Head lice and nits in children

Head lice are tiny insects (parasites) that live on your hair and feed on blood from your scalp. They are:

• greyish-brown
• about the size of a sesame seed
• flat
• have no wings

Lice can't jump or fly. They crawl quickly and hold tightly onto hair with their legs. They don't spread diseases, but their bites can make your scalp itchy.

Nits are the eggs of head lice. They are:

• very small
• oval-shaped
• yellowish-white

Nits stick tightly to your hair near the scalp, often close to the roots of your hair. You'll often find them behind your ears or at the back of your neck.

Nits are often mistaken for dandruff or scabs. Unlike dandruff, nits don't fall off when you shake or brush the hair. They hatch in about one week and can quickly lead to more lice.

You may not notice head lice right away. Symptoms may include:

• an itchy scalp, caused by lice bites
• a tingling feeling or the sense of something moving in your hair
• sores or red patches from scratching too much
• trouble sleeping, because lice are more active at night

Head lice are usually passed from one person to another through close contact. Children are more likely to get head lice because they often play closely together. Sharing personal items, such as hats, brushes or headphones can also spread head lice.

Anyone can get lice, whether their hair is clean or dirty. Hair length doesn't affect your chance of having lice, but they may be harder to spot in long, thick or curly hair.

Lice need warmth and blood to survive. They do not live for long on furniture, hats, bedding, carpet or anywhere else in the environment.

To check if your child has head lice or nits:

• Use a special lice comb on wet hair.
• Spread your child's hair and comb strand by strand, from the scalp to the ends.
• Wipe the comb on a paper towel after each section to see if any lice or nits are caught.

You might need a magnifying glass to see the lice more easily, especially in thick hair.

Look behind the ears and at the base of the neck for nits, which stick to the hair. They're usually found close to the scalp. Dandruff or scabs might look similar, but they don't stick to the hair and will fall out if you shake the hair.

You don't need to see a doctor to treat head lice.

If your child has head lice, they do not always have to leave school right away. In many schools, your child can stay for the rest of the day if steps are taken to stop lice from spreading to others.

These steps may include:

• avoiding head-to-head contact
• keeping your child's long hair tied back
• starting treatment as soon as possible, preferably that evening
• continuing treatment at home over the next few weeks to remove all lice and eggs

Once the first proper treatment is done and there are no live lice left in the hair, your child can usually go back to school the next day.

Check with your child's school or daycare in case they have any special rules you should follow.

Head lice can be treated in several ways. The right treatment depends on your age, health and personal preferences.

Manual removal

You can remove head lice and nits by hand using a fine-toothed comb. Special nit combs are available. This method is safe and chemical-free.

It's best done on wet, conditioned hair. Combing should be repeated every few days for at least 3 weeks (one full life cycle of the lice).

Chemical treatment

You can buy chemical treatments over-the-counter at the pharmacy. Some chemicals are only available with a prescription from your doctor.

Check the packaging to make sure the product is safe for your child's age. Some can be used for babies over 2 months of age, others only for children over 2 years of age.

Some treatments may need a second application. Apply treatment once at the start, and again 7 to 10 days later to kill any newly hatched lice.

Always follow the instructions carefully. Don't use conditioner before applying the treatment, as it can stop the chemical from working properly.

Treatment during pregnancy

Using the hair conditioner and combing method is safe when you are pregnant. Some chemical treatments are safe to use during pregnancy.

Always talk to your doctor or pharmacist before using any lice treatments during pregnancy.

Treatment during breastfeeding

Using the hair conditioner and combing method is safe when you are breastfeeding. Most topical lice treatments have low absorption and are safe during breastfeeding.

Always talk to your doctor or pharmacist before using any lice treatments during breastfeeding.

Head lice do not cause serious health problems. However, they may lead to some complications if not managed properly, such as:

• stress — one of the biggest challenges with head lice is the social stigma
• itching and skin irritation — scratching the scalp can break the skin and lead to irritation and redness
• treatment side effects — some treatments may cause reactions, such as stinging, itching or dryness of the scalp
• resistance to treatment — resistance can make it harder to treat lice and may require several treatments

There's no guaranteed way to prevent getting head lice. There are steps you can take to help stop lice from spreading if you have them.

To help prevent the spread of head lice:

• Avoid sharing hats, scarves, combs, brushes or hair accessories.
• Clean hairbrushes and combs with hot water and soap, then set them aside for a few days.
• Wash clothing, towels and bedding in hot water (at 60°C) or put them in the dryer.
• Put items you can't wash, such as soft toys, in a sealed plastic bag for 3 days.

You don't need to treat pets. Head lice only live on people. You also don't need insect sprays or to disinfect your home. Simple cleaning and washing are enough.

• NSW Health has information on choosing the right head lice treatment.
• Check out the NSW Health Nitbusters program, which includes tips to reduce the spread of head lice in the community.
• Read the SA Health quick graphic guide to how to get rid of head lice using the wet combing method.
• Northern Territory Government offers treatment information on head lice and nits.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to answer your questions 24 hours a day, 7 days a week.

Languages other than English

Health Translations offers translated resources in languages other than English:

• Information on head lice treatment for parents and carers.
• Information on treating and controlling head lice.
• Consent form for head lice inspections.