GUIDELINES

FOR THE

MANAGEMENT AND CONTROL

OF HEAD LICE

GUIDELINES FOR

THE MANAGEMENT AND CONTROL OF HEAD LICE

Head lice are tiny parasitic insects that live in hair, where they breed and feed on blood from the scalp.They are about the size of a sesame seed, have six legs, and range from tan to greyish-white in colour. Lice cannot survive for more than two days away from the human scalp. Head lice crawl but cannot fly or jump and do not live on animals. They cling to the hair with hook-like claws at the end of each leg. The lice are spread by head-to-head contact, or sometimes from sharing hats, combs and brushes with an infected person.

Nits are the eggs of the head lice. They look like small whitish specks about the size of a pinhead and stick to the hair shaft. Eggs are first laid close to the scalp and grow out with the hair. They are usually found around the nape of the neck, under the fringe and behind the ears. Depending on the temperature and humidity, eggs hatch after 5-7 days. Small nymphs emerge and grow into adult sized lice after about 7-8 days. It is about 14 days after the eggs are laid that the mature louse begins breeding.

Adults live for up to 14 days. The lifecycle of a head louse is only about 30 days.

Head lice are not known to transmit disease and have been common in the community throughout history, spreading anywhere that a number of people work, play or live together. School communities and families are therefore vulnerable to infestations. Head lice infestation is unpleasant and embarrassing for many children and their families and may affect a child’s ability to learn or be comfortable in the classroom.

Recent research conducted in the United Kingdom has found that excluding children from school because they have head lice may cause anxiety and lead to bullying. The survey of 200 children found that 1 in 10 had been taunted for having head lice. More than 1 in 6 of those surveyed had felt upset by getting the infection and 1 in 10 said it made them feel miserable. Joint author of the study and clinical psychologist Oliver James noted “Louse infection still carries a heavy social stigma……it is strongly associated with an inferior social status….it is taken as a sign of dirty, incompetent care.”

Signs and Symptoms

  • Visible signs of nymphs or lice clinging to shafts of hair (often difficult to see). Sometimes the lice can be seen crawling along the scalp
  • Visible signs of eggs very close to the scalp and/or along the hair shafts in abundance (eggs far from the scalp and few in number are probably no longer viable)
  • Fine black powder (lice faeces) or pale grey lice skins may be seen on the pillow case
  • A tickling feeling in the hair
  • Itchy scalp from lice bites
  • Sores can develop from scratching and these can sometimes lead to infection and swollen glands

Management

All family members infested with head lice should be treated at the same time to avoid re-infestation. Although lice will only survive for two days away from the human scalp, it is advisable to wash towels, bed linen, hats, brushes and combs at the time of treatment for head lice. Anything that cannot be washed or dry-cleaned can be placed in a plastic bag for a minimum of four days.

Alternative Treatments

Using commercial head lice preparations

  • When head lice have been detected treatment can be commenced, but never treat someone with a head lice preparation if they do not have head lice.
  • For a baby under 12 months, a child with an inflamed scalp or a pregnant or breast feeding mother, a doctor should be consulted for advice on the treatment head lice.
  • A commercial head lice preparation can be purchased at a pharmacy. These usually come in shampoo or lotion form. Ask the pharmacist for advice. Most head lice treatments contain common chemicals and there are some natural products on the market. Head lice may develop a resistance to common chemicals used in many head lice products.
  • Read the label before use for instructions on how to apply. Apply product to all areas of the scalp and every strand of hair and work through, according to instructions. Comb out after specified time, using a fine tooth lice comb. Wipe contents onto a tissue and look for any movement. If dead lice are found, the product has been successful, but if lice are still active, wash hair and treat again, using another product with a different active ingredient. Remember to read the new instructions.
  • Head lice preparations will not kill all nits (eggs), so a follow-up treatment seven days later is required to kill nymphs that have emerged in that time.

Using the comb and conditioner method

[this method has become very popular in recent times, especially as some parents are concerned about the effect of the regular use of chemical treatments]

  • Conditioner does not kill the lice but stuns them for about twenty minutes, which is long enough to comb out the lice.
  • Apply generous amounts of cheap conditioner to dry hair, covering each hair from root to tip. Use white conditioner as the lice and eggs are easier to see.
  • Detangle the hair using an ordinary comb and part into sections.
  • Immediately comb the hair with a fine tooth lice comb, starting from the base of the scalp.
  • Comb each section several times, wiping comb onto a tissue to check for lice and nymphs.
  • Repeat combing all through the hair until no more lice are found on the comb.

Safety

  • As some head lice products contain chemicals, be careful not to get it in the eyes. Cover eyes with a towel or washer when applying the product.
  • Wear gloves when applying the product and wash hands thoroughly after use.
  • Many products have a strong smell – before purchasing, consider the effect this may have on a child, as the smell may be overpowering.
  • Do not use insecticides, methylated spirits or kerosene on heads as a treatment for head lice.

Control of Head Lice

  • The comb and conditioner method used on hair once or twice a week will control head lice. It is a cost-effective way to stop head lice re-establishing themselves and get rid of re-invading lice.
  • Use the method (as above) and look for lice and eggs on a tissue. If less than five lice are found, repeat the process on a daily basis until all the lice are gone. If more than five lice are found, use a commercial product and repeat the treatment in seven days.
  • Then resume the comb and conditioner method twice a week.
  • The comb should be kept in the shower so that every time someone washes their hair it can be used.
  • Younger children will need adults to do this for them.

Head Lice Detection Kit will consist of the following:

  • Conditioner – white conditioner is best since the lice and eggs are easier to see
  • A fine tooth comb – to comb out the lice stunned by the conditioner
  • A normal comb – to detangle hair and make the fine tooth comb easier to use
  • Paper tissue – white tissues are best as the lice and eggs are easier to see

Responsibilities

  1. Parents/Carers have responsibility for their children.

This includes:

Prevention

  • encouraging thorough hair brushing at least daily
  • keeping hair short or worn tied back or braided
  • avoid sharing combs, brushes, hats, caps, headgear etc

Detection

  • checking weekly for head lice and daily when there is an infestation
  • notifying the Principal when head lice are detected and advise that treatment has begun
  • keeping a child with head lice at home until treatment has occurred (including an attempt to remove eggs)

Treatment

  • purchasing and carrying out a recommended treatment or the items as noted in the Head Lice Detection Kit
  1. School communities have responsibility for:
  • developing school procedures to support the prevention of head lice infestations eg no sharing of combs, hats etc
  • supplying information to parents on the prevention, detection and treatment of head lice
  • alerting parents/carers of head lice infestation within the school and requesting parents/carers check their children regularly
  • requesting that the parents/carers keep their children at home until the infestation is treated and, preferably, all the eggs have been removed
  • supporting parents through practical advice and a sympathetic attitude to avoid social stigma

Principals and teachers should not check students’ heads for lice unless this is done as a part of an official head lice detection program. Any such program must be carefully implemented ensuring that the parent community is fully informed and that only those children are involved whose parents have given written consent. Schools wishing to run such programs are asked to contact their Schools Consultant in the first instance.

School Programs

Nitbusters

The Nitbusters program is a NSW Health initiative to tackle the issue of head lice in the community. NSW Health in conjunction with the NSW Federation of Parents and Citizens Associations, NSW Department of Education and Training and the University of Queensland has been conducting a statewide program on reducing head infestations in NSW primary school-aged children. The project, Nitbusters, educates school children and parents about head lice and how to screen for and treat them, as a community.

The Nitbusters website provides information about how to run a Nitbusters Day, about head lice and other useful information

The website address for Nitbusters is

Nitpickers – Head Lice Education and Prevention

The Nitpickers Program is a similar program to the Nitbusters program but exclusively promotes the comb and conditioner method. Comprehensive information about how to run a Nitpicker program in the school can be found on the website The organisers of this program provide various items such the Nitpickers Comb which comes accompanied by a comprehensive educational brochure, an information video for teachers and parents and a life cycle poster of head lice. Schools can obtain a discount for bulk purchase of the combs.

JamesCookUniversity – North Queensland

The James Cook program also recommends the comb and conditioner method. A Head Lice Information Sheet is available from the James Cook website

Guidelines for the Management and Control of Head Lice 2011page 1