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Head Lice

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Head Lice

Head lice are tiny parasitic insects which can end up in a head of hair and cause irritation and scratching. These insects are commonly caught by people, particularly by children and they can be easily spread through close contact with others or when the lice latch on to clothes, bedding and furniture. Identifying head lice on a child is not difficult if you know what to look out for and often a special fine-toothed comb and regular shampoo can prove enough to remove lice from the head. If this proves insufficient, then there are medicinal shampoos which can be bought that are effective at eliminating lice and their eggs (nits).

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D4U Doctor

Dr. Daniel Cichi

GMC No. 6163403

Our Health Care Team

"Head lice and nits are very common in young children and they can cause a lot of discomfort and irritation. Head lice can spread from head-to-head contact or from clothes or furniture which someone who carries lice has used. Head lice can usually be treated without needing to see a GP or use any medicinal products. If, however, you are having trouble removing them, then there are certain products which can help, such as medicinal shampoos, which can be acquired over the counter or with a prescription."

Head Lice explained

Lice are tiny and wingless parasitic insects which feed on blood and can be found in hair. There are a few different types of lice and one of the types is head lice (there is also body lice and pubic lice). As the name suggests, head lice are found on the hair of peoples’ heads. They are commonly found on young children and are often passed on to other members of their family. Head lice are not dangerous but they can cause a lot of itching, discomfort and embarrassment.

Signs and symptoms of Head Lice

Head lice move around within a person’s hair and bite into the skin to extract blood for sustenance. As a result, they tend to cause intense itching and tickling feelings.

They also cause small red bumps on the scalp, neck and shoulders. People with head lice also tend to constantly scratch their skin in these areas due to the itchiness and tickling which the lice cause, causing more damage and irritation to the skin.

When examining a head of hair, lice can be spotted despite their tiny size. Check behind the ears and around the nape of the neck as well.

There are certain things you can look out for, such as lice eggs (also known as nits) which look like small yellow, tan or brown dots before they hatch. Lice lay nits on hair shafts close to the scalp, so this is where you’re most likely to find them. Nits in hair can be mistaken for dandruff, but unlike dandruff, they cannot be removed by simply brushing or shaking them off.

A head lice egg hatches 1 or 2 weeks after it’s laid, and once this has happened, the remaining shell appears clear or white and tends to stay on the hair shaft. As the hair grows longer, the egg shell moves further away from the scalp, making it easier to spot. Adult lice are no bigger than the size of a sesame seed and are either white or tan in appearance. Baby lice, which are known as nymphs, are even smaller than adults but they grow into adults just 1-2 weeks after they hatch. Lice and nymphs can be hard to spot because there aren’t normally many of them on the head and they move fast, but lice eggs are easier to spot, especially when you know where to look and how to differentiate them from dandruff.

Most lice feed on blood several times a day and they can survive up to 2 days off the scalp. The bites of lice cause itching and scratching due to the saliva of the creatures. It can vary with how sensitive a child is to the bites of lice (it may take weeks before a child with lice starts scratching), but they may also complain of tickling or feelings of movement around their head. If sensitivity to the bites are strong enough, then bites from head lice can cause small red bumps or sore and possibly a bothersome rash as well.

Scratching areas where lice have been could also lead to a bacterial infection. When searching for head lice, look out for swollen lymph nodes (glands) on the front and back of the neck and any red, tender skin which might be crusting and oozing.

Why do people get head lice?

Although lice are not capable of flying, people can easily catch them if they come into close proximity with items or other people which already have lice. A lot of people who get head lice catch it through head-to-head or body-to-body contact. These often occur when children or family members play or interact closely with one another.

Lice and lice eggs can also end up infesting clothing and other personal items such as combs, pillows, blankets, headphones, hair decorations, towels and cuddly toys. Items like these which are kept in homes and in close proximity to other people gives the lice opportunities to latch on to more people. Lice can also end up on furniture at home or within other buildings (depending on how good the hygiene standards are).

Head lice in adults

Head lice are particularly common in children but they can also be passed on to adults too. Children often end up spreading head lice to one another because of close personal contact when playing each other.

Head lice also often spreads between family members within a household. It’s easy to imagine a scenario where a child catches head lice and if it isn’t spotted soon enough, then the lice and nits are easily spread at home while the child is close to family members or via various items used around the house which get contaminated.

Best Head Lice treatment

There are medicinal lotions and sprays which can help get rid of head lice. Before using any of these, however, it is worth first trying to get rid of head lice by wet combing.

You can get a special fine-toothed comb (known as detection combs or nit combs) either online or from a local pharmacy. These are effective at removing lice and nits. Usually what you do is wash the affected hair with ordinary shampoo, apply lots of conditioner (any will do) and then comb the whole head of hair, from the roots to the ends. This can take anywhere between 10 and 30 minutes depending on how long the hair is. You should repeat wet combing after a few days have passed on 2 or 3 occasions to make sure you get any newly hatched head lice.

If you have tried wet combing for 17 days but have been unable to get rid of the head lice, then it’s worth speaking to a pharmacist for advice. They can recommend some medicated lotions and sprays which can kill head lice within a day. Treatments like these may need to be used more once (for instance, you may need to use it again a week after first using it to ensure removal of lice). Always check the ingredients of any recommended treatments to be sure that you can safely use them on yourself or a child you're helping.

Head lice shampoo

A pharmacist may recommend over-the-counter or prescription shampoos which contain ingredients that are effective at combating lice infestations. Shampoos which contain pyrethrin or permethrin may be suggested.

Medicinal shampoos, lotions and sprays should only really be used when you need to treat head lice. If you use them regularly as just a preventive measure, then you could end up irritating the scalp. If you have head lice and you are pregnant, do not use anti-lice shampoo without consulting your doctor or local pharmacist first.

How to prevent catching head lice

Preventing the spread of head lice among children is difficult and hygiene has little to do. There is a myth that how often you wash your hair affects your chances of getting lice. In reality, lice will not hesitate to move onto someone’s head and do the things they usually do regardless of how clean or dirty the hair is.

There are some products which are sold which claim to repel lice. Such products may contain ingredients like coconut, olive, rosemary and tea tree. However, more scientific research is required to determine such products are actually safe and effective.

If it is discovered that someone in your household has head lice, then everyone else in the house should be checked for lice and nits as soon as possible. The lice may have spread on to certain items, so wash all bed linens, stuffed animals, and clothing used in the past couple of days before you discovered the head lice. Dry clean items that can’t be washed, or put them in an airtight bag for 2 weeks. Vacuum carpets and any upholstered furniture (in both your home and your car) and dispose of the vacuum cleaner’s contents. Hair-care items like combs, barrettes, hair ties or bands, headbands, and brushes should either be soaked in hot water or thrown away.

Finding and preventing head lice can be tricky because of how small they are, but precautions like these can minimise your chances of being pestered by them or at least minimising their spread.