How to get rid of head lice

We comb through head lice treatments to help you get rid of nits.

Kate Browne

Alice Richard

Last updated: 12 January 2021

Head lice, nits, creepy crawlies, curse of the playground... whatever you want to call them, head lice are the scourge of parenting life.

From littlies in day care who just love putting their heads together, right through to teens taking selfies (yes, selfies can spread nits, according to at least one expert), head lice are regular visitors in many Australian homes.

Here's how to get rid of them.

How to treat head lice

No one product is 100% effective at removing head lice, and no product has been proven to 'repel' head lice in the first place – despite the claims you'll see on chemist and supermarket shelves.

But before you fall into a deep, itchy despair there is some good news, especially when it comes to your wallet. The most effective treatment option for mild infestations is also the cheapest: conditioner and a lice comb.

The most effective treatment option is also the cheapest: conditioner and a lice comb

The conditioner stuns the lice for up to 20 minutes and makes it difficult for them to grip the hair or crawl around. You can then mechanically remove them with a nit comb.

You'll need to repeat this treatment every few days for 10 days to break the lice life cycle. While it isn't fast, your child's hair will look soft, glossy and gorgeous after days of deep conditioning.

How to get rid of lice using conditioner and a lice comb:

Brush your child's hair while it's dry to get the tangles out.
Grab a bottle of thick, white conditioner and squirt it liberally over the hair.
Using the nit comb, work your way through the hair methodically, combing from root to tip. (You can divide hair into sections if it's particularly long or thick.)
Wipe the comb on some paper towel or a tissue after every stroke (you'll probably see lice and eggs in the conditioner).
Comb each section of hair several times, wiping the comb on paper towel after each stroke.
Once you're done, put the paper towel in the bin and wash the comb with detergent and hot water.

You'll need to repeat this process every few days for 10 days. The first treatment kills live lice, the second kills any young lice that have hatched in the interim.

Which lice comb is best?

Generally your best bet is a comb with metal, cylindrical teeth. But there's a bevy of options available and you may want to experiment to find the one that's best for you or your child.

Combs with metal, cylindrical teeth are gentle on scalp and hair, and when used with conditioner they remove most lice and most eggs. While more expensive than plastic, they last longer.
Combs with plastic teeth are gentle on scalp and hair, and when used with conditioner they remove most lice and some eggs.
Combs with flat metal teeth can damage the hair shaft, and when used with conditioner they remove some lice and few eggs.
Electronic combs (which kill or stun lice with an electric shock) should only be used on dry hair, and remove most lice, but no eggs. They can't be used on babies and shouldn't be used by people with epilepsy, heart disease or a pacemaker.

Terminology – nits vs lice

Lice

These are the actual little creepy-crawlies themselves. They can't fly, so they spread via direct head-to-head contact. Adult lice are 2–4mm long and they're a light brown colour.

Nits

These are the lice eggs. They're about the size of a pinhead, and can't be brushed off the hair like dandruff can.

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Other treatment options

Check for live lice or nits (the live nits will be 'cemented' onto the hair shaft close to the scalp and pop if squeezed) before resorting to insecticidal treatment. If you only have a mild case, the comb and conditioner method is the safest. But if that doesn't do the trick, you'll probably need to opt for an insecticidal treatment.

Insecticidal treatments are registered with the Therapeutic Goods Administration (TGA), which means they're evaluated as both effective and (relatively) safe. To make sure the product you choose is registered with the TGA, check for the AUST-R number on the label.

No insecticide will kill 100% of the nits (eggs), so you’ll need to re-apply the treatment seven days later. This kills the lice that hatched from the eggs that weren't killed the first time around.

Herbal head lice treatments contain various combinations of essential oils and herbal extracts. Most haven't been clinically tested or independently assessed for effectiveness or safety. If your child is heavily infested, you might want to try an insecticide-based product before going herbal.

Do they work? The short answer is maybe. If you're having no luck with insecticide treatments, some herbal treatments are worth a try. Many herbal ingredients have been shown to be effective in lab tests or small clinical trials (though not on children's heads).

Why isn't the treatment working?

Lice are wily creatures and they're becoming resistant to conventional insecticides, which is why resistance can vary region by region. The bottom line is: if one product ain't working, try another.

Other reasons a treatment might fail:

You're not using enough of it to cover the scalp and hair.
You're not repeating the treatment after seven to 10 days. (This kills any nits that have survived the first application.)
You're getting reinfested due to head-to-head contact with another person.

Kids can get reinfested through head-to-head contact.

How to stop head lice from coming back

The risk of transmitting lice by sharing hats, hair brushes or bed linen is low. NSW Health says you don't need to worry about washing these as head lice quickly dehydrate and die if they leave the head.

There's no evidence that anything you put on your child's hair will act as a repellent. Some studies suggest that because head lice are crawling insects that can't jump or fly, once they're on your child's head they can't 'choose' to leave, even if they want to.

There's not much you can do to keep head lice away (though tying up long hair can help)

So while there's not much you can do to keep head lice away in the first place (though tying up long hair can help), you can catch any new arrivals by running your lice comb and conditioner through your kids' hair once a week.

So as you grab your bottle of conditioner and get to work, it's good to remember that famous old Pantene TV commercial: when it comes to lice removal, "it won't happen overnight, but it will happen".

And as a consolation for the hours of combing, maybe you can spend what you save on expensive head lice treatments on a nice bottle of wine or chocolates, just to keep your spirits up while you get to work with the comb.

We care about accuracy. See something that's not quite right in this article? Let us know or read more about fact-checking at CHOICE.

Stock images: Getty, unless otherwise stated.

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