A note from school about head lice is something many families receive at some point. It can feel a little embarrassing, but lice turn up most often among children and the people they live with. Head lice are small insects without wings that live, breed and feed on the human scalp. The Better Health Channel notes that they do not generally carry or transmit disease.

That makes lice a nuisance rather than a danger. A calm, regular routine at home is usually enough to find them and deal with them. This guide covers how lice spread, how to check for them and what the main options are. It draws on Victorian health information, so check your own state’s school rules too.

How head lice spread

Lice spread through direct head to head contact. That happens a lot when children play, cuddle or work closely together. Lice cannot fly or jump. They can only crawl from one head of hair to another.

This is why they are most common among children and their families. If one child has lice, tell close contacts so they can check too. According to the Better Health Channel, the whole family does not need treatment unless they also have lice. Checking everyone is the sensible first step.

What lice and eggs look like

Adult lice are whitish brown to reddish brown. They have six legs that end in claws. A female louse lays between three and eight eggs a day. The eggs, often called nits, are oval and about the size of a pinhead.

Eggs are glued firmly to the hair shaft, within 1.5 centimetres of the scalp. They need the warmth of the head to hatch. A live egg will pop when you crush it between your fingernails. A hatched egg looks like an egg with the top cut off.

Itching is the sign most parents look for, but it is not reliable. Some people with lice do not itch at all. Itching can also carry on for a while after treatment, and it can have other causes. A proper check with a comb is the best way to know.

How to check using conditioner and a comb

The conditioner and comb method is simple and cheap. Health authorities suggest it as a weekly check, even when nobody has a note from school. You need hair conditioner, a lice comb and some paper towel or tissues. Good light makes the job easier.

• Comb conditioner through dry hair and untangle it with an ordinary comb.
• Comb small sections thoroughly with the lice comb.
• Wipe the comb on a paper towel or tissue as you go.
• Look at the tissue and the comb for lice and eggs.
• Comb every part of the head at least four to five times.

If you find lice or eggs, it is time to treat. If you only find hatched eggs after a recent treatment, you may not need to treat again. The most effective combs have long, rounded stainless steel teeth set very close together. Any lice comb can be used, though.

A weekly check also gives you some quiet one on one time with your child. Many parents use moments like this to chat and listen. If you have been wondering about signs of delayed language in children, relaxed time together is a good chance to notice how your child talks. Keep the check light and unhurried.

Treatment options

There are two preferred options. One is the conditioner and comb method on its own. The other is an insecticide product made for head lice. Whichever you choose, read the label or speak with a pharmacist first.

Products sold for head lice in Australia should carry an AUST R or AUST L number. This shows the Therapeutic Goods Administration has accepted the product. Lotions go on dry hair. Shampoos go on wet hair, using as little water as possible.

Apply the product to every part of the hair, then comb out the dead lice and eggs. No topical insecticide treatment kills every egg. For this reason, the Better Health Channel advises two applications seven days apart. The second round deals with lice that hatched after the first.

If you would rather not use an insecticide, the comb method can be used on its own. Use conditioner and the comb every second day. Keep going until you find no live lice for ten days. It takes patience and regular time with your child.

Who should take extra care

Some people need extra caution with insecticide products. These include people who are pregnant or breastfeeding and children under 12 months. People with allergies, asthma or scalp wounds should also take care. Ask a pharmacist or doctor if you are unsure.

When a treatment does not seem to work

After an insecticide treatment, check whether the lice you comb out are dead. Dead lice suggest the product worked. If the product has worked, the lice should be dead within 20 minutes. Lice still alive after that may be resistant to it. In that case, try a product with a different active ingredient or ask a pharmacist.

Common active ingredients include pyrethrins and synthetic pyrethroids such as permethrin and bioallethrin. Others contain maldison, also called malathion. Herbal products are sold as well, some with natural pyrethrins. The label tells you which group a product belongs to.

If live lice keep coming back after the first treatments, see your doctor. The doctor may refer you to a dermatologist. A dermatologist may prescribe a tablet called ivermectin, taken twice, seven days apart. A lasting itch without signs of live lice is not a reason to treat again.

You do not need to clean the whole house

Many parents feel they must strip every bed and scrub every room. The Better Health Channel says there is no evidence that cleaning the house or classroom is necessary. Only the affected person’s pillowcase needs changing. Wash it at 60 degrees or dry it on a warm or hot setting.

That is a relief for busy households. A big clean is better saved for times it really counts, such as moving out of a rental. If that day is coming, our piece on end of lease cleaning looks at whether to hire a professional. For lice, a fresh pillowcase and a good comb are enough.

School and childcare rules

Schools have rules about head lice, and they can differ between states and territories. In Victoria, the Public Health and Wellbeing Regulations 2019 say children with untreated head lice cannot attend school or children’s services. Once treatment has started, they can go back, even if some eggs remain. Check with your school or state health department for the rules where you live.

Telling the school is nothing to feel awkward about. It helps other families check early. Children can feel embarrassed if a fuss is made, so keep it low key at home. A calm approach helps protect their self confidence at school.

Prevention and family routines

No product prevents head lice. Tying back long hair can help limit spread. So can a weekly check with conditioner and a comb. Making the check part of a normal routine, such as the weekend hair wash, keeps it simple.

Grandparents and other carers can help too. If a grandparent is coming to Australia on a parent visa and will help with school runs, show them the comb method. Anyone who brushes a child’s hair often is well placed to spot lice early. Sharing the job means checks are less likely to be missed.

Frequently asked questions

Can lice jump or fly?

No, they cannot. Lice have no wings and cannot jump. They crawl from one head to another during close contact. That is why head to head contact is the main way they spread.

Does an itchy scalp after treatment mean the lice are back?

Not always. Itching can continue for a while after treatment. A lasting itch without signs of live lice is not a reason to repeat treatment. Do a comb check to see what is really going on.

Should the whole family be treated?

Only people who have lice need treatment. Check everyone in the house with the comb method. Treat anyone who has live lice or eggs. Tell close contacts so they can check too.

When can my child go back to school?

In Victoria, children can return once treatment has started, even if some eggs remain. Rules can differ in other states and territories. Your school or state health department can confirm what applies. Keep up weekly checks after your child returns.

This article is general information only and is not medical advice. Speak with a doctor, pharmacist or qualified health professional about your family’s situation.