From littlies in day care who just love putting their heads together, right through to teens taking selfies (yes, , 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 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.

Other treatment options

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.

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.

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.

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On this page:

• Hayfever treatment options for children
• Saline nasal irrigation
• Antihistamines
• Eye drops
• Immunotherapy
• Other treatments

With symptoms including sneezing, a runny or blocked nose, itchy, watery eyes and itchy throat, hayfever can affect sleep and mood, impacting on school and learning, and quality of life in general.

Meanwhile, for children with asthma, uncontrolled hayfever can bring on asthma attacks, while controlling allergies can help prevent asthma developing.

Hayfever treatment options for children

Preventive measures are an important first line of treatment, which means identifying and avoiding the allergens causing the hayfever – for seasonal hayfever that’s usually pollens, while pet hair and dust mites are common allergens for ongoing symptoms. 

However, it’s not always practical or possible to avoid allergens, leading parents to seek other treatment options. And hayfever management for adults isn’t always appropriate for children.

The following treatments are considered suitable for children. Note that ages are those provided by manufacturers – in some situations, children younger than this may be recommended to take a particular medicine under medical supervision.

Saline nasal irrigation

As a first line of treatment, try saline nasal irrigation. It’s inexpensive and in many cases effective, helping reduce runny nose, congestion, nasal itching and sneezing. It’s the most gentle option, and suitable for babies from one month old. Try once a day, while bathing the child.

Kits for children are available at pharmacies, and contain a nasal irrigation bottle and sachets of pre-measured salt for mixing with warm water. A syringe or bulb applicator could be used instead, or you could buy ready-made spray.

Antihistamines

If saline nasal irrigation isn’t helping, your next port of call is antihistamines – either oral (tablets, liquid or drops) or nasal spray.

Oral

Antihistamines in tablet or liquid form are good for managing a range of symptoms. However even the newer ones may leave kids a little drowsy, especially when they first start taking them. Headaches and stomach upsets are other side effects.

Cetirizine (for example, Zyrtec) and loratadine (for example, Claratyne) can be used in children from one year old, and fexofenadine (for example, Telfast) in children from two years for hayfever. Ask your pharmacist for products in forms and dosages appropriate for children.

Nasal spray

An antihistamine spray may be a better alternative for children five years or older – they act in the nasal passages, work faster than liquids (within 15 minutes) and last up to 12 hours. Their main downside is they can leave a bitter taste – using before a meal or flavoured drink could help. A bleeding nose, nausea and headache are other possible side effects.

Unlike antihistamine tablets and liquids, nasal sprays don’t treat sore or itchy eyes – consider using eye drops if this is a problem (see below).

Azelastine (Azep) is suitable for children five years and older and can be used for up to six months uninterrupted. Levocabastine (Livostin and Zyrtec) can be used for children six and older for up to eight weeks.

Eye drops

For red, itchy or watery eyes associated with allergies, medicated eye drops can help.

Levocabastine (Zyrtec) eye drops are suitable for children six and older for up to eight weeks at a time, and help treat red, itchy and watery eyes. Azelastine is also available as eye drops (Eyezep), suitable for children four and older for use up to six weeks at a time.

Another type of eye drop is a decongestant and antihistamine combination – naphazoline hydrochloride and pheniramine maleate – found in Visine-A and Naphcon A. They can be used by children six and older, but only for a few days.

Immunotherapy

If your child’s hayfever is so severe it dramatically impacts on their quality of life, your doctor may recommend immunotherapy. This means having allergy testing, then taking regular doses of the allergens that affect you, starting with very small doses and increasing over time.

For children, sublingual (tablets or drops under the tongue) are often used, mainly for their convenience – they can be taken at home. Injections – which are cheaper – are also used.

While it might not ‘cure’ hayfever, immunotherapy can relieve the severity of symptoms and reduce the need for other medication. Talk to your doctor about immunotherapy options.

Other treatments

If antihistamines don’t help, corticosteroid nasal sprays may be worth trying, as long as your doctor agrees. They don’t work as quickly as antihistamines – it could take hours rather than minutes. They’re most effective when used regularly to maintain a steady dose over time, and reach maximum effectiveness after two to four weeks’ use. 

When nasal congestion is the primary symptom they have been shown to be more effective than antihistamines. However, side effects include nosebleeds, headaches and irritation of the nose and throat, and some nasal corticosteroids have been implicated in growth retardation in children.

Many over-the-counter products carry advice that they are not for children under 12,  however, your doctor may recommend a suitable one for younger children, and prescribe directions for use.

Oral and nasal decongestants are not recommended for children.

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