How to get rid of headlice

Head lice eggs generally hatch 7 to 10 days after being laid on the hair shaft (the part of your hair closest to the scalp), so it’s important to break the reproductive cycle of the head lice. Even if only one or two adult lice are missed, they can lay about 6 eggs per day, and the cycle of outbreaks will continue.

10-day hair conditioner method

Just as you can use the hair conditioner method to check for head lice, it can also be used to get rid of them.

You will need:

• Any type of hair conditioner, including generic ‘home’ brands. Using white hair conditioner makes it easier to see the head lice.
• A metal or plastic fine-tooth ‘nit comb’ (available from most pharmacies).

What do I do?

• Comb through with an ordinary comb or brush to remove tangles (then wash the brush or comb in hot water to make sure you don’t transfer any live lice to someone else).
• Apply plenty of hair conditioner to dry hair until it is saturated.
• Section and comb the hair thoroughly with the nit comb in 4 directions – forwards, backwards, left, and right.
• Wipe the comb on a white paper towel to check that the dark adult lice or the paler hatchlings (young lice) are being removed. You may need a magnifying glass and good lighting to see them.
• Continue combing the hair in sections until the whole head has been checked.
• Some eggs will be removed by combing but you may need to use your fingernails to remove as many eggs as possible from the base of the hair shaft near the scalp. Hatchlings that emerge from missed eggs will be removed by combing with conditioner over the 10-day period. Only eggs within 1cm of the scalp will hatch. Eggs that have grown further out with the hair shaft will have already hatched or died.
• When you have finished checking, rinse the conditioner out and dry the hair.
• Repeat this process every 1 to 2 days over the 10-day treatment period. To save time during a school week, consider this combing schedule: Tuesday, Thursday, Saturday, Sunday, Tuesday, Thursday.
• Check the waste material you comb out for adult head lice each day after combing. If any are found, this indicates a new outbreak and you will need to start again from day 1, as new eggs may have been laid by the adult lice.
• Check for head lice once a week for at least 4 weeks after you complete the 10-day treatment. Doing this on a weekend may be easier than on a busy weeknight. Applying plenty of hair conditioner makes combing easier and more effective.
• ‍Check all other household members for head lice and treat as necessary.
• Signs your child has headlice

Commercial head lice treatments

There are many headlice treatments available over the counter. If you are not sure which is the best for you, ask for advice from your local pharmacist.

Using an insecticide treatment

• Before using the insecticide, rinse out any hair conditioner as it may stop the insecticide from working. Follow the product information and instructions.
• Lift the hair in sections and saturate the hair with the insecticide.
• Comb the insecticide through with an ordinary comb from the scalp to the ends of the hair. Work from the back of the head to the front. Pay particular attention to treating behind the ears, at the back of the neck and close to the scalp.
• Leave the insecticide on for the time recommended in the product information, then wash out.
• Section the hair again and comb through with a metal fine tooth nit comb to remove dead lice and eggs.
• Check that the head lice are dead. Do this straight after the recommended treatment time and again the next morning. It may take a few hours for all the lice to die. Remember, if any head lice are found still alive the next morning, re-treat the hair the same day with another type of insecticide (for example, permethrin, pyrethrin or malathion), not a different brand of the same type of insecticide.  

Alternatively, change to the 10-day hair conditioner treatment.  

Check all other household members and close contacts for head lice and treat as necessary. There is no need to treat anyone unless they also have head lice.

Warning

To avoid adverse reactions the following people should not routinely use insecticide head lice treatments:

• Babies under 6 months
• People with asthma, epilepsy, insecticide allergies, scalp conditions or very sensitive skin
• Women who are pregnant or breast-feeding.
• People who cannot use insecticides should use the 10-day hair conditioner treatment instead.

Key points about insecticides

• No insecticide is guaranteed to kill all eggs. Eggs which are not killed or removed manually will hatch 7 to 10 days after being laid.
• Following insecticide treatment, remove as many remaining eggs as possible with your fingernails. Use a magnifying glass in strong light, and concentrate on ‘live’ eggs, which are found within 1 cm of the scalp.
• If insecticide alone is used, it should be applied on days 1, 7 and 14 to kill any hatchlings before they lay more eggs. However, if after the first insecticide treatment the 10-day conditioner method is used, there is no need for the second and third insecticide treatments.
• To prevent skin irritation, do not repeat insecticide treatment more than 3 times, 1 week apart.
• Some head lice may be resistant to an insecticide and will still be alive the morning after the treatment. If this happens, thoroughly wash out the first insecticide and either use a different type of insecticide treatment (speak to your pharmacist for advice) or change to the 10-day hair conditioner treatment instead.

If treatment is unsuccessful:

• Did the chosen treatment cover the 10-day hatching cycle of the eggs?
• Did you check the waste from the comb for adult head lice (indicating new outbreaks) over the 10-day period?
• Were as many eggs as possible removed every day?
• Was hair conditioner applied to dry hair, not wet?
• Was enough hair conditioner applied to saturate the hair?
• If an insecticide was used, was it applied exactly as instructed and for the recommended application time?
• Was a metal fine-tooth nit comb used?

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Source: healthywa.wa.gov.au

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