Causes of head lice or nits

Head lice 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 get head lice several times a year.

If your child gets head lice, it’s nothing to be embarrassed about. It doesn’t mean your child and home are dirty. Head lice don’t carry any diseases.

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 back of his neck and behind his ears. But many children have no symptoms.

When you look closely at your child’s hair, you might see small oval-shaped eggs attached to the root of the hair, near the scalp. These are the nits.

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 check all affected family members at the same time and treat them if they have lice. There are two ways to treat head lice – anti-lice hair products and wet-combing.

Anti-lice lotions, liquids and creams
In most countries you  can get anti-lice products from your pharmacy without a prescription. It’s important to follow the instructions carefully.The main substance used is permethrin 1% that is approved for use on children aged 2 month and older.

Head lice are becoming resistant to the chemicals in these products, 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 product with a different active ingredient. The different active ingredients in these products include permethrin, malathion, spinosad or pyrethrin. Ask your doctor or your pharmacist if you’re not sure which product to try.

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.

Wet-combing 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 your pharmacy, and any type of conditioner will do.

Here’s what to do:

1. Apply lots of conditioner to your child’s wet hair. Rub it into the scalp and along the hair shafts.
2. 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.
3. Use the special lice comb to remove the conditioner from your child’s hair. Insert the comb until it gently touches the scalp and then brush down firmly. 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.
4. Comb your child’s entire head thoroughly at least twice.

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, often more than 30 minutes. 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, he doesn’t need to have a drastic haircut – this won’t treat or prevent 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. If they share a bed with the affected child, they should probably be treated regardless of symptoms.

Don’t let children share brushes or hats with each other.

Your child is unlikely to get head lice from things like furniture, pillows and carpet. But if someone in your family has head lice, you could consider washing any clothes or bedding the person has used in the last 48 hours. Use a hot wash cycle and dry things in a hot dryer. You could also vacuum carpets and furniture.

Let your child’s child care, preschool or school know that your child has lice. Keep your child at home until the day after appropriate treatment has commenced.