Birth to five

Lots of children get head lice, regardless of whether their hair is clean or dirty. Children catch head lice by coming into contact with another child who already has them. When heads touch, the lice walk from one head to the other. They can’t jump or fly.

Checking for head lice

Head lice eggs are dull and well camouflaged. Nits are the empty eggshells. Nits are white, shiny and about the size of a small pinhead. They’re often found further down the scalp, particularly behind the ears. It’s easy to mistake them for dandruff but, unlike dandruff, they’re glued to the hair and can’t be shaken off.

The easiest way to check for lice is by combing. Wet your child’s hair and part it about 30 times. Then comb each section carefully with a plastic, fine-tooth nit comb. Do this over a pale surface, such as a paper towel, white paper or basin of water, or when your child is in the bath. If there are any lice you’ll be able to see them on the scalp or the comb, or they may fall on the paper or in the water. They're usually grey or brown in colour.

You can also look for the following signs:

• A rash on the scalp.
• Lice droppings (a black powder, like fine pepper) may be seen on pillowcases.
• An itchy head. This is not always the first sign. Lice will usually have been on the scalp for three or four months before the head starts to itch, or they may not cause itching at all.
• You may also spot eggs or the lice themselves.

Treating head lice

There are two ways of dealing with lice. The first is wet combing (the non-insecticide method):

• Wash the hair normally using your usual shampoo.
• Using plenty of hair conditioner and while the hair is very wet, comb through from the roots with a fine-tooth comb. Make sure the teeth of the comb slot into the hair at the roots with every stroke.
• Clear the comb of lice between each stroke with a tissue or paper towel.
• Wet lice find it difficult to escape, and the conditioner makes the hair slippy and harder for them to grip on to, so they’re easier to remove.
• Repeat this routine every three to four days for two weeks so that any lice emerging from the eggs are removed before they can spread.

The second method involves using a lotion containing an insecticide, such as malathion, phenothrin, permethrin or carbaryl.

Lotions containing carbaryl can only be obtained on prescription from your GP. The others can be bought over the counter or obtained on prescription. Research shows that lotions containing a silicone compound, dimeticone, may also be effective.

Your school nurse, health visitor, pharmacist or GP can advise you which one to use. You should only use lotions when you’ve already detected head lice, not to try to prevent them. Head lice shampoos and repellents are not recommended. Always follow the instructions on the label, or use as advised by your GP or pharmacist.

Natural methods

Natural methods of treating head lice using essential or aromatherapy oils, such as lavender, rosemary, tea tree or blends of different oils, are popular with some parents. However, little research has been done into their effectiveness or whether they can be toxic if used repeatedly or in the wrong volume. Some oils can also irritate the skin or may not be suitable for children.

If you do use essential oils to treat head lice be cautious. Don’t use them to try to prevent lice. Some essential oils should not be used in pregnancy, so if you’re pregnant always check before using an oil to treat your child.

Further advice

• One infected child can infect an entire nursery, so treat your child as soon as you discover head lice.
• Tell the nursery and other parents.
• Check your child’s hair regularly, and always check if there’s an outbreak at the nursery or school.
• If your child has head lice, check the whole family (including dad) and treat them if necessary.
• Older people, such as grandparents, may have head lice without knowing it and could pass them on to children.
• Brush and comb your child’s hair often. This may stop head lice taking hold.