How do you get head lice?

Head lice are a common problem, primarily affecting school-aged children and their families. If you have found head lice affecting someone in your family, you may be wondering how do you get head lice? In this article we will explore how these annoying critters move from child to child and family to family.

What are head lice?

Head lice are tiny, wingless insects that are found exclusively on the head and scalp of humans. There small size means it can often be difficult to tell what head lice look like. Head lice prefer to live close to the scalp where they can have access to feed on human blood. To many people, these pesky parasites are considered an annoyance but, unlike other parasites, head lice are not a public health hazard as they do not spread disease.


Who gets head lice?

Anyone can get head lice!1 Yet, head lice have been found to be more common in school aged children (4-11 years).1 Contrary to common misconceptions, head lice do not prefer dirty or clean hair. 1 It is thought misconceptions like these are why there is such a stigma around the catching of head lice, yet head lice have been around for as long as human have.

How do you get head lice

Head lice cannot jump, fly, or swim. So, how do these little critters manage to get around so easily? Head-to-head contact with a person who has head lice is how you get head lice. Here are some examples of occasions when head-to-head contact may occur:


  1. hugging or nuzzling someone2
  2. close contact sports
  3. children playing close together
  4. slumber parties
  5. taking selfies with others


Can you think of other opportunities for head-to-head contact to occur?

Although it is uncommon, there is also a slight chance you can get head lice by sharing clothing or belongings with a person who has head lice. It is not recommended to share the same pillows, sheets, towels, brushes, or clothing of someone you suspect has head lice.

Risk factors for catching head lice

There is evidence to show that those more at risk of catching head lice are:


  1. Girls – head lice have been found to more common in girls than in boys1
  2. People with long hair – long hair also increases the difficulty in treating head lice1
  3. Children with more siblings are at risk because there is more chance of head-to-head contact among siblings and more resources are needed to check for and treat head lice.1
  4. Families of lower socio-economic status – these families may struggle with poverty or are poorly educated which can make it difficult for them to recognise the signs of head lice or afford treatments. 1
  5. Poor communication – a lack of communication among families with children who have head lice can result in head lice infestations going undetected for longer.2


How do you know if you have head lice?

The diagnosis of head lice can only be done when a living, moving louse is found on the scalp or in the hair. There are lots of signs and symptoms of head lice. However, it is not enough to diagnose someone with head lice if they have an itchy head, as not everyone gets the itch symptom.

If you need help diagnosing head lice you can get some tips from your local pharmacy team who can explain how to do wet or dry detection which is a method for checking hair for head lice.

If you feel confident checking for head lice at home, you can use a technique called wet combing. You will need:


  1. A brush
  2. A nit comb (fine-toothed comb)
  3. Conditioner
  4. Tissues
  5. Hair clips
  6. Towel


Watch a short video of how to check your child’s hair using wet combing.


How to get rid of head lice

If you do find your child has head lice, there are simple steps you can follow to tackle the head lice infestation. There is no need to see your GP if you have head lice, as these days it is unlikely you will be given a prescription for medicated lotions or sprays that will help you eliminate head lice. The reason being that that treatments are widely available over-the-counter at your local pharmacy, supermarket or online.

If you are looking to eliminate head lice and nits you will find shelves full of options, such as:


  1. Nit combs for wet or dry detection and removal
  2. Insecticide lotions or sprays that kills head lice and eggs by chemical means
  3. Non-insecticides which kill head lice and eggs by physical means such as suffocation or dehydration are available as a mousse, spray, lotion or shampoo.


Choosing a treatment depends on how many people are infested, length and thickness of hair, and how much time and budget you are willing to spend.

If you need assistance in choosing a treatment, your local pharmacist will help you navigate the shelves of head lice treatment to find a solution that suits the needs of your family.

When head lice don’t disappear after treatment

There are several reasons why head lice come back after treatment. This may not always be due to resistance (treatment not working due to head lice resistance). Resistance to head lice treatments has been found to be more likely when using insecticide treatments. However, head lice are less likely to be resistant to non-insecticide treatments that kill head lice and eggs by physical means.

So, why are the head lice back after treatment? Ask yourself these questions before concluding that the treatment did not work:


If you used a non-insecticide medicated lotion, spray, mousse, or shampoo

  1. Did you leave the treatment on for long enough? (each treatment has a recommended leave on time depending on the ingredients)
  2. Did you have enough product to liberally cover all the scalp and hair (from root to tip)? – some products only have enough for mid-length hair, people with long thick hair may have to buy double to get enough coverage.


If you used wet combing

  1. Did you sweep the comb from scalp to tip?
  2. Did you wipe the comb in-between strokes?
  3. Did you sweep the comb through sections of the hair multiple times before moving onto another section?
  4. Did you repeat the wet combing on days 5, 9, 13 and 17?


Another reason head lice an nits have not cleared after treatment is the there is the possibility to you have been re-infested by a family member of friend. This is why it is important to check all members of the same household if someone at home has head lice or nits. It is also important to treat everyone in the same household who has been diagnosed with head lice on the same day.

Points to remember

1) You are more likely to get head lice from direct head-to-head contact with someone who is infested with head lice
2) You might not know you have head lice as not everyone gets an itchy head so, if you have school-aged children check their hair once a week
3) If you want to reduce the spread of head lice then avoiding activities that could increase head-to-head contact and do not share clothes and belongings on someone you suspect may have head lice.
4) There are many treatments available to help you eliminate both head lice and their eggs, but if you are struggling to choose one, your local pharmacist can help you find a solution that is right for you.



  1. NICE Clinical Knowledge Summary Head Lice 2016. Available at:!backgroundSub:3
  3. Demystifying Pediculosis. PEDIATRIC NURSING/September-October 2014/Vol. 40/No. 5. Available at: