nits, kutu bugs, utu, head louse

What are headlice?

Headlice live, eat and breed on the hair and skin of the human scalp. They are small, wingless insects, about 2 to 3mm in length. Headlice cannot jump, fly or swim but get around the scalp by moving from hair to hair with strong claws. Healthy headlice can be very difficult to see on the scalp.

Female lice lay about seven to 10 eggs (nits) every night. Eggs are laid close to their food supply - the scalp. The eggs, which are small whitish flecks, are often seen behind the ears and on the forehead. They are attached firmly to the hair and are very hard to remove. Eggs hatch about nine days after being laid.

How are headlice spread?

Because they cannot fly or jump, headlice are spread by close contact with another person's hair or head. This can be done by sitting or lying next to a person with headlice or using the same hairbrush, comb or hat. Headlice are not associated with a lack of cleanliness.

What are the symptoms and how is it diagnosed?

Headlice may cause the scalp to itch, although often there are no symptoms. It is diagnosed either by finding a live insect on the scalp or finding an egg within 1cm of the scalp (eggs more than 1cm from the scalp are dead). You do not need to visit your doctor.

How do I treat headlice?

Insecticide lotions, liquids, creams and shampoos

Speak to your pharmacist or public health nurse (ask at school for her phone number) for advice about what treatment to use. It is very important to follow the directions on the package carefully, using a clock to time how long the product is left on. Read the instructions carefully before you buy; some treatments will be tolerated better than others by your child.

It is usually best to treat all family mermbers at the same time. A second round of treatment is generally recommended a week after the first as, often, not all headlice eggs are killed the first time.

Check regularly after treatment for eggs (nits) close to the scalp. You may find nits still attached to hairs after a course of treatment - but these may be dead or empty eggs, and the infestation may still have been cured.

Removal by hand

Although slow, this method can be very effective. Using a metal 'nit comb', carefully comb the hair, removing the lice and eggs. Combing should be done twice daily for 14 days. There is a comb available that kills the lice electronically but this has not been shown to be particularly effective.

Combing tends to work well on children with short, fine hair, and is not so good for those children with curly or long hair.

An Australian study found that applying thick white (so you can see the lice easily) conditioner to dry hair and using a fine-toothed headlice comb is just as effective as commercial anti-lice agents.

How do I reduce the spread of headlice?

• Brushing the hair often is a cheap and effective way of reducing the spread of lice. This may help kill or injure headlice and stop them from laying eggs.
• If headlice are a continuing problem in children, encourage them to use their own hook at school to hang their clothes and belongings. Hats should be hung on hooks and not put in a communal box. Discourage girls from sharing hair ribbons, clips and hair ties.
• Don't worry about washing all the bedding and clothes, eggs will not survive away from their food source after hatching. If everyone uses the combs or brushes in the house, wash them in the shampoo as well. Check for headlice on the scalps of family members and close friends.
• Notify your school or preschool.

Continuing re-infestation

It can be really frustrating if your child is continually being re-infested from other children. If this is a problem for you and your child, you may wish to cut your child's hair very short. This method, although extreme, will almost certainly stop the problem.

If short hair is not acceptable, this author has resorted to sending her child to school with a cap on and requesting special permission for it to be worn in the classroom (back to front). Worked like a charm!

For further information and support talk to your local pharmacist. Or ask to speak to the public health nurse attached to your child's school.

Written by Anna Mickell RCpN. Reviewed in July 2005 by everybody.