It’s very common for children to get head lice, especially once they go to child care, preschool and school. You can usually treat head lice at home. Head lice are often called nits.
Causes of head lice or nits
Head lice (Pediculus humanus capitis) are tiny, wingless insects that live in human hair and feed on the blood circulating in the scalp.
Nits are actually the eggs of adult head lice. Once lice lay nits, the nits take about a week to hatch.
Head lice spread when people are in close contact – for example, when heads are close together, when you wear an affected person’s hat or scarf, or when you use an affected person’s comb or hair brush.
It’s common for children to get head lice because their heads are often close together as they play or do their schoolwork. Some children can get head lice several times a year.
If your child gets nits, it’s nothing to be embarrassed about. It doesn’t mean your child and home are dirty.
Symptoms of head lice or nits
If your child has head lice, the first thing you might notice is your child itching and scratching, especially around the nape of his neck and behind his ears.
When you look closely at your child’s hair, you might see small, white, oval-shaped eggs attached to the root of the hair, near the scalp. These are the nits. The further away from the scalp a nit is, the longer it’s been there (hair grows about 0.3 mm each day).
You also need to look for live head lice as well as nits. If your child still has live lice, they’re still laying nits. And you won’t stop the nits and lice cycle until you get rid of the live lice.
Live head lice move fast. To spot live lice, you might have to part your child’s hair very quickly or use the wet-combing treatment described below.
Note that nits alone might not be good enough evidence that the head lice are still alive. This is because eggs more than 6.5 mm away from the scalp (on the hair shaft) are evidence of an old infection. The lice might have already hatched or might never hatch.
If you think your child might have head lice, you should check for head lice in every member of the household.
When to see your doctor about head lice or nits
You should see your doctor if:
- your child is itching and scratching a lot and it interrupts her sleep
- sores develop on her scalp.
Head lice treatment
You should treat all affected family members at the same time.
You can try using anti-lice shampoos, which you can get from chemists without a prescription.
These shampoos can be unpleasant for your child because of their strong smell and because they sometimes irritate the skin on the scalp. It’s important to follow the instructions carefully.
Head lice are becoming resistant to the chemicals in these shampoos, so it’s important to check that the lice are dead once you’ve used the treatment. If they aren’t dead, try using a shampoo with a different active ingredient. The different active ingredients in these shampoos include permethrin, maldison or pyrethrin.
You’ll need to treat your child again about one week after the first lice treatment, to kill any eggs that have hatched and become mature lice since the first treatment.
This head lice treatment involves combing wet hair with a special, fine-toothed, metal lice comb and hair conditioner. You can buy these combs from pharmacies, and any type of conditioner will do.
Here’s what to do:
- Apply a generous amount of conditioner to your child’s wet hair. Rub it into the scalp and along the hair shafts.
- Leave the conditioner on for at least 15 minutes. You might want to put a shower cap over your child’s head while you’re waiting. The conditioner suffocates the lice, and they release their claws from the hair shaft or scalp.
- Use the special lice comb to remove the conditioner from your child’s hair. Rinse the comb between strokes using a tissue or tap water. You’ll often be able to see how many lice you’ve combed out of your child’s hair.
Repeated wet-combing is a very good head lice treatment. Comb every 2-3 days for two weeks, until a full combing doesn’t show any eggs or lice on the entire scalp.
Wet-combing is time-consuming, but you can distract your child by discussing the day’s events, reading a book or watching the TV or a DVD while you comb. Your child might also enjoy seeing how many dead lice come out of his hair.
If your child has head lice, she doesn’t need to have a drastic haircut – this won’t treat or prevent lice infestation.
Prevention of head lice
Lice can easily spread between children in the same class, and throughout your family.
If your child has head lice or nits, check your whole family. You should treat other family members if they complain of an itchy scalp, even if you don’t find any lice or nits.
Wash all your child’s bedding (especially the pillowcase), towels, blankets and clothes in hot water (at least 60°C). Seal hats, sleeping bags or other things that you can’t easily wash in plastic bags for 2-3 weeks to kill the eggs. Soak all brushes and combs in anti-lice shampoo for several hours to disinfect them, then clean them in boiling water.
You might also like to vacuum your child’s room, as well as any indoor areas where your child plays, although there’s no clear evidence to show that this will prevent the spread of head lice.
Let your child’s child care, preschool or school know that your child has lice. Keep your child at home until treatment has finished.