You find head lice by combing wet hair with conditioner and a fine-toothed comb over a sheet of white paper. If you find live lice, treat with a product from the apotek (pharmacy) according to the instructions, repeat after a week and comb the whole family. Lice spread only head to head, they don't jump, and they have nothing to do with hygiene. Your child goes to förskola (municipal preschool, from age one) as usual once treatment has started.
The notice in the förskola hallway says there are lice in the group, and that evening the six-year-old is scratching the back of his neck. You can feel your own scalp starting to itch too. Head lice are one of the most unpleasant and least dangerous things in family life. They do no harm, spread no disease, and you can be rid of them in two weeks if you do the right things in the right order. Here is the order.
How to find them
- Wet the hair and use plenty of conditioner. The conditioner stops the lice moving and lets the comb glide.
- Comb with a nit comb from the apotek, close to the scalp, section by section, from the nape forwards. Wipe the comb on white paper or rinse it in the basin after every stroke.
- Look for lice: greyish brown, two to three millimetres, moving. And for nits: small pale eggs glued to the hair shaft close to the scalp, within a centimetre, which can't be brushed away like dandruff.
- Behind the ears and at the nape of the neck are the most common spots. Look extra carefully there.
- The whole family the same evening. By the time you find lice, they are often on more than one child.
Itching is a late sign; it only starts after a few weeks when the skin reacts to the bites. A child can have had lice for a month without scratching. That is why combing helps more than waiting for symptoms, and why many schools hold a joint combing week at the start of term.
The treatment
- Only if you have found live lice. Nits alone, far out on the hair shaft, may be old empty eggs.
- A product from the apotek. Most contain dimethicone and suffocate the lice, and they work, unlike the old products the lice have become resistant to. The apotek knows which one suits your child's age.
- Follow the instructions exactly, especially how long the product should stay in and how much to use. A common mistake is too little product in thick hair.
- Comb out dead lice and nits with the nit comb afterwards.
- Repeat after seven to ten days. The product doesn't always kill the eggs, and new lice hatch. The second treatment is not optional.
- Comb once a week for three to four weeks afterwards, until you have found nothing on two combings in a row.
What needs doing at home, and what doesn't
| Do | No need |
|---|---|
| Wash bedding, hats and towels used in the last 24 hours at 60 degrees | Deep-clean the whole home; lice die within a day without a head |
| Put brushes and hair ties in hot water for a while | Throw away pillows, soft toys and hats |
| Tell the förskola, the school and close friends' families | Keep your child at home |
| Comb everyone in the household the same day | Treat family members who don't have lice |
| Put long hair in a plait for the next few weeks | Cut the hair |
Förskola and school
Your child goes to förskola or school as usual as soon as you have started the treatment. There is no recommendation to keep children at home for lice, and it wouldn't help, because the other children have already been exposed. What breaks the chain is every family combing at the same time, which is why it matters that you say something. It is embarrassing for ten seconds and saves weeks of reinfestation. Also ask about any friends your child has recently had sleepovers with.
Why do they come back?
Three common reasons. The second treatment was skipped, so the eggs that survived hatched. Someone in the family or the förskola group was never treated, and your child caught them again. Or the product was used too sparingly or for too short a time. None of these has anything to do with dirty hair or dirty homes. Lice are just as happy in freshly washed hair; all they care about is warmth and closeness, and children of förskola age are the closest there are.
What doesn't work
Oil, mayonnaise, a hairdryer on high heat and washing the hair often. None of these kills lice reliably, and some of them can damage the scalp. The older type of lice shampoo, with insecticide, works less well today because the lice have become resistant. What works is a product that physically suffocates the lice, the right amount, the right time and a second round. Boring but true.
Seek medical care?
Almost never. Head lice are not an illness. Call 1177 (the national healthcare helpline) or ask the apotek if your child has scratched so much that the scalp has become infected, with redness, swelling, weeping sores or swollen glands in the neck, or if you have treated twice according to the instructions and are still finding live lice. For children under one and pregnant women, ask the apotek which product is suitable.
How we do it with our families
The lice hunt is a job that suits a nanny, because it needs doing thoroughly and the child needs keeping in good spirits for twenty minutes. Denise has combed many heads: she sits the child in front of a film, takes the conditioner, combs section by section and shows the child what lands on the paper, because children find it more exciting than disgusting. On her note she writes whether she found anything, and whether the second treatment is due next week. The same nanny every week can also remind you about the combing three weeks on, when everyone else has forgotten.
This article is general information and does not replace advice from BVC (the child health clinic every family is enrolled in), your vårdcentral (local health centre) or 1177. If you are worried about your child, call 1177. In an emergency, call 112.
Would you like a nanny who knows your child, knows what is normal for them and notices when something is different? Book a free first meeting with the nanny in your home.
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Frequently asked questions
How do you spot head lice?
By combing through wet hair with conditioner and a fine-toothed comb over white paper or a basin. The lice are greyish brown, two to three millimetres long, and the eggs, called nits, are glued close to the scalp, often behind the ears and at the nape of the neck. Itching only starts after a few weeks, so comb rather than wait for the itch.
How do lice spread?
Only through direct head-to-head contact, when children lie close together, play or look at the same screen. Lice cannot jump or fly, and they survive only a day away from a head. Hats, pillows and brushes are a very unusual route of infection.
Does my child have to stay home from förskola?
No. Your child goes to förskola as usual as soon as treatment has started. Tell the staff so they can ask other families to comb the same week. That is how you break the chain, not by keeping your child at home, because the other children have already been exposed.
Which product should we use?
The products sold at the apotek, often with dimethicone, which suffocates the lice. The apotek will guide you on which one suits your child's age and how to use it. Follow the instructions exactly, especially the timing, and repeat after a week. Home remedies with oil or mayonnaise are not reliable.
Should the whole family be treated?
The whole family should be combed, but only those with live lice are treated. Lice products are not something you use preventively. Comb everyone in the household the same day and then once a week for a few weeks, so you catch any eggs that have hatched.