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Management of Infectious Diseases - Head Lice

17th Nov 2023
Dear Parent or Guardian,
There has been a case of headlice in your child’s school and your child may have been exposed.

What are headlice? Headlice are little insects with moving legs. They are often not much bigger than a pin head, but may be as big as 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 shaft for very long. They can only live on humans; you cannot catch them from animals.

What are nits? Nits are not the same thing as lice. Nits are egg cases laid by lice, stuck on to hair shafts. They are smaller than a pin head and pearly white. If you have nits it doesn’t always mean that you have headlice. When you get rid of all the lice, the nits will stay stuck to the hair until it grows out. How are they spread? Anyone can pick up headlice. They are most common among young children as they often put heads together during play allowing the lice walk from one head to the next.

Headlice do not reflect standards of hygiene. They are just as willing to live in clean or dirty hair.
Can you stop them? The best way is for families to learn how to check their own heads. This way they find any lice before they have a chance to breed. They can then treat them and stop them being passed round the family. The way to check someone’s head is called “detection combing”.

This should be done regularly and in the case of a confirmed infection in one family member, the other members of the household should carry out “detection combing” twice weekly for one week.

How do I do detection combing? You need a plastic detection comb, good lighting and an ordinary comb.
• Wash the hair well, then dry it with a towel. The hair should be damp, not dripping. A small amount of conditioner may help if the hair is tangled.
• Make sure there is good light, daylight is best.
• Comb the hair with an ordinary comb.
• Start with the teeth of the detection comb touching the skin of the scalp at the top of the head. • Draw the comb carefully towards the edge of the hair.
• Look carefully at the teeth of the comb in good light.
• If there are headlice, you will find one or more lice on the teeth of the comb. A magnifying glass may be useful in identifying lice.
• Do this over and over again from the top of the head to the edge of the hair in all directions, working round the head.
• Do this for several minutes. It takes 10 to 15 minutes to do it properly for each head. Who needs treatment? Only treat those who have living, moving lice. If more than one family member has lice, treat all those at the same time. How do I treat them? A headlice lotion (not shampoo) should be used.

Ask your local pharmacist, public health nurse or GP which lotion to use, and how long to leave it on. Follow the instructions that come with the particular product.
• Repeat treatment again seven days later, in the same way, with the same lotion.
• Check all heads a day or two after the second treatment. If you still find living, moving lice, ask your public health nurse or GP for advice.