on the hair shaft close to the scalp. They are not dangerous, don’t carry diseases and are not a sign of poor hygiene.

How are head lice spread?

Head lice are spread by head-to-head contact with another person who has head lice, e.g. when doing group work at school, playing, or hugging. Head lice can run from one head to another in seconds. Head lice cannot fly, jump or swim, but they can sometimes ‘trapeze’ from one hair to another.

Brushes and combs can transfer mature head lice but are unlikely to transfer viable eggs, as these are very hard to detach from the hair shafts. Head lice are not spread through bed linen, clothing or head gear, as they do not leave the scalp unless they are dead or dying. Eggs (‘nits’) do not fall off until weeks after they have hatched as they are glued tightly to the hair shaft.

What are the signs of head lice?

The scalp may itch as the skin reacts to the saliva of the head lice. Itchiness can take weeks to develop. If you have had head lice more than once, the skin may become desensitised and there may be little or no itch. Crawling head lice may be seen in the hair, but they can move at 30cm per minute and can be difficult to spot. Head lice can quickly run and hide from searching hands. Adult lice are usually dark brown and about 2-3mm long.

Hatchlings (young lice) are often a lighter brown and about 1-2mm long. Eggs (nits) may be seen attached to the hair shaft but they may be very tiny and hard to see, especially newlylaid eggs close to the scalp. They are grey-white and about the size of a grain of salt.

How do I look for head lice?

To check hair for head lice, carefully comb plenty of hair conditioner through the dry hair, then comb again in sections with a metal fine-tooth ‘nit’ comb. The hair conditioner slows the head lice down so they can be trapped in the comb (see page 3). Wipe the combings on a white paper towel and examine them with a magnifying glass in strong light, e.g. sunlight, to look for head lice and eggs.

To check more effectively for eggs, use a magnifying glass in strong light, e.g. sunlight, to examine the hair close to the scalp, especially behind the ears and at the nape of the neck.

What other things can be mistaken for head lice?

Other objects in the hair can be mistaken for head lice or eggs. These include sand, dandruff, flakes of hair spray, ants, aphids, or other insects. If you are unsure of the identity of your findings, use clear sticky tape to fix them to a piece of white paper. You can then ask the Community (School) Nurse or the Environmental Health Officer at the Council to check if they are head lice or not.

What do I do if I find head lice?

Treatment Methods

There are several effective ways to treat head lice. Choose whichever method best suits you and your family. For successful removal of head lice, be sure to follow the directions for your preferred treatment exactly.

Download the 10 Day Conditioning Treatment method (in PDF, file size: 20kb)

Download the Insecticide Treatment method (in PDF, file size: 20kb)

Household Cleaning

Head lice and eggs do not live away from the human scalp so it is not necessary to wash all the household linen or clothing, to vacuum, scrub or spray the house with insecticide, or to treat the dog or cat. Pillowslips and towels may be soiled with head lice debris including droppings and moulted lice skins, so they should be washed on the first day of treatment.

Exclusion from School

Under the School Education Act 1999, a principal may exclude a child with head lice from school until treatment has commenced. The Department of Health recommends exclusion at the end of the school day.

The child may return to school when all live head lice have been removed. A few remaining eggs are not a reason for continued exclusion. However, the parent must continue treatment until all eggs and hatchlings have been removed, usually over the following ten days.

Prevention

Useful activities and ideas to help prevent infestation:

• check your child’s hair every week for head lice and eggs (‘nits’) - use a metal fine tooth ‘nit’ comb and plenty of hair conditioner to make the task easier and more effective. To help children sit still for this, offer distracting activities, e.g. play a favourite video, provide games, encourage reading, offer a head massage.
• tie long hair back - braid and/or put it up if possible.
• consider applying hair gel or mousse - these do not prevent or repel lice but help to keep stray hair strands from contact with other heads.
• avoid sharing combs or brushes.
• regularly immerse brushes and combs in hot water for 10 minutes to kill any head lice or eggs trapped in
  them. An old toothbrush will also help remove any debris.
• remind your child to avoid head-to-head contact with other children, e.g. when working at the computer with others, or when playing, or hugging.

Repellents

There are no known repellents which have been tested and shown to discourage head lice. Products including head bands and caps impregnated with insecticide may have some insecticidal effect when head lice come in contact with them. However, these products need to be worn all the time and like all head lice insecticides, do not kill all head lice eggs. The insecticide may also cause skin irritation.

‘Trouble-shooting’ Checklist

If treatment is unsuccessful, check the following:

• Did the chosen treatment cover the 7-10 day hatching cycle of the eggs?
• Were the combings examined for adult head lice (indicating reinfestation) over the 10 day period?
• Were as many eggs as possible removed every day?
• Was hair conditioner applied to dry hair, not wet?
• Was sufficient hair conditioner applied to saturate the hair?
• Was insecticide (if used), applied exactly as instructed, particularly for the recommended application time?
• Was a metal fine-tooth ‘nit’ comb used?
  

Further Information

Contact your Community (School) Nurse for further assistance – the school office will have a contact phone
number. If all else fails Contact the Communicable Disease Control Branch of the Department of Health, Western Australia on
9388 4999 or email your enquiry to headlice@health.wa.gov.au