How long can lice live on bedding

Which means the bedding is almost never how lice spread, and the extensive house cleaning people do is mostly wasted effort at a time when they have plenty else to do.

How they actually spread

Direct head-to-head contact. That is overwhelmingly it. Lice cannot jump or fly, and they crawl, so they need heads to touch.

This is why they circulate among primary school children, who put their heads together constantly, and why the usual route into a household is a child rather than the furniture.

Sharing hats, brushes and pillows is frequently blamed and is a far less common route than head contact.

Lice are not a sign of poor hygiene and have no preference for clean or dirty hair. That belief causes unnecessary embarrassment and delays people telling the school, which is what actually stops it circulating.

What to do with bedding

Proportionate, on the day of treatment:

Wash pillowcases, sheets and towels used in the last two days at 60 degrees and tumble dry hot. Heat kills lice and eggs.

Anything that cannot be washed hot, seal in a bag for 72 hours, which comfortably outlasts their survival time.

Vacuum where heads rest, sofas and pillows, and empty it afterwards. Precautionary rather than necessary.

You do not need to wash every item in the house, replace pillows or mattresses, treat furniture with insecticide, or hire a cleaner.

For the mattress specifically: strip it, vacuum the surface, and leave it. Do not steam clean, because it drives moisture into the fillings, can void the guarantee, and is disproportionate for an insect that dies on its own within two days.

What actually treats them

The head, not the house.

Wet combing with conditioner and a fine-toothed detection comb, done thoroughly, repeated every few days over a couple of weeks to catch newly hatched lice. Free apart from the comb, and effective if done properly.

Treatment lotions from a pharmacy. A pharmacist can advise on what suits the age of the child, and most need repeating after around seven days to catch anything that has hatched since.

Check everyone in the household on the same day, and treat only those who have live lice, not everyone as a precaution.

Tell the school or nursery. Unglamorous, and it is the thing that stops reinfection from the same group of children.

Children do not generally need to be kept off school.

Nits are not the same as lice

Worth separating, because it changes what you are looking for.

Lice are the live insects, about the size of a sesame seed, grey-brown, and they move and avoid light.

Nits are the egg cases, glued firmly to the hair shaft close to the scalp. They do not brush out the way dandruff does, which is the practical way to tell them apart.

Empty white nits further down the hair shaft are old and are not evidence of a current infestation. Treating on the basis of those leads to repeated unnecessary treatment.

Only live lice mean a live problem. If you are unsure, a pharmacist can tell you.

If it is not lice

Persistent itching that is not lice has other common causes.

Scabies causes intense itching that is worse at night, frequently between the fingers, and needs treatment from a GP or pharmacist for the whole household.

Bed bugs leave small dark spots along mattress seams and bite exposed skin, so the evidence is on the bed rather than only on the person.

Dust mite allergy causes congestion, sneezing and itchy eyes rather than scalp itching, and responds to hot washing and encasements.

Eczema and dry scalp, which worsen at night as skin warms.

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