The best way to banish head lice

Blog Image for article The best way to banish head lice

Head lice are persistent little critters and it’s very likely that these itchy insects will find a home in your child’s hair at some point or other.

Studies have shown that around one in four primary school aged Australian children have head lice, and although this statistic sends a shiver down the spine, we’re pleased to report that head lice don’t carry disease, and you can get on top of infestations with the help of a humble lice comb.   

Here, we look at head lice in closer detail and share CHOICE’s expert advice for banishing these bugs.

What’s the difference between head lice and nits?

Head lice are often called ‘nits’, but in actual fact, head lice are the small, wingless insects that live on the human head or hair, and nits are the eggs of adult head lice.

While some head lice are laying eggs, others may be hatching, and this continuing life cycle means that lice treatments aren’t a one-time wonder. Repeat treatments are needed to remove current and future head lice.

How are head lice transmitted?

All ages and all people can get head lice, but children are prime candidates because they learn and play in close proximity.

Head lice crawl from head-to-head through close contact, and although they can’t fly or jump between human hosts, head lice can spread easily in the early learning environment, at school, among family members and even when teens are taking selfies.

Head lice will happily stay on your child’s scalp when they go swimming or have a shower, but they usually die within about 24 hours if they’re not on a human head (e.g. if they find themselves on bed linen, clothing or furniture).

How can you tell if your child has head lice?

Head lice are blood suckers and their bites can leave your child’s scalp feeling itchy and scratchy, particularly around the nape of the neck, behind their ears and on the crown of their head.

Itchiness isn’t always associated with head lice, though. It’s possible for your child to have no symptoms, but you can confirm a case of head lice by looking closely at their hair and scalp and finding small, oblong eggs attached firmly to the root of their hair and live lice moving through it.

If you do find head lice, it’s important to check your whole family’s hair and embark on a treatment program (at the same time) for everyone who’s infested.

Do you need to exclude your child from child care or school while they have head lice?

There’s no requirement to keep your child home from child care or school, as long as effective treatment begins before the next day they attend.

Your child won’t be immediately sent home from care if head lice are detected, and NSW Health says that exclusion isn’t an effective way of breaking the cycle of head lice infestations.

Instead, head lice eradication is most successful if the whole child care or school community works together to tackle the problem (e.g. when all families check for head lice on the same night and treat any cases then, too).

What’s the best way to treat a mild case of head lice?

There are two main ways to get rid of head lice:

  • Mechanically, using the ‘comb and conditioner’ method, or
  • Chemically, using a product containing synthetic or natural insecticides.

Both methods involve you using a fine-toothed metal lice comb to remove the lice and nits, but the effect on the insects is different.

Conditioner ‘stuns’ head lice for up to 20 minutes and makes it hard for them to hold onto your child’s hair or crawl around, giving you a window of opportunity to comb them out; while chemical products kill the lice, but won’t kill 100 per cent of the nits in one treatment.

To help you choose a plan of attack, the consumer advocacy group, CHOICE has researched the best way to get rid of head lice and found that, ‘The most effective treatment for mild infestations is also the cheapest: Conditioner and a lice comb.’

They recommend a metal lice comb with cylindrical teeth (which remove ‘most lice and most eggs’ with the help of conditioner), and it’s important to know that, ‘No one product is 100% effective at removing head lice, and no product has been proven to ‘repel’ head lice in the first place.’

If you’d like to use the ‘conditioner and comb’ method, these are the seven steps to follow:

  1. Start by untangling your child’s hair with an ordinary comb.
  2. Squeeze a generous amount of thick conditioner over their hair, covering the whole scalp from roots to tips (white-coloured conditioner is recommended because it will show up the dark lice more clearly).
  3. Divide your child’s hair into sections (if it’s long and/or thick) and work your way through it with a lice comb, combing from the root of your child’s hair to the tip.
  4. Wipe the nit comb on a piece of paper towel after every stroke and check for head lice and nits.
  5. Comb each section of hair several times, wiping the comb after each stroke, until you’ve done your child’s whole head and the conditioner is gone. If the fine-toothed lice comb gets clogged, use an old toothbrush to clear the teeth.
  6. Dispose of the paper towel and wash the lice comb with hot water and detergent.
  7. Repeat this process every few days for 10 days to catch new head lice as they hatch.

What should you do if the head lice treatment isn’t working?

CHOICE says the ‘comb and conditioner’ technique is the safest if your child only has a mild case of head lice, ‘But if that doesn't do the trick, you'll probably need to opt for an insecticidal treatment.’

It’s important to follow the instructions carefully, and keep in mind that you’ll need to do a second treatment, seven days after the first, because no insecticide will kill every single nit the first time around.

When it comes to herbal head lice treatments, CHOICE says, ‘If your child is heavily infested, you might want to try an insecticide-based product before going herbal.’ Alternatively, ‘If you’re having no luck with insecticide treatments, some herbal treatments are worth a try.’

If you’re being frustrated by an ongoing or recurring infestation, they say it’s possible that:

  • You’re not using enough of the treatment to cover your child’s hair and scalp,
  • You’re not repeating the treatment after seven to 10 days,
  • Your child is getting re-infested through head-to-head contact with others, or
  • The lice in your region have built up a resistance to the product you’re using (in which case, you should switch to a product with a different active ingredient).

How can you help to prevent head lice?

Although CHOICE found no evidence that any hair product works as a head lice repellent, you may be able to limit head lice infestations by:

  • Tying back or plaiting your child’s long hair,
  • Checking their hair regularly and running a lice comb through it once a week with conditioner, to catch any new arrivals,
  • Encouraging your child not to share brushes, combs or hats with others, and
  • Working with your child care centre or school to treat an infestation, e.g. by telling them if your child gets head lice when there’s not a known outbreak, and acting on their advice if an outbreak is established.

Unfortunately, parenting and head lice go hand-in-hand, and although it can be tiresome to be tangled up treatments, you can take solace in the fact that lots of families are going through this, and your child’s hair will be very well-conditioned. Good luck!


NSW Health

National Health and Medical Research Council


Raising Children

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