St Joseph s Memorial School

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1 St Joseph s Memorial School Head Lice Information Sheet Head lice are tiny insects that lay their eggs on hairs next to the scalp. If your children have head lice, it does not mean that they are dirty. The only health problem arising from lice is that their bites are very itchy, and the skin can become infected from scratching. What are head lice? Head lice are tiny insects without wings. They are about 2-3 mm long, with 6 legs, each with a claw at the end. They crawl quickly, but do not hop, jump or fly. They are able to move fast on the scalp, so they are often hard to see. It is the nit (egg) which is usually the sign that someone has head lice. They feed on human blood, and need the warmth of a human scalp to live. Each female louse can lay 150 to 300 eggs, starting from about 2 weeks after hatching. They cannot live for long away from the human head. Lice found on carpets, bedding or soft toys are either old, sick or dead. A head louse on a fingernail Nits and hatched eggs The eggs (nits) are firmly stuck to the hair, right at the bottom where the hair joins the head. They are a yellow-white colour and less than 1 mm long. They hatch about 7 to 10 days after they are laid. If they are more than 10 to 15 mm from the scalp (further along the hair) they are dead or hatched. Hatched eggs stay stuck to the hair. They are white, flat and usually easy to see.

2 How do head lice spread? Head lice mainly spread through close head-to-head touching. They may be spread through sharing brushes and hats. They are not likely to be spread through bedding, furniture or carpets, as they cannot live and lay eggs away from a warm human scalp. How to tell if you have head lice If you think you or your child may have head lice, look very carefully at the scalp and hair. Look for live eggs and lice, especially around the ears, at back of the neck and under fringes. A good light (such as sun light) and magnifying glass will help, because head lice and eggs are very small. Sometimes you can see tiny spots of black (lice poo) on pillows and collars. Eggs may have a gritty feel when fingers are run through the hair. Head lice treatments The Department of Health in South Australia recommends a combination of using a comb to remove lice and nits (the 'wet-combing' method described below is probably the easiest) combined with a chemical treatment. There are several different types of chemicals, and they need to be used in different ways. They should be used exactly as described on the labels. You can get advice about which treatments to use from your chemist or family doctor but check the costs, as some cost a lot more than others that work just as well. You can get lotions, foams or shampoos. It is important to use them exactly as it says on the container. Some may need to be on for at least 8 hours, while some need only a few minutes. Heat can stop the treatment from working - so do not use a hair dryer on the hair after you have treated the lice. Leave at least 24 hours between using hair conditioner and using head lice treatment because chemicals in the conditioner may stop the treatment working well. Always treat again 7-10 days after the first treatment to kill any lice that hatched after the first treatment. Not all unhatched eggs will be killed by the treatment. Repeating the treatment kills the newly hatched lice before they start laying eggs. Check everyone who has been close to the person with the head lice, especially family members, including adults. Treat them if there are signs of lice. Adults can get used to head lice and not know they have them, so they keep re-infecting the children. Do not treat people who do not have lice. Check eyebrows and eyelashes as well as hair. Treatments for head lice include maldison, pyrethrins and permethrin.

3 Wet Combing Wet combing works for about 40% of families. It must be done on alternate days for at least 3 weeks, until there have been no live lice found for two times. It needs to be repeated many times because it does not kill the eggs. Each lot of newly hatched lice need to be removed before they can lay more eggs. The idea is to quickly smother the lice to prevent them from moving and then to remove them by hand before they can mature and lay more eggs. Wait for at least 24 hours after using a chemical treatment before using conditioner on the hair, because the conditioner can stop the chemical treatment from working well. 1. Apply a large amount of hair conditioner to the hair. A cheap one is OK. 2. With the conditioner still on the hair, use an ordinary comb to comb the hair and get rid of tangles. 3. Carefully comb every part of the hair with a fine tooth head lice comb. (You can get this from a chemist or local council). Place the comb flat against the scalp and comb from the scalp towards the tips of the hair. 4. After each stroke of the head lice comb, wipe the comb with a tissue or kitchen paper towel and look for lice on the tissue. 5. Comb each section of the hair 4 times. 6. Keep doing this until all the hair has been combed with the head lice comb. 7. Wash the conditioner out of the hair (having a shower may be an easy way to do this). 8. Wash combs in hot water. When treatment does not work This can be caused by: not using the treatment exactly as the directions say. not repeating the treatment 7-10 days after the first treatment. catching head lice again from someone else (treatment does not prevent getting lice, it only treats what is there). the head lice may becoming resistant to the chemical used. Check all family members. They may have lice without itching. Do other things which may stop children catching them again from other children, like plaiting long hair or tying it back tightly, making sure children do not share hats and brushes, telling them how lice are spread. If it seems that the treatment has not worked try a different one. Sometimes head lice become resistant to one treatment. Treatments are sold by several different companies. Check whether a different treatment has a different chemical. It could be the same chemical with a different brand name. The places that have been bitten can go on itching for several days after the lice have been killed. Check whether live lice and eggs are still there and it is not just the itch. See your doctor if the head lice are still there after you have used two treatments.

4 Managing head lice o o While the head lice may be adequately killed by the chemical treatment, some people want to be very sure that their family, or others, cannot catch the lice from bedding, towels, clothes, toys, furniture or carpets. Any live lice will be killed by heat. Washing in hot water (over 60ºC), or putting bedding etc. into a hot tumble dryer, or ironing clothing or bedding will kill lice. Use of pesticide bombs' or steam cleaning carpets is not needed. Vacuuming is sufficient. You could put soft toys or other items that cannot be washed or ironed into a plastic bag, and leave them in the sunshine for 2 or 3 days. Removing nits While dead nits do not need to be removed to stop the head lice spreading, most people think they should be removed. It is difficult to remove nits, as they are strongly glued to the hair. Use a fine toothed comb. Metal is probably better because it can cut the individual hair at the point where the nit is attached rather than trying to unglue the nit. Nits can also be picked out by hand. Warm vinegar dabbed onto the hair may help unstick the nits from the hair. Alternative treatments. Many parents do not want to use chemical treatments even when they are claimed to be safe. Many 'natural' head lice treatments have chemicals in them that are the same as the treatments recommended above (many have pyrethrins). Others have chemicals which have not been proven to be safe, but some may be both safe and effective. We are not in a position to recommend or criticize these treatments. There are several ways of removing lice without using chemicals, and they can be effective for some families. Hair Gel This has been found to work for some people, presumably by interfering with how the lice move, perhaps preventing mating. Robi Comb** This is a battery operated comb that is used on dry hair and kills or knocks out the lice with small amounts of electricity. The comb then removes the lice from the hair. To use it successfully, you need to use it often - 10 to 15 minutes every day for 2 weeks to break the breeding cycle of the lice. It also needs to be carefully maintained to work well. The Robi comb does not kill the nits. Nitpickers Comb** Some people who have used this say that it works well and saves time. The comb has rounded teeth so it does not tear the hair. The Nitpickers comb is available at a growing number of chemists and pharmacies and local councils.

5 Hair cutting Short hair is easier to treat and comb, but shaving the head and cutting long hair is not necessary. In some communities shaving the head is acceptable. This does protect a person from getting head lice. ** Any products referred to in our health topics are usually well-known brands readily available in Australia. The brand names are given as examples only, and do not necessarily represent the best products, nor the full range of effective products on the market. Preventing head lice It is very important to remember that head lice are harmless, but they also cause a lot of distress. Instructions to children like the ones below might lessen the risk of getting head lice but it is more important for children to interact with other children in natural ways. Avoid direct head-to-head contact. Don't share brushes, combs, ribbons, hats, helmets, hair ties, or 'dress-up' clothes. Discourage children from playing with each others' hair. Keep long hair tied back or plaited. Check hair regularly (children and adults). Have a look at the topics on the Kids' Health site for ideas about how to help children learn about head lice. Do not use the chemical treatments to try to prevent getting head lice. They don't work (head lice can be caught again within hours of treatment), and using them often will increase the amount that children absorb. Resources South Australia There is a lot of excellent information for parents, schools and health professionals on the South Australian Public and Environmental Health site. This includes printable pamphlets, posters, policy drafts and where to get access to videos and teaching material, and information in many different languages. Treatments are expensive HEAD LICE MYTHS AND FACTS A treatment does not have to be expensive to be effective a very cheap conditioner through the child s hair and combed out with a head lice comb, section by section is effective. All this requires is your time. My child doesn t have any head lice, just eggs, so doesn t need treatment. Head lice are not easily spotted, eggs are easier to see If eggs are dead, they do not attach to the hair bit can be flicked away. Dead eggs do not require treatment Live eggs are firmly attached, close to the scalp and are very difficult to remove by hand. this requires treatment Head lice jump from head to head Head lice crawl very quickly, they do not jump, fly or hop. Head lice spread through head to head contact

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