Head Lice: A Survival Guide

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As if the pressures of starting or returning to school or nursery weren’t enough, coughs, colds and snotty noses seem to dominate yet there is a sinister little creature waiting in the wings to hop on and mix things up a little. Head lice, the dreaded guests who move in and squat until forcefully evicted!

To put it simply, head lice are small insects that live on the scalp and in between human hair strands. Lice are more common in children than in adults however, parents, siblings and others in close contact with a child who has head lice can also become infested.

Who’s who?

Head lice are brown, grey or whitish in colour and when they first hatch, they can seem smaller than a pinhead. Once fully grown, they can represent the size of a sesame seed or slightly larger in some cases. Lice cannot fly, swim or jump and are usually spread through direct head to head or upper body contact. In some cases, they may transfer from clothing items, hairbrushes or pillows for example. It is important to note that lice can affect those with good or poor hygiene. Head lice do not discriminate, one head is as eagerly coveted as the next. All hair lengths, types and conditions can be affected. Head lice cannot be transferred to or be passed from an animal to a human.

The nitty gritty

The eggs laid by lice are called nits. The female head louse will lay her eggs, fusing them to the hair shaft, usually close to the base of the hair strand or root. The scalp will then keep the eggs warm until they’re ready to hatch. These pinhead size eggs are often brown in colour and can be seen throughout the scalp surface but quite often in clusters around the temple, behind the ears and at the base of the neck.

Once hatched, the eggs will appear whitish in colour. These can be difficult to remove, whether live or hatched and it is useful to have a specific lice combe that has a particularly fine toothed design to trap and scrape the eggs off the hair shaft. This process of removal can be a time consuming and challenging exercise, particularly when trying to treat young children who would prefer not to sit still! Nits or empty shells may remain on the hair well after treatment. Their presence does not indicate infestation and they will come off it time with regular washing and brushing. Live head lice are the only way to confirm true infestation.

What’s all the fuss about?

Head lice may cause the host human to experience an itchy scalp. While head lice live off the skin on the scalp, the biting is not usually what causes the itching as their mouths are so small it is very unlikely that this would be felt. The most common cause is either the movement of the live head lice on the head, once fully grown or if infestation has taken place, and an allergy to the head lice secretions. Some children may develop a rash where the skin becomes irritated by the allergic reaction or from constant scratching.

Not everyone infested with head lice will experience itching which is why the infestation goes from minimal to significant so quickly. The first indication of an infestation may be the sight of a live head louse crawling through your child’s hair. Remember to check all members of the family once a case has been confirmed.

How to check for head lice

While difficult to see at first glance, a thorough examination of the head should reveal either head lice or their eggs. If your eyesight is poor and you’re not confident in your ability to check your child’s head, ask a teacher, carer or family member to have a good look to put your mind at rest.

As mentioned previously, a live head louse must be found in order to confirm an infestation. Detection combing can be a very reliable method for finding and confirming a head lice infestation. Detection combing involves the use of a specialised comb that has a fine-toothed design that targets and removes head lice and nits. Wet hair combing is often the most effective method for detection combing, either before, during or after applying a treatment to your child’s hair. Follow the instructions provided by your treatment information leaflet for best results.

Head lice life cycle

After seven to 10 days, the baby lice hatch and the empty eggshells remain glued in place. These remains are known as nits. Nits are white and become more noticeable as the hair grows and carries them away from the scalp.

Head lice feed by biting the scalp and feeding on blood. They take nine to 10 days to become fully grown. Head lice normally only crawl from head to head when they're adults or nearly mature juveniles. A female head louse may start to lay eggs from nine days after she's hatched. Therefore, to break the cycle and stop them spreading, they need to be removed with that timescale in mind.

Treating a head lice infestation

Head lice are easily treated and there are many effective products on the market promising to do the job quickly and with relative ease. You may wish to try a spray on treatment, a lotion, oil, cream or shampoo. In all cases, it is advisable to use a lice comb afterwards, possibly once a week until all the dead nits have been removed.

Checking weekly can ensure that you’re on top of any possible re-infestations. Some treatments offer a once only treatment option, others require multiple applications. Most are effective. A metal comb or plastic alternative specifically marketed for the removal of head lice and nits should be used.

You may wish to use a wet combing technique initially without using lotions or sprays to remove the live head lice and eggs. This is an effective method however be prepared to commit a lot of time to regular combing as you are aiming to remove live lice and nits rather than the remnants after treatment. Check all members of the family and those in close contact with your child until you are certain that the infestation is no longer an issue.

Alert the school or nursery and any close friends. This will help to contain the outbreak and everyone will then have an opportunity to act early and prevent more serious infestations. Head lice do not suggest poor hygiene or inadequate living conditions, they affect all socio-economic groups.

The most important factor to consider when using a treatment is to take advice from your pharmacists on proper use and follow the instructions carefully. Proper use is the only way to ensure that you are treating the lice infestation appropriately.

Preventing head lice

It is not possible to completely prevent head lice. The best approach it to check your child’s head and hear regularly. Children are more susceptible to infestation due to the nature of their habits. Close contact with others in play and comfort mean that they are particularly vulnerable to cross-infection. Boys are slightly less likely to have long term infestations and girls with longer hair may be more at risk.

Regular detection combing, weekly head checks and even the use of lice preventing shampoos now widely available, can promote lower rates of infestation. The treatments don’t prevent a re-infestation so it is particularly important to check regularly and treat immediately. Some schools and nurseries have a head lice policy in place meaning that your child may not return until they have been successfully treated and in some cases, clear of nits too.