Head Lice (Nits)

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Head lice are tiny insects that live in hair. Nits are the empty egg cases attached to hair that head lice hatch from. Head lice are more common in children but can affect anyone of any age. They are not a sign of dirty hair or poor hygiene. Close hair-to-hair contact is needed to pass lice on; head lice cannot jump or fly but walk from one head to another. When away from hair they soon die and cannot live in bedding or clothes etc.

Head lice can be difficult to spot, even when the head is closely inspected. They’re very small whitish or grey-brown insects that range from the size of a pinhead to the size of a sesame seed. The only way to be sure someone has head lice is to find a live louse by combing their hair with a special fine-toothed comb. This is called detection combing.
There’s no need for children to stay off school, or to wash laundry on a hot wash.

Less reliable signs of head lice include:

Small white eggs or nits (egg cases) in the hair behind the ears or at back of the neck
An itchy scalp
A rash on the back of the neck
Feeling as though something is moving in the hair

Head Lice Myths

True

Infect both clean & dirty hair
Infect long & short hair
Walk from head to head
Only itch if allergic to the bites/ faeces (poo)
Can be treated without using chemicals

False

Head lice can jump from one head to another
Will always have an itchy head or scalp
Head lice prefer clean hair
Head lice prefer long hair
Need to keep child off school

How can I avoid?

There’s nothing you can do to prevent head lice. You can reduce the risk of lice spreading by avoiding head-to-head contact and tying long hair up. Do not use medicated lotions and sprays to prevent head lice.
This can irritate the scalp.

The following treatments aren’t recommended because they are unlikely to work:

Products containing permethrin
Head lice “repellents”
Electric combs for head lice
Tree and plant oil treatments, such as tea tree oil, eucalyptus oil and lavender oil herbal remedies

How do I treat?

Use lotion or spray (Chemical Method)
You can use medicated lotions and sprays that kill head lice in all types of hair. You can buy these from pharmacies, supermarkets or online. Lotions and sprays come with a comb to remove dead lice and eggs.

Some treatments need to be repeated after a week to kill any newly hatched lice. Check the pack to see if they’re OK for you or your child and how to use them.
Follow instructions on the packaging
Check for lice again after three to five days, and again 10 to 12 days after using the treatment. This is because not all the eggs may be killed by the first application.
If lotions or sprays don’t work, speak to your pharmacist about other treatments.

Detection Method (Non-Chemical)

Alternatively, you can use a detection comb which is a special fine-toothed plastic comb you can buy from your pharmacy, supermarket or online. Detection combing can be carried out on dry or wet hair. Dry
combing takes less time, but wet combing is more accurate because washing with conditioner stops head lice moving.

To use the wet detection method:

Wash the hair with ordinary shampoo and apply plenty of conditioner.
Use an ordinary, wide-toothed comb to straighten and untangle the hair.
Once the comb moves freely through the hair without dragging, switch to the louse detection comb.
Make sure the teeth of the comb slot into the hair at the roots, with the edge of the teeth lightly touching the scalp.
Draw the comb down from the roots to the ends of the hair with every stroke, and check the comb for lice each time – remove lice by wiping the comb with tissue paper or rinsing it.
Work through the hair, section by section, so that the whole head of hair is combed through.
Do this at least twice to help ensure you haven’t missed any areas and continue until you find no more lice.
Do wet combing on days 1, 5, 9 and 13 to catch any newly hatched head lice. Check again that everyone’s hair is free of lice on day 17.

If you find head lice, you should check the rest of your family. Treat everyone found to have head lice on the same day.

Speak to your pharmacist – for advice if you’re not sure.

When should I seek advice?

You can treat head lice without seeing a GP, but if you feel you need some advice please speak with your pharmacy.

Where can I get more information?

NHS Choices
Visit your local pharmacy for advice