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 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 oval-shaped eggs, also called nits, attached to the root of the hair, near the scalp. There are two different kinds of nits:
White nits: these have already hatched.
Brown-black nits: these contain live eggs that will hatch into lice after about a week.
If you see only white nits, you can’t be sure that your child still has an active head lice infection. This is because white nits are evidence of an old infection.
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.
If you think your child might have head lice, you should check for head lice in every member of your 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 your child's scalp
- your child has been treated three or more times in a year.
Head lice treatment
You should treat all affected family members at the same time. There are a couple of ways to treat head lice – anti-lice shampoos and wet-combing.
You can get anti-lice shampoos 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 lots 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. Clean 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 takes time. You can distract your child by discussing the day’s events, or letting your child read a book, play games on a mobile device, or watch the TV or a movie while you comb.
If your child has head lice, she doesn’t need to have a drastic haircut – this won’t treat or prevent lice infestation.
Treatment for repeated cases of head lice
It can be very hard to get rid of head lice.
Some children get head lice several times each year. This can be very upsetting for both your child and for you.
If your child has been treated for head lice more than three times in a year, you might like to talk to your GP about other treatments for head lice. Children who keep getting head lice can be prescribed a medication called ivermectin, which is very good at killing lice.
Prevention of head lice
Lice can easily spread between children in the same class and also 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, and you find lice or nits.
Don’t let children share brushes or hats with each other.
Let your child’s child care, preschool or school know that your child has lice. Keep your child at home until treatment has finished.