01 Sep 2015


Head Lice-Getting Rid of Unwanted Guests

The Unwanted Guest

  • Head lice are small insects with six legs. They are often said to be “as large as a match head”; in fact, they are often not much bigger than a pin head, and rarely bigger than a sesame seed (the seeds on burger buns).
  • They live on, or very close to the scalp, and don’t wander far down the hair shafts for very long as they do not like light. In fact, they are more active at night and can cause a restless sleep.
  • The louse’s mouth is like a very small needle. It sticks this into the scalp and drinks the blood.
  • They can only live on human beings; you can’t catch them from animals. They can’t survive longer than two days without blood.
  • Nits are not the same thing as lice. Lice are the insects which move around the head. Nits are egg cases laid by lice, stuck on to hair shafts; they are smaller than a pin head and are pearly white.
  • If you have nits it doesn’t always mean that you have head lice. If the nits are more than 1/4″ from the scalp they are probably empty casings of lice that have already hatched.  When you have got rid of all the lice, the nits will stay stuck to the hair until it grows out.
  • You only have head lice if you can find a living, moving louse (not a nit) on the scalp. The nit cannot attach to the strands of hair on other heads.

Who Do They Prefer?

  • Anybody can get head lice.
  • Head louse infection is a problem of the whole community, not just the schools.
  • Infection is just as common during school holidays as when it is in session. During summer, children are often in daycares during the day and at camps where they are still around many children.
  • A lot of infections are caught from close family and friends in the home and community, not just from the school.
  • It’s not just children who have them; adults get them too.
  • It’s often said that head lice prefer clean, short hair. In fact, they probably don’t much care whether hair is dirty or clean, short or long. Short hair may make it easier for them to get from one head to another.

How Do You Get Them?

  • Head lice can walk from one head to another when the heads are touching for some time.
  • You are very unlikely to pick up head lice from brief contact with other people. The longer you have head to head contact with someone who has lice, the more likely it is you will get them too.
  • They can’t swim, fly, hop or jump. The idea that they can jump may have come from the fact that, when dry hair is combed, a head louse caught on the teeth of the comb is sometimes flicked off by static electricity (this is one reason why detection combing should be done with the hair damp).
  • You don’t get them from objects such as the chair back. Although it’s possible that a louse might get from one head to another if a hat is shared, this is very unlikely. It’s not the way infection is usually caught. A louse’s feet is adapted for holding onto human hair. It would have difficulty attaching firmly to smooth or slippery surfaces. If a strand a hair that has a louse attached to it clings to an object, such as a brush or comb, and then comes in contact with someone else’s hair it could be passed to the other person.

How Do You Know You Have a Problem?

  • If you catch one or two lice, they may breed and increase slowly in number. At this stage, most people don’t have any symptoms and won’t know they have lice unless they look very carefully for them.
  • When infested for the first time , it may take 4-6 weeks before itching starts to occur. This is due to developing an allergic reaction to the bites.
  • Most people only realise they have head lice when this itch starts. By then they’ve had lice on their head for weeks without knowing it.
  • In most infections, there aren’t more than a dozen or so lice on the scalp at any one time.
  • Some people never get the itch, including adults. They may have a few lice on their heads for years without knowing it, and can pass them to other people.
  • Lice are more active at night when it is dark. This can cause a restless sleep from the itching.
  • Louse droppings may fall on to the pillow during the night. Pillows may then get dirty more quickly than usual.


  • Combing is an important part of good personal care, but head lice are not easily damaged by it.  Combing may help to spot lice early and so help to control them.
  • The best way to stop infection is for families to learn how to check their own heads. This way they can find any lice before they have a chance to breed. They can then treat them and stop them going round the family.
  • The way to check heads is called “detection combing”. It can be done as often as families want to.
  • If a living, moving louse is found on one of the family’s heads, the others should be checked carefully. Then any of them who have living lice should be treated at the same time.

How to Treat Head Lice

  • You should only treat someone for head lice if you have found a living, moving louse.
  • There are several treatments for lice.   Ask advice from the local pharmacist, the health department, your family doctor, or the school nurse. Depending on the type of treatment used, a second treatment may need to be given seven to nine days after the first to kill any remaining lice that hatched after the first treatment.
  • After treatment, the person’s head should be combed with a nit comb every 2-3 days to check for moving lice that may have hatched.
  • It is possible for reinfestation to occur if the child comes in contact with another child’s head who has lice.

How Can I Prevent a Re-infestation?

  • The problem may not be head lice at all. We all start to itch as soon as head lice are mentioned. There are other causes for itching of the scalp.
  • Using treatments over and over again can cause dermatitis, which itself makes the head itch.
  • When living, moving lice are found, they can almost always be cleared by using the right treatment. This will only work if enough of it is used, if it is put on in the right way, and if any other family members who have lice are treated properly at the same time.
  • To prevent re-infestation, wash any articles of clothing, bedding, linens, stuffed animals,etc., that the infested person came in contact with in the previous 48 hours in hot water and then dry in a dryer for at least 20 minutes. Do not air dry.  Dry clean any articles that can not be washed or store in a sealed bag for two weeks.
  • Soak brushes and combs in hot water for 10-15 minutes.
  • Vacuum floors and furniture where the infected person may have sat or lay in the previous 48 hours. Head lice will die 1-2 days after falling off an infected person’s head.
  • When you have got rid of the lice, you might still itch for two or three weeks. This doesn’t mean you still have lice. Check the head carefully. Remember, you don’t have head lice if you can’t find a moving living louse.
  • When you have got rid of all the lice, the nits (empty egg cases stuck on the hairs) will still be there. This doesn’t mean you still have lice, and you shouldn’t treat again no matter how many nits there are if you can’t find a living louse. Using a nit comb every 2-3 days will help remove the empty nit casings.
  • People who think their children keep on getting head lice may have made the mistakes listed above, and may keep on “treating” lice which have long since been cleared, or were never even there in the first place.
  • If children do really keep on having living lice, this is most likely to be due to not doing the treatment properly and not treating all those close contacts who have also been found to have lice. Remember, if infection really does keep on happening, it is almost always from a member of the family, or a close friend. It is rarely from other children in the classroom except from a “best friend”.
  • If you still have problems, ask your family doctor,  local pharmacist, or health department if a wet-combing method to remove the head lice might help.

What Schools Can Do

  • The School Nurse can advise and support parents to check their own families.
  • “Alert” letters should not be sent out. These can cause an “outbreak” of imaginary lice.
  • Children who may have lice should not be excluded from school; if they do have lice, they will probably have been there for weeks already. The School Nurse can help the parents to make sure whether there really are lice there, and how to get rid of them if they are.
  • The school should give information on lice for parents and staff including regular detection combing and how to do it. This should be on a regular basis, not just when there is thought to be an “outbreak”, and should be done with the School Nurses.
  • Talks for parents by the School Nurse can be helpful.

What Families Can Do

  • Make sure that all family members know about good hair care, including regular, thorough combing.
  • The only way to control head lice which works is for the family to check their own heads.
  • Check all the family’s heads every now and then with a special plastic detection comb from the pharmacist.
  • All the family means everyone (adults as well as children) in the same household.
  • Only if you are sure you have found living, moving head lice in your family, tell your relatives and close friends so that they can check their own heads. Treat any of your family you are sure have lice at the same time. Ask the pharmacist,  your doctor, the health department, or the School Nurse which treatment you should use.
  • Remember, never use the lotions unless you are sure you have found living, moving head lice (not nits).
  • Try not to worry too much about head lice. They are unpleasant, but they rarely do any harm other than causing an itchy scalp.


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