Head lice
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Symptoms
How do you know if you have head lice?
Knowing if you or your child has head lice can be tricky, but there are some signs to watch out for. The most common sign is frequently itching the scalp. This itching is caused by a reaction to the bites of the lice. You might also feel like something is moving in your hair and have a rash on the back of your neck.
If you think you or your child has head lice, here are some steps to help you check for them:
How do you get head lice?
Getting head lice can be concerning for many people, but it’s important to know that it’s a common issue that can be easily managed. They’re mostly spread through direct head-to-head contact with someone with lice. This can happen:
- If children are playing closely
- During sports activities
- If children are putting their heads together to look at a book or device
- If adults are in close contact with anyone who has lice, including children
Lice are spread by direct head-to-head contact. They don’t jump or fly – instead, they crawl from one person’s hair to another. They’re unlikely to be spread by objects like hats or pillows.
Treating & managing head lice
Treating head lice can seem daunting, but there are effective methods to help you get rid of them. You need to treat head lice as soon as you spot them and they can be treated without seeing a GP.
Can you prevent head lice?
Unfortunately, it isn’t possible to prevent head lice but if you suspect you, your child or someone in your family might have them, then spotting them quickly can help to limit them from spreading. You may see repellents advertised, however, there is no evidence to suggest that these work effectively to reduce head lice.
Wet combing
Most people prefer to start with natural methods to treat head lice, which is a good idea given that lice are becoming increasingly resistant to chemical treatments.
You should:
- Wash the hair and apply a generous amount of conditioner, this should be left in
- Use a fine-toothed steel comb and comb the hair in small sections over a piece of paper to make sure you can see the lice drop out. You should wipe the comb clean on a piece of tissue between each comb
- Make sure to continue until you can’t see any more lice or nits while you’re combing. This can take at least half an hour
- Repeat this every three or four days for at least two weeks so you’re removing any hatching lice before they have the chance to lay new eggs. You can only remove the actual lice by combing, not the nits
Over-the-counter treatments
If wet combing hasn’t worked or isn’t suitable, you could try alternative treatments. These should kill the head lice within a day. Some treatments don’t kill nits, so you might need to repeat the treatment after seven days to kill any newly hatched lice before they mature.
There are several over-the-counter (OTC) treatments available like shampoos, lotions and creams specifically designed to kill lice. It’s important to follow the instructions on the package carefully.
You’ll need to apply the treatment to all areas of the scalp. Some head lice treatments need to be left in for up to 12 hours. You can check the time needed for your head lice treatment on the instructions.
For many brands, you might need to apply the treatments a week apart. If you still have lice after the second application of treatment, the lice might be resistant to the treatment, so you might have to try a different brand with different active ingredients.
Even when using a head lice treatment, it is still important to check for live head lice two or three days after finishing treatment, and again another seven days after that – or according to the instructions that come with the product. Read the label carefully to follow instructions for the product you use. Head lice treatment shouldn’t be used to prevent head lice.
If you’re pregnant, breastfeeding or your child is under two or has a condition like asthma or eczema, you might need to avoid certain products. Make sure to check the leaflet of your treatment product and speak to your pharmacist for advice if you’re ever unsure.
- Using conditioner helps to saturate the hair fully, so don’t be tempted to skip this step
- Make sure the comb touches the scalp when you first insert it, as this is where lice attach to feed and get their nutrients
- Using a magnifying glass may help you spot the lice more easily
- Consider what type of comb you choose. If you struggle to see the lice, you may prefer to use a brightly coloured plastic comb
- Follow the instructions for the comb you choose carefully. You may need a different comb for detection and removal depending on how far apart the comb’s teeth are
- Be sure to leave three days between checking to allow time to find any newly hatched lice. This is recommended based on the life cycle of lice
- Combs with flat-faced teeth with spaces between 0.2mm and 0.3mm are best for removing head lice
To prevent the transfer of lice back to the scalp, make sure to clean combs and brushes regularly. Try to avoid sharing brushes with other people. If you have more than one child, it can be useful to have one brush for each child.
If you’re concerned about head lice, you might want to think about regular detection combing.
Your child might still be able to go to school or nursery if they have head lice but it’s wise to let their close friends’ families know, as well as their class teacher or any carers. Most schools have a head lice policy in place, so they can advise if they need to stay at home or they can come to school.
Letting others know may help them catch any infestation early and reduce the chances of the head lice being passed on more widely.
If you don’t see any lice during at least three wet combing sessions, this usually means the treatment has worked. If you’re using a head lice treatment product, then follow the instructions carefully to work out if the treatment has been effective.
If you’re still finding head lice, then you may want to try the treatment again, depending on the product information. Or you may want to speak to a pharmacist about the different treatment options available.
It’s also important to make sure that everyone in the household is checked for head lice, to make sure that lice aren’t spreading from others after treatment.
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Frequently asked questions
Head lice eggs are oval, yellow, brown or white, and tiny, less than one millimetre long. They can be found near the scalp, behind the ears or at the back of the neck.
Plant oil treatments like tea tree oil, eucalyptus oil, lavender oil and herbal remedies should be avoided. They’re unlikely to work.
Head lice are spread by direct head-to-head contact. They can’t jump, fly or swim. They climb from one person’s hair to another.
The life span of a female louse is around 40 days. During this time, it can lay more than 100 eggs.
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