Approximately one in 10 primary school children has head lice at any one time, yet many parents are badly informed about this common pest. Nurse consultant Christine Brown is here to help:

Checking for head lice shouldn't be considered a big deal; it is just a normal part of a family's personal hygiene routine - like brushing teeth or washing hair. Parents should check their children's hair regularly, ideally once a week, including during the school holidays.

Head lice are small, six-legged wingless insects that live on or close to the scalp, feeding on blood from the scalp. They range in size from a full stop to a sesame seed depending on their age –adult lice are just 3-4mm long.

Louse eggs are translucent which makes them hard to spot – each one is laid on an individual hair as close to the scalp as possible, they are difficult to see and even harder to remove with a comb.

When hatched a young louse (known as a nymph) is transparent but after its first blood meal, it will darken to a greyish brown colour. It is important to note that nits are not the same thing as lice. Nits are the empty eggshells which remain glued to the hair shafts long after the nymphs have emerged.

Follow Christine's top tips on beating head lice:

• Checking your family's hair regularly is essential. Use a good quality, plastic detection comb with rigid teeth no more than 0.3mm apart, rather than your fingers.
• Check freshly-washed hair, as lice become inactive in water, and a conditioner can ease combing. Distract your child with a book or TV. Check the back of the neck, top of the head, under the fringe, behind the ears and close to the scalp. 
• Use a magnifying glass to help spot really small nymphs, which can be as small as a full stop (1mm) and hard to spot as they live close to the scalp.
• Despite popular belief head lice are brown in colour so to make the treatment process as painless as possible for children, place a white towel round their shoulders.

As 'nit nurses' no longer exist, primary responsibility for head lice management and treatment lies with parents.

There are four principle types of head lice treatment:

• Non-insecticide treatments. Lice have not built up a resistance to non–insecticide treatments and they have been shown to be highly effective at eradicating lice. 
• Insecticide treatments. These can be ineffective as lice have built up a resistance to many and some parents are reluctant to expose their children to insecticides. Follow directions very carefully and do not use more than three times in a row. 
• Wet combing with conditioner. This takes patience – twice a week for at least a fortnight, and it's easy to miss a few. 
• Alternative treatments. Herbal and alternative treatments are available but effectiveness varies. Many of the alternative products available lack an evidence base on which to assess effectiveness. In addition, the safety of some alternative methods is unknown and there is the risk that safety problems could arise.
  

Many treatments require a repeat application to kill any nymphs which have hatched since the first treatment was applied. The checking process should be repeated a couple of days after treatment to ensure that all the head lice have been killed.

You should always tell your school or nursery and the parents of your child's friends if you find head lice. They can spread extremely quickly as children are often in head-to-head contact.


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Head Lice Fact v Fiction

"Lice indicate whether you're clean or not"
FICTION: lice don't care if your hair is clean or dirty! Any hair will do.

"Head lice jump"
FICTION: they can't 'jump', 'fly' or swim and ONLY spread from direct head to head contact.

"You can get them from hairbrushes, towels or bedding."
FICTION – Off the scalp, lice die very quickly indeed.

"Infected children should be kept out of school"
FICTION: there's no reason to keep children away from school if they have been treated.  Only adult lice tend to seek new hosts so if eggs hatch before a treatment has been completed, young lice will not go in search of a new home.

"Lice are impossible to get rid of"
FICTION: Research shows 80% of head lice are resistant to traditional insecticide treatment, but they are easily killed by non-insecticide treatments or removed by careful combing.

"Cutting your hair off will get rid of them"
FICTION: Lice can live in really short hair (1cm long) and chopping off your own or your children's hair should not be seen as a treatment option.

"You can catch them from your dog"
FICTION: Human head lice live on humans only and as such, spread only from person to person.