This blog is written by our clinicians and aims to keep patients informed with up to date information on medical conditions.
What are Head Lice and What are Nits?
Head lice are the insects that live in the hair, nits are the empty white sacs where the lice eggs have hatched from which are attached to a hair shaft using a strong glue-like substance making them difficult to remove.
A usual outbreak contains about 30 lice per head. The lice are the size of a sesame seed and cling onto the hair shaft with little hook-like claws on the ends of their 6 legs. They survive by biting the scalp and feeding on the blood.
How Does Your Child Get Head Lice?
Head Lice move about by crawling so can only be acquired through head-to-head contact with someone who already has them.
Once hatched, it takes 10 days for the lice to mature to adults and they can live for roughly 1 month in someone’s scalp.
Lice will die if they are away from a human’s head/body for more than 2 days so it is very rare to catch them from a pillow or a towel.
Lice congregate behind the ears and at the nape of the neck so make sure to check thoroughly in these areas.
Dispelling The Myths:
- Lice cannot hop like fleas, burrow like mites or fly like mosquitos;
- You cannot catch head lice from pets;
- Not all cases of nits cause itchy scalps;
- Itching does not guarantee their presence – only live lice on wet combing confirms diagnosis.
Head Lice Treatment Options
Only treat if live head lice are present on combing as this confirms a live infestation. Don’t treat them ‘just in case’.
Don’t forget to wet/detection comb the rest of the family for any live lice, as they will need treatment too.
Treatment used to consist of insecticides but lice would often develop resistance to them, so these types of treatments have been replaced with silicone and oil-based preparations which have a physical rather than a chemical action on lice (e.g. it blocks the lice’s breathing tubes).
So what are the treatment options?
- Dimeticone 4% lotion (trade name: Hedrin®). This is a silicone-based product which is thought to work by blocking the lice’s breathing tubes but it does not kill unhatched eggs, so a second treatment is needed. It should be applied twice, 7 days apart, with each application left on overnight and then washed off with shampoo and water. Dimeticone is suitable for all ages, and is available on prescription. You can also buy Dimeticone over-the-counter (although not for children younger than 6 months of age).
- Wet combing using the Bug Buster® comb and method. This method removes head lice (but not eggs) without having to use a lotion to kill them, and is similar to detection combing. This treatment can be very time consuming as it takes up to an hour to do wet combing sessions properly and you need to repeat this every 4 days for a total of 16 days to ensure you are removing the lice that hatched from eggs after the previous session. Wash the hair with ordinary shampoo, rinse and put on lots of ordinary conditioner. Detangle the hair with an ordinary brush/comb and then, using the specialized detection comb, start combing from the scalp to the ends, paying particular attention to behind the ears and nape of the neck. Check the comb for lice after each stroke, wiping any onto a tissue. After combing the whole head, rinse out the conditioner.
- Isopropyl myristate and cyclomethicone solution (trade name: Full Marks Solution®). This works in a similar way to Dimeticone. You apply the solution to the scalp and leave in place for 10 minutes. The hair is then combed with a fine-toothed comb to remove lice. Then wash the solution away using ordinary shampoo. The treatment should then be repeated in 7 days time. It is not suitable for children younger than 2. It is available on prescription and also to buy over-the-counter.
- Coconut, anise and ylang ylang (CAY) spray (trade name: Lyclear Spray Away®). This too works in a similar way to Dimeticone. You apply the spray to the hair and scalp and leave in place for 15 minutes. The hair is then combed with a fine-toothed comb to remove lice. Then wash the spray away using ordinary shampoo. The treatment should then be repeated in 7 days time. It is not suitable for children younger than 2. It is available on prescription and also to buy over-the-counter.
- Malathion 0.5% aqueous liquid (has various trade names e.g. Derbac-M). This is a chemical insecticide that has been used for many years and poisons the lice. You should apply the lotion twice – 7 days apart. Each application is left on for at least 12 hours (overnight) and then washed off with shampoo and water. It is available on prescription but you can also buy Malathion over-the-counter (although not for children younger than 6 months). Please note: shampoos, mousses and creme rinse preparations of Malathion or other insecticides are not recommended, as they do not work as well as lotions or liquids.
If you have any further queries or wish to come and consult one of our doctors, do get in touch.