Dr Julia Driscoll looks at ways to detect, treat and help prevent head lice in children.
What Are Lice?
Lice are blood-sucking bugs about 1.5mm long fully grown. They cling with their claws to the hair shaft and lay eggs (nits) that adhere to the hair and hatch in about seven days. Lice are attracted to the warmth of scalps, and are commonly found at the sides of the head near the ears and at the nape of the neck, where it is warmest. While there may be egg casts further along the hair shaft, the eggs are within about two centimetres of the scalp, and may look like dandruff.
Lice suck miniscule amounts of blood from the scalp, and without it will dehydrate and die within about a day. Unlike fleas, lice can't infest carpets, rugs or upholstery, and although they are unpleasant and annoying, they don't cause illness or disease.
Children are more prone to lice than adults because the bugs are more likely to spread in the kinds of close-contact group settings in which children spend their time, such as school and childcare, and then be passed on to siblings. Lice infest all kinds of hair, and children with clean hair are just as susceptible as those with dirty hair.
How Can I Tell If My Child Has Lice?
Children may have lice if they:
- Complain of itching on the scalp
- Continually scratch the scalp
- Have inflamed skin from scratching
However, some children may have no symptoms.
How Can I Get Rid Of Lice?
Hair conditioner stuns lice, which can then be combed out of the hair, preferably with a fine-metal-tooth comb. This method can be used on any family member to check for lice. There are shampoos that kill lice, but they need to be repeated about seven days after the first application to destroy lice that have since hatched. Lice have also become resistant to some treatments, so check your child's hair thoroughly afterwards.
Avoid using treatments, such as flea wash or kerosene, that are not approved for controlling lice, and ensure approved treatments are suitable for the child's age and skin type.
Sometimes it can help to follow treatment with a hot blow-dryer or heated flat iron to remove hard-to-shift eggs, as extreme heat seems to break the bond adhering the nits to the hair shaft.
How Can I Prevent Lice Spreading?
Lice can crawl from scalp to scalp, so children with lice may be required to stay away from school or childcare until treated. Avoid sharing hats, hair ties and hairbrushes where lice may have transferred from the head less than a day earlier, and change pillow cases (there is no need to change sheets).
For children with long hair, put it in plaits or a bun to prevent contact with other children's hair. You could also use a conditioning spray or make your own with conditioner (100mL), tea tree oil (5mL) and water (400mL). Mix and pour into a spray bottle. This will help lice slip off the hair shaft.
Dr Julia Driscoll is a family GP and mother of three children with special interests in paediatrics, women's health and mental health.