Nits and Head Lice: Treatment That Actually Works
Head lice are tiny wingless insects that live on the human scalp and feed on small amounts of blood. Nits are their eggs, which stick firmly to the hair close to the scalp. Head lice are very common in primary school children, spread through head to head contact, and are harmless.
They cause itching, but they do not carry disease and are not a sign of poor hygiene. In fact, lice are perfectly happy on clean or dirty hair, so catching them says nothing about how often a child washes. Almost every family with school aged children will deal with head lice at some point, and with the right method they are straightforward to clear, even if it takes a little patience and repetition.
This guide explains why head lice have nothing to do with cleanliness, how to check for them, the conditioner and comb method that works, how medicated treatments fit in, and how to treat the whole household so the lice do not simply come back.
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It is worth saying clearly: head lice have nothing to do with cleanliness. They cannot fly or jump, so they spread almost entirely through direct head to head contact, which is why they pass so easily between children playing closely, taking photos together, or sitting side by side. They can occasionally travel on shared hats, brushes or pillows, but this is far less common than person to person contact.
Because lice do not care whether hair is freshly washed, no amount of extra bathing will prevent or cure them. This puts head lice alongside other common, harmless childhood conditions that worry parents but say nothing about their care, such as molluscum contagiosum, a viral skin condition that also spreads through ordinary contact. Try not to feel embarrassed if your child brings home lice, as it is a normal part of childhood. Treating it calmly and promptly is what matters most, and letting the school know helps other families check and treat at the same time.
The most common sign is an itchy scalp, particularly behind the ears and at the back of the neck, though some children feel nothing at all. An itch on its own is not proof, because a dry or sensitive scalp can also cause itching. Conditions such as eczema in children can feel similar, so it is worth confirming before you start any treatment.
The surest way to check is to look for live lice, which are small, fast moving and about the size of a sesame seed, and for nits, the tiny eggs glued to individual hairs near the scalp. Unlike flakes of dandruff, nits cannot be flicked or brushed off easily. The clearest way to find live lice is the conditioner and comb method described below, because the conditioner slows the lice down and makes them much easier to see on the comb. Checking under a bright light, or outside in daylight, makes the whole job quicker and more reliable.
The conditioner and comb method is the recommended first line for treating head lice, and it works without any chemicals. Start by covering dry hair generously with white conditioner, which stuns the lice and stops them moving. Then, using a fine tooth nit comb, comb from the scalp to the ends in sections, wiping the comb on a tissue or paper towel after each stroke to see what you collect. White conditioner makes the dark lice much easier to spot against it.
Work through the whole head methodically, then rinse. The key is repetition: repeat the process every three to four days, and keep going until you have found no lice for ten days in a row, which covers the time it takes any newly hatched eggs to appear. This patient, consistent approach clears most cases on its own. Our families and kids help centre has more practical guidance for parents managing everyday childhood conditions like this one at home.
If the conditioner and comb method is not clearing the lice, or you would like to use it alongside a product, medicated head lice treatments are available from a pharmacy. These are described here as a class only, and it is important to follow the instructions carefully and always repeat the treatment after seven days, because most products kill only the hatched lice and not the eggs. A word on resistance: in some parts of Australia, certain chemical treatments no longer work as well as they once did, because lice have become resistant to them. Combing, by contrast, stays effective when it is done thoroughly and regularly, which is why it remains the backbone of treatment.
On school, children can return as soon as treatment has started. There is no need to keep them home, and no exclusion period applies for head lice. Rules can still vary between states and territories, so check your own state's guidance. Our guide to children's health and telehealth explains how a GP can support you with everyday concerns like this one.
See the same doctor each time
Head lice move between people in a household, so the most effective approach is to check everyone on the same day and treat every person who has live lice at the same time. Treating only one child while lice quietly move between siblings is the most common reason an outbreak drags on for weeks. There is no need to treat people who do not have lice, and no need to fumigate the house. Simply wash recently used pillowcases, hats and hair brushes in hot water.
Head lice rarely cause any real harm, so there is no cause for alarm. Occasionally, though, constant scratching can break the skin on the scalp and let in a skin infection. Our guide to impetigo, or school sores describes what that can look like. See a doctor if the scalp becomes red, weeping, crusted or tender, if the glands in the neck swell, or if your child seems generally unwell, as these can point to an infection that needs treatment.
Abby Health is an online-first clinic, so you can talk to an Australian GP from home, seven days a week, if you are unsure whether it is head lice, if treatments do not seem to be working, or if a scratched scalp looks infected. Over video, a doctor can talk through the comb method, advise on treatment options, and check whether an irritated scalp needs anything more. You can choose to see the same doctor each time, so your family's history is understood.
Booking is simple, and our help centre explains how to book an appointment on Abby. If managing an outbreak means you need time away from work, we can also help with a medical certificate. Book through our everyday family clinic when it suits you. Bulk billed for eligible patients with a valid Medicare card. Strict eligibility criteria apply. This is general information only and not a substitute for personal medical advice. If your child is seriously unwell or a scalp infection is spreading quickly, call 000.
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