Nits are the eggs of lice. They are one to two millimetres in size, oval in shape and gray in colour. They attach themselves firmly to the hair, very close to the scalp. In seven to nine days the eggs hatch. During this time the hair will only have grown about 5 millimetres so the nits remain close to the scalp and difficult to see. They become mature lice in another week.

Lice are wingless insects and are about the size of a sesame seed. They have three pairs of legs and are grayish-brown in color. The female louse has a life span of about 25 days and lays up to 10 eggs each day. It is easy to realize how rapidly they multiply.

The lice only live on humans, feeding on the blood of their host, much like mosquitoes. As they feed, they inject digestive juices and waste material into the skin. This material and the puncture wound itself cause intense itching. Adult lice can only survive away from the human scalp for about 48 hours at room temperature. They cannot live on furniture or in carpet without a human host.

How do I know if my child has head lice?

If your child complains of an itchy head or persists in scratching, consider the possibility of lice. Take a close look at the scalp. If you see nothing under natural light, use a flashlight. Adult lice are often difficult to find, but their eggs or nits are seen most easily above the ears and on the back of the head. Sometimes the lymph nodes of the child’s neck can become enlarged as a result of the lice infestation.

How did my child get lice?

Head lice are spread through shared clothing, combs, brushes, hats, earphones or towels and pillows. If two children have their heads together sharing a book, working on a project, playing a video game or wrestling, one child can transmit the lice to the other. If just one classmate has lice, the whole class can become infested.

Home treatment

Hair does not need to be shaved to cure lice. Four common commercial products are available without prescription: Nix™ (permethrin), R&C Shampoo™ (pyrethrin/piperonyl/butoxide), Lindane 1% Shampoo and Resultz ™. See the chart for directions on how to use them.

Lice in the eyelashes

Medications to treat lice should not go into the eye or on the eye lashes. If you see lice or nits on the eyelashes, try applying petroleum jelly twice daily for eight days. Or speak to your doctor about having them (carefully) removed. Do not do this yourself.

The clean-up

Your child’s mattress, upholstery and carpet should be vacuumed thoroughly. Wash sheets, blankets and pillowcases in hot water and detergent. Bedding that cannot be washed should be put in the clothes drier on a hot setting for 20 minutes, or be dry cleaned to kill the lice. Remember that although lice cannot survive away from a human host for long, there is still a chance of passing lice to another person by sharing pillows or stuffed animals.

Wash hats and scarves and any other item that comes in contact with the child’s head. Iron the seams of clothing, as some types of lice that like to hide in these seams. Combs and brushes should be replaced or can be cleaned by placing them in water warmed to 65ºc for 10 minutes. Any articles that cannot be treated by these methods should be tightly sealed in a plastic bag for two weeks.

Nit removal

After you have used a medicated shampoo, nits still need to be removed using tweezers or a fine-tooth nit comb. Nits can be difficult to remove as they stick to the hair shaft near the scalp. The best way to remove nits is to comb wet hair with a regular comb to remove tangles. Then, separate the hair into strands no wider than the nit comb. Comb a strand of hair with the nit comb starting at the scalp and moving to the end of the hair. Wipe off the comb and repeat until all the hair has been combed. Although alternate methods such as applying olive or mineral oil to the hair may work initially, the oil is very hard to remove from the hair.

What can I do to prevent the lice from coming back?

All family members should be checked to make sure that the nits have not infested someone else’s hair. Close contacts and family members should only be treated if infestation is confirmed.

It is important to inform all family members, teachers, babysitters and parents of your child’s playmates so they can be sure to check their children’s heads. If your child is in school, check with the administrator to find out when your child can return to school.

Sometimes a child may return after one treatment. Some schools have a ‘no-nit’ policy which means your child must have all nits removed before returning to school. Remind your child not to share personal items like combs, brushes and hats. This will reduce the risk of recurring infestation.

Nits and lice are a common nuisance of childhood. They do not mean that your child is poorly cared for or your home is dirty. They simply show that your child has been involved in the day-to-day play with other children. If you suspect that your child has been infested, check for nits and talk to your family doctor or pharmacist about an appropriate treatment.

Treatment of Head Lice

Product Used to Treat Head Lice	Nix™ cream rinse Kwellada-P Cream Rinse	R & C Shampoo + Conditions (2 in 1)	Lindane 1% Shampoo	Resultz ™ head lice treatment
Active Ingredients	Permethrin 1%	Pyrethrins & Piperonyl butoxide	Gamma benzene Hexachloride	50% isopropyl myristate
Contraindications	Use with caution in children aged 2 months to 2 years old. Do not use if you have an allergy to ragweed or chrysanthemum plants.	Do not use if you have an allergy to ragweed or chrysanthemum plants.	Those with seizure disorder or infamed skin conditions, children under age 10, the elderly, pregnant and breastfeeding women shoud not use this product.	Do not use in children under age four. Safety has not been established for use during pregnancy. Do not use if you have or develop skin irritations or skin infections. Do not use this product on eyelashes or eyebrows.
Directions for Use	Wash hair with conditioner-free shampoo, rinse and towel dry. Apply the medicated cream rinse to damp hair and scalp creating a lather. Leave on hair for 10 minutes before rinsing. Remove any remaining nits with a special nit comb	Apply the medicated shampoo / conditioner to DRY hair. Ensure enough has been applied to soak the hair and scalp. Leave on for 10 minutes. Lather with a small amount for water and rinse the hair. Remove any remaining nits with a nit comb.	Apply medicated shampoo hair that has been washed and completely dried. Massage into hair and scalp for 4 minutes. Add a small amount of water and massage into a lather for four minutes. Rinse hair thoroughly with water. Remove any remaining nits with a nit comb	Apply the treatment to dry hair and massage into the scalp and hair. Make sure to cover the hair from root to tip. Allow the product to remain on the scalp and hair for 10 minutes. After 10 minutes, rinse hair and scalp with warm water. Remove any remaining nits with a nit comb.
Effectiveness	One treatment has excellent coverage (96-100%) against lice and eggs (nits). A second treatment may be needed in 7 to 10 days.	One treatment is about 45% effective so a second treatment is recommended 7 to 10 days later.	One treatment is about 67% to 92% effective. A second treatment is often recommended in 7 to 10 days.	A second treatment is required seven days after the initial treatments. The overall effectiveness of this product verses other treatments is still being evaluated.
Comments	Has the best efficacy against lice and nits after one dose. Has low systemic absorption.	Has minimal absorption.	Can have up to 10% systemic absorption. Excessive applications are discouraged.	May leave hair feeling greasy and can be difficult to wash out. This product can leave surfaces like floors and bathtubs slippery. Could stain clothing and fabrics.

Head Lice Solutions for an itchy little problem

What are nits and lice?