Around one in three children in the UK is likely to get head lice at some point during a year. That’s a lot of itchy scalps! But what exactly are head lice and how can you get rid of them?
Head lice are insects, the size of a pinhead, that live in human hair. They spread by head to head contact, walking from the hair of one person to another, and attach their eggs to individual strands of hair, close to the root where the blood supply to the scalp creates a nice, warm environment. The term “nits”, which is often used to describe head lice, actually refers to the empty egg cases that remain in place once the lice hatch.
The main symptom of head lice is itching, caused not by the lice biting the scalp, but instead the skin reacting to the bites after they have occurred. Sometimes there may also be a rash on the back of the neck, and occasionally tiredness and grumpiness if the head lice have been present in the hair for a long time.
How do I know if I have head lice?
Looking through the hair isn’t a very reliable way of telling whether someone has head lice. It is far better to do detection combing, which involves running a special detection comb (which has teeth set very close together) through the whole head of hair, checking after each stroke if a louse has been caught on the comb. This can be done on wet or dry hair, but whichever is chosen, the hair should first be untangled using a normal wide toothed comb, so the detection comb can easily move through the hair.
What do I do if I have head lice?
If a live head louse is found, everyone else in the household should check their hair to see if they have head lice too. It is much more effective to treat everyone who has head lice in one go, rather than doing it one at a time. There are a number of treatments available to buy from pharmacies, which differ in the amount of time they have to be left on the head before washing out with normal shampoo. Because the chemical in these products needs to be in contact with the head lice for a certain amount of time before being washed out, lotions and sprays are much more effective than medicated shampoos and crème rinses.
The normal advice is to repeat the treatment after seven days, to ensure any head lice that hadn’t hatched when the first application was used are killed, and to use a nit comb to remove dead lice and eggs, but the pharmacist or pharmacy assistant will provide advice for individual products. It is important to make sure you buy enough product to treat everybody who is affected, and to thoroughly coat all of the hair during application.
Not all medicated products are suitable for everyone, so make sure to say when asking for a product in the pharmacy whether anyone who will be using it is pregnant, younger than six months old, or has asthma or any allergies.
An alternative to chemical treatments is wet combing. This involves using a special fine-toothed comb, to systematically comb the hair after it has been shampooed and while it has been coated in hair conditioner. Because the comb needs checking and wiping after every stroke, and the process needs repeating after five, nine and 13 days, it is time-consuming, but some people prefer it as it doesn’t involve using chemicals.
Is there anything I can do to stop getting head lice?
Because head lice are spread by head to head contact, it is difficult to prevent them proliferating. The best thing to do is regular detection combing – once a week is ideal – so you can find any new head lice quickly and then start treating it straight away.
National bug busting days aim to inform children and their parents and carers about head lice, and how to detect and treat them. By getting everyone to check on the same day, it can help reduce the spread of these tiny insects.
There are a lot of myths about head lice, but many of them are untrue, such as:
- You can catch head lice from brushes, combs and towels – no, because head lice feed off human blood, they only last a matter of minutes once off someone’s head.
- Head lice can jump from one head to another – no, they are wingless insects without the ability to fly, jump or swim.
- Only people with dirty hair get head lice – this is untrue, and head lice don’t seem to have a preference for clean or dirty hair.
- An itchy head always means head lice – there are lots of conditions that can cause an itchy scalp, including eczema, dandruff, an allergy or psoriasis.
- You need to stay off school if you have head lice – not at all. Once someone discovers they have head lice, they have probably had them for several weeks anyway. Keeping someone off school only makes them feel self-conscious, and does nothing to stop them spreading.
- Boys get head lice more than girls – in fact, girls are more likely to get head lice than boys. The reason for this is unknown, but may be to do with the fact that girls tend to work more closely together than boys at school.
- Everybody in a household should be treated if one person has head lice – this used to be recommended, but now it is considered better to check and then only treat those who find a live louse in their hair as treating everybody increases the chance of head lice becoming resistant to the available treatments.
- Prevention sprays are a good way of reducing the chance of getting head lice – there is no evidence that these products work.
Asha Fowells is a health writer and editor, and registered pharmacist. She has been working in the world of pharmacy for over 20 years, and has a particular interest in common ailments, childhood illnesses, women’s health and education and training. As well as being a freelance writer (shortlisted in 2013 for a Medical Journalists’ Association award), Asha has two young daughters and is a parent governor at a local nursery school.