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Head Lice

We often receive reports of headlice in school. Please make sure you check your children regularly, and treat as necessary so we can keep the incidence of headlice to a minimum.

Please note that it is necessary to repeat treatment several times in order to remove newly hatched lice. 

The following guidelines, issued by the NHS, give advice on the detection and treatment of headlice.

Introduction

Head lice are tiny grey-brown, wingless insects, which live by sucking blood from the scalp. Their eggs, known as nits, are laid glued to the base of hairs, and look like tiny white specks. The eggs hatch after 7 to 10 days, and 10 to 14 days after hatching the nymph louse is mature and between 2 and 4 mm long (the size of a sesame seed). Once mature they reproduce so numbers can grow alarmingly if not treated.

The head louse (Pediculus capitis) affects only humans, and cannot be passed on to, or caught from animals. Infestation with head lice is also known as pediculosis. Head lice are common in schoolchildren, particularly between the ages of 4 and 11, but anyone with hair can catch them.

Symptoms

Infestation often causes itching of the scalp, but may also go unnoticed. If you suspect head lice, check the base of hairs for eggs and comb the hair over a piece of white paper to see if you can spot any dark mature lice

Sometimes an infestation is marked by tiny red spots on the scalp.

The hair behind the ears and at the nape of the neck are favourite spots so lice and eggs may be spotted here.

Causes

Head lice are transferred by close hair-to-hair contact. They cannot jump, fly or swim, but walk from one hair to another. It is a misconception that head lice infestation is a result of dirty hair and poor hygiene; in fact, head lice prefer clean hair and skin. They like both long and short hair.

Lice can also be transferred by sharing combs, brushes and hats.

Diagnosis

The presence of head lice is indicated by repeated itching of the scalp, or by detecting them in the hair. This can be done using a special comb. Your GP or nurse can only confirm the diagnosis if a live louse is found in the hair.

If you or your children have head lice you should check the rest of the family, and alert close friends and your child’s school.

Itching is not always present because it is not caused by the bugs biting the scalp, but by an allergy to the bugs themselves. Some people are not allergic to them so may not notice they have been infested, and it can take up to three months after the initial infestation for an itch to develop.

Treatment

Head lice are difficult to remove because of their size, reinfestation rate, life cycle, and their ability to develop immunity to insecticides. Lice can be a persistent and recurring nuisance, so it is important to treat them quickly and thoroughly.

Once infestation is confirmed it can be treated at home either using wet combing with conditioner, or medicated lotions, combined with a special nit comb available from pharmacies.

Wet combing method

Wet combing, or ‘bug-busting’ is used to remove lice without using chemical treatments:

  • wash the hair as normal
  • apply conditioner liberally (this causes the lice to lose their grip on the hair)
  • comb the hair through with a normal comb first
  • with a fine tooth nit comb, comb from the roots along the complete length of the hair and after each stroke check the comb for lice and wipe it clean. Work methodically over the whole head for at least 30 minutes
  • rinse the hair as normal
  • repeat every three days for at least two weeks

This method can be helpful because head lice are growing increasingly resistant to the insecticides used to remove them.

Medicated lotion or rinse

Ask your pharmacist for an over-the-counter insecticide lotion or crème rinse. Apply the preparation according to instructions, and remove the lice and eggs with a fine-toothed nit comb. Care should be taken when applying treatment because they are usually toxic. The normal advice is to treat once, and repeat seven days later.

Always ask for advice before using medicated lotions on young babies (under 6 months), pregnant women or people with asthma, and always read the instructions carefully.

Sometimes complementary therapy treatments such as tea tree oil are recommended for treating head lice, but their effectiveness has not yet been proven.

There is no need to wash clothing or bedding specially – any lice found away from the scalp are likely to be damaged, dead or dying, and so unable to start a new colony.

Prevention

There is no prevention for head lice infestation other than normal hair care and checking hair and scalp periodically.

Tying back the hair of children with long hair, helps reduce the likelihood of contact between their hair and that of an infected child.

Do not use medicated lotions or rinses ‘just in case’, for example in close friends or family members. They should only be used if live lice are found. Regular combing of hair using the bug-busting method (see Treatment section) can help with early detection as well as treatment.