Confirming You Have Lice

Head lice are small (sesame seed sized), greyish-brown insects that live close to the scalp. Nits (eggs) are tiny white or yellow oval specks cemented to hair shafts close to the scalp — unlike dandruff, they do not flake off when you brush. Common symptoms: itching (especially behind ears and at the nape of the neck), feeling of movement in hair, difficulty sleeping (lice are more active in the dark).

Step-by-Step Treatment

  1. 1

    Choose an effective treatment

    Dimethicone-based products (e.g. NYDA, Hedrin): physical treatment — silicone oil smothers lice. Effective and no resistance issues. Permethrin-based products (e.g. Lyclear): insecticide treatment. Effective but some lice have developed resistance in certain areas. Ask a pharmacist which is recommended in your area. Both are available over the counter.

  2. 2

    Apply to dry hair

    Most treatments work best on dry (not wet) hair. Part the hair into sections and apply the treatment thoroughly, making sure to cover from roots to tips. Pay extra attention to behind the ears, the nape of the neck and the crown — where lice prefer to live.

  3. 3

    Leave for the directed time

    Follow the product instructions exactly — typically 8–12 hours (overnight works well) for dimethicone, or 10–30 minutes for permethrin. Do not rinse early.

  4. 4

    Rinse and comb with a nit comb

    Rinse the treatment out. While hair is still wet with conditioner, comb through every section with a fine-tooth nit comb. Work from roots to tips, wiping the comb on a white paper towel after each stroke to check for lice and eggs. This is tedious but essential — do not skip it.

  5. 5

    Repeat after 7–10 days

    Most treatments kill live lice but not all eggs. Repeat the full treatment 7–10 days later to catch newly hatched lice before they can lay eggs themselves.

Treating the Home

  • Wash bedding, pillowcases and recently worn clothing at 60°C or above
  • Put items that cannot be washed (stuffed toys, hats) in a sealed bag for 2 weeks
  • Soak hairbrushes and combs in hot water for 10 minutes
  • Vacuuming soft furnishings is helpful but lice rarely survive off the head for more than 24 hours
Check all household membersLice spread through head-to-head contact. Check everyone in the household and treat simultaneously if lice are found on more than one person.

Frequently Asked Questions

Theoretically yes, but it is rare. Lice spread almost exclusively through direct head-to-head contact — not through the environment. They cannot jump or fly, and they do not survive off the head for more than about 24 hours. The main risk is physical contact between heads, most common in young children playing together.
Check everyone but only treat those who actually have live lice. Treating people who do not have lice is unnecessary and can contribute to resistance. Check carefully using a fine-tooth comb on wet, conditioned hair — this is the most reliable detection method.