Head lice are often called ‘nits’. Head lice infestation is very common in children, especially once they go to child care, preschool and school.
Head lice (Pediculus humanus capitis) are tiny, wingless insects that live in human hair and feed on the blood circulating in the scalp.
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. Head lice eggs (nits) take about a week to hatch.
Body lice or pubic lice are uncommon in children. They can be spread via clothing or linen, and don’t necessarily indicate sexual contact.
The first signs of head lice are itching and scratching, especially on the nape of the neck and behind the 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. The further away from the scalp the egg is, the longer it’s been there (hair grows about 0.3 mm each day).
Lice move around quickly. You might have to part your child’s hair very quickly to spot them. To be sure you’re dealing with a live lice infection, you can use the wet-combing treatment method explained below, then wipe the comb on a tissue and look for lice and nits. You’re looking for the actual lice, not just the eggs. The eggs alone might not be good enough evidence of a current lice infection. This is because eggs more than 6.5 mm away from the scalp (on the hair) are evidence of an old infection. They 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
You should see your doctor if:
- your child is itching and scratching a lot and it interrupts her sleep
- sores develop on her scalp.
All affected family members should be treated simultaneously.
You can try using anti-lice shampoos, which are available from a chemist without a prescription. The different active ingredients in these shampoos include maldison, permethrin and pyrethrin. These shampoos can be unpleasant because of their strong smell and because they can irritate the skin on the scalp. If you choose to use them, follow the instructions carefully. Head lice are becoming resistant to these chemicals, so it’s important to check that the lice are dead once you’ve used the treatment. If they’re not, try using a shampoo with another active ingredient.
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 live lice since the first treatment.
Another treatment uses wet-combing with a specialized, fine-toothed, metal lice comb and hair conditioner. You can buy the special comb from a pharmacy, and any type of conditioner will do. Here are the steps for this treatment:
- 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 place 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 very effective at treating head lice and should be repeated 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 her hair.
If your child has head lice, he doesn’t need to have a drastic haircut – this won’t treat or prevent lice infestation.
Lice are highly contagious and can easily spread between children in the same class, and throughout your family. Check your whole family for lice. You might want to 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 (in particular the pillowcase), towels, blankets and clothes in hot water (at least 60°C). Seal hats, sleeping bags, or other items that can’t be washed easily 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.