Head lice are tiny insects that live on the scalp, feeding off human blood. They are the size of a sesame seed and have six legs. They can be difficult to see because they are very small, move quickly, and their color often blends with the person’s hair. When a person has lice, it is described as an infestation. Lice are especially common in children due to their close contact in places like schools and playgrounds.

Nits, on the other hand, are lice eggs. Lice lay these tiny yellow or white oval-shaped eggs at the base of the hair shaft, close to the scalp where the temperature is perfect for keeping them warm until they hatch. Nits are often confused with dandruff or hair spray droplets, but they cannot be easily brushed out of hair. Nits take about one to two weeks to hatch into baby lice, or nymphs. After hatching, the empty nits stay attached to the hair shaft until they are physically removed.

Treating head lice requires an over-the-counter or prescription medication that kills lice and their eggs, and combing wet hair with a fine-toothed nit comb to remove lice and nits. It’s also essential to wash in hot water any clothing, bedding, or stuffed animals that the person with lice has been in contact with recently.

Head lice

Causes of Head lice and nits

Head lice and nits are mainly caused by a type of insect known as Pediculus humanus capitis. These small parasites live on the scalp hair of humans and have an existence largely limited to the scalp, eyebrows, and eyelashes. Here are some reasons why they could infest someone:

1. Direct Contact: The most common way to get head lice are direct physical contact with the head of an infested person. Lice cannot jump or fly, but they crawl fast. This means they can easily move from one head to another if people are close together, for example, during play, sports or sleepovers among children.

2. Sharing Personal Items: Sharing personal items such as combs, brushes, hair accessories, headphones, hats, scarves, or even towels and bedding that have been used by an infested person can spread lice.

3. Poor Personal Hygiene: This is a common myth; lice infest people regardless of their personal hygiene. In fact, lice may be more attracted to clean hair because it’s easier to move around.

4. Overcrowding: Conditions where people live in close proximity, such as schools, family homes, or orphanages, can facilitate the spread of lice.

5. Lack of Awareness: Many people are unaware of the signs and symptoms of head lice and how they are spread, which can lead to a higher risk of infestation.

Please remember that anyone can get head lice, and it’s important to check and treat as necessary to prevent infestation.

Risk Factors of Head lice and nits

Head lice and nits are small insects that live on the scalp and feed off of human blood. They are most commonly found in children aged 3 to 11 years old, but can affect anyone. Here are some risk factors associated with the contraction of head lice and nits:

1. Close head-to-head contact: This is the main way lice are spread. This can occur during play, sports activities, sleepovers, and at school, among other situations.

2. Sharing personal belongings: Head lice can spread through the sharing of combs, brushes, hats, headphones, scarves, towels, and pillows. However, it’s important to note that lice cannot survive long without a human host, so while possible, this is not the main method of transmission.

3. Age: While anyone can get head lice, they are most commonly found in preschool and elementary school-age children and their family members and caregivers. This may be because children of this age are more likely to have close contact with their peers.

4. Self-care practices: Lack of regular hair-washing or bathing doesn’t increase the likelihood of getting head lice. On the contrary, head lice often infest people with good hygiene and grooming habits.

5. Non-human contact: It’s important to note that pets or other animals do not play a role in the transmission of human lice.

6. Overcrowded living conditions: In crowded living conditions where people are in close contact with one another, there is a higher risk of spread.

7. Gender: In some age groups, girls may be more likely to have head lice, potentially due to more frequent head-to-head contact.

However, anyone can get lice, regardless of their personal hygiene or the cleanliness of their home or school. It’s crucial to guide children regarding the importance of not sharing their personal belongings and to avoid head-to-head contact. Regularly checking full head of children for lice or nits can facilitate early detection and make treatment easier.

Signs and Symptoms of Head lice and nits

Head lice are tiny, wingless insects that thrive on human scalps. Nits are the eggs laid by head lice. Here are some signs and symptoms associated with these:

1. Intense Itching: This is an allergic reaction to lice bites and is the most common symptom.

2. Visible Lice or Nits: Adult lice are the size of sesame seeds and are grayish-white or tan. Nits are tiny, about the size of a pinhead, and are often confused with dandruff. However, unlike dandruff, they can’t be easily brushed out of hair.

3. Lice Eggs (Nits) on Hair Shafts: Nits attach to hair shafts, remaining there even after treatment. If you see these tiny yellow or white dots and they can’t be easily combed out, they may be nits.

4. Sores on the Head: These can be caused by scratching. Sores can sometimes become infected with bacteria found on the person’s skin.

5. A Tickling Feeling: Some people may feel like something is moving in the hair or experiencing a tickling feeling on the scalp.

6. Irritability and Difficulty Sleeping: Head lice are most active in the dark. Therefore, people affected may experience sleep difficulties.

7. Red Bumps on the Scalp, Neck, and Shoulders: The bumps can become infected due to constant scratching.

Remember that the presence of nits does not necessarily mean an active infestation. It is possible for nits to remain attached to hair after successful treatment, so the only sure sign of an active infestation is seeing a live louse. If you suspect a lice infestation, consult a healthcare provider for proper diagnosis and treatment.

Diagnosis Head lice and nits

Head lice and nits pertain to an infestation of the scalp by the parasitic insect Pediculus humanus capitis. This condition is common, especially among children of school age, as lice can be transferred from one individual to another through direct contact, or by sharing personal items such as combs, headphones, hats, or clothing.

Head lice are tiny insects that live on the human scalp and feed on human blood. They are about the size of a sesame seed and can be hard to see because they move quickly and are often the same color as the person’s hair.

Nits are the eggs laid by adult lice. They are quite small (about the size of a pinhead), oval in shape, and are typically off-white to yellowish-white in color. Nits are attached to the hair shaft close to the scalp where the temperature is perfect for incubating the eggs. They are often found behind the ears and near the nape of the neck.

Symptoms of head lice and nits include itching, visual discovery of lice or nits, the feeling of something moving in the hair, and sometimes sores on the head from scratching.

If suspected, lice or nits can usually be detected by close visual examination of the scalp and hair. Treatment commonly involves over-the-counter or prescription shampoos or lotions that kill lice. Additionally, combs are used to manually remove nits from the hair.

It’s important to note that having head lice is not a sign of poor personal hygiene or an unclean living environment. It’s an extremely common condition that, while a nuisance, does not pose a significant health threat.

Treatment of Head lice and nits

Treatment for head lice usually involves the use of medicated shampoos or lotions that kill lice and their eggs (also known as nits). Here’s the general procedure:

1. Over-the-counter Medications: The first line of treatment usually involves over-the-counter lice-killing-product, such as permethrin (Nix) or pyrethrin (Rid). You apply these products directly to the scalp and hair, wait for a few minutes to a few hours (follow the instructions on the product), and then rinse off.

2. Prescription Medications: When over-the-counter treatments fail to work, prescription treatments are used. These may include malathion (Ovide), benzyl alcohol (Ulesfia), or ivermectin (Stromectol), and must be used under the guidance of a healthcare provider.

3. Removal of Nits: After the application of any treatment, the nits should be manually removed from the hair shafts. This is often done using a fine-toothed nit comb. Nits can be hard to see, so this process is usually done under bright light and may need to be repeated over several days to ensure effectiveness.

4. Cleaning Personal Items: To prevent re-infestation, it’s necessary to wash or dry-clean all bedding, clothing, and plush toys that the infested person used during the two days before treatment. Combs and brushes should be soaked in hot water for 5 to 10 minutes. For things that can’t be washed, seal in a plastic bag for two weeks, which is longer than any nits or lice can survive without feeding.

5. Treat Close Contacts: Because lice are easily spread to close contacts, everyone in the household and all close contacts should be treated at the same time.

6. Repeat Treatment: Most lice treatments need to be repeated in about a week to 10 days to kill any newly hatched lice.

Lastly, remember to consult with a healthcare provider before beginning any lice treatment, to identify the best treatment option and to learn how to use the product correctly.

Medications commonly used for Head lice and nits

Treating head lice and nits typically involves medications that are designed to kill the lice and their eggs. Here are some commonly used medications for head lice and nits:

1. Permethrin (Nix): Permethrin is a synthetic insecticide that’s available over the counter and is usually the first line of treatment for head lice. It’s typically used as a cream rinse and is applied to the scalp and hair and then rinsed off after 10 minutes.

2. Pyrethrin (Rid): Pyrethrin is a natural insecticide made from chrysanthemums. It’s available over the counter and is applied to the scalp and hair and then rinsed off after 10 minutes. Pyrethrin is considered safe for children 2 years of age and older.

3. Malathion (Ovide): Malathion is a strong prescription insecticide that’s applied to the hair and left on for 8 to 12 hours. It’s usually recommended for difficult-to-treat lice infestations. Malathion can be used for children over 6 years old.

4. Benzyl alcohol (Ulesfia): This is a prescription medication that works by suffocating the lice. Benzyl alcohol lotion is applied to the hair and scalp and then rinsed off after 10 minutes. It can be used on infants as young as 6 months.

5. Lindane: This is a prescription shampoo that is sometimes prescribed for a second treatment if other treatments are not successful. Lindane is not recommended for pregnant women, babies, young children, people with a history of seizures, or people who weigh less than 110 pounds.

6. Ivermectin (Sklice): This is a prescription lotion that you apply to the scalp and hair and rinse off after 10 minutes. It works by killing lice directly and is usually well tolerated.

Remember, do not try to treat lice infestations by using more medication than recommended or by using the medication more often than recommended, as this can lead to skin and scalp irritation and other side effects. Always follow the treatment instructions provided by the manufacturer or your healthcare provider. Also, note that treatment may need repeating after a week to 10 days to kill any newly hatched lice.

Please also keep in mind that personal hygiene and cleanliness in the home or school have nothing to do with getting head lice.

Prevention of Head lice and nits

Preventing head lice and nits requires several key steps, including:

1. Avoiding Close Contact: Head lice spreads through direct contact, so avoid head to head contact with individuals who’ve been confirmed to have lice.

2. Proper Hygiene: Regular washing and cleaning of hair, scalp, and skin can go a long way in preventing head lice and nits. However, it is important to note that lice can affect clean hair too.

3. Not Sharing Personal Items: Do not share hats, towels, headphones, combs, brushes, or any personal items that come into contact with the hair of someone who has lice.

4. Cleaning Items Frequently: Regularly wash and disinfect items such as clothing, bedding, hair accessories, and toys that come into close contact with the head or hair.

5. Avoiding infested Places: Avoid places or objects infested by lice. This includes staying away from infected bedding, furniture or toys.

6. Frequent Checks: Regularly check the scalps of family members, especially children, to identify head lice and nits early. Lice are small and move quickly which makes them hard to spot.

7. Education: Educate children about the spread of head lice and discourage them from close head-to-head contact and sharing personal items with their friends.

8. Treating Affected Persons: If a family member gets lice, it’s important to treat them immediately so it doesn’t spread to others. Over-the-counter treatments are usually effective, but your doctor can recommend other ways if these treatments don’t work.

Remember: Prevention is better than cure, but if lice is already present, do consult with a healthcare provider for appropriate treatment steps.

FAQ’s about Head lice and nits

Certainly, here are some common FAQ’s associated with head lice and nits:

1. What are head lice and nits?
Head lice are tiny, wingless insects that live on the human scalp. They are about as big as sesame seeds. Nits are the eggs of head lice.

2. How do head lice spread?
They spread mainly through direct head-to-head contact with an infested person’s hair, but they can also spread by personal contact or the sharing of combs, brushes, caps, and other clothing.

3. What are symptoms of head lice?
The most common sign of lice is itching. There may also be a feeling of something moving in the hair or an allergic reaction to the bites. Over time, constant scratching may lead to skin infections.

4. How to diagnose a head lice infestation?
By carefully examining the hair and scalp under good light and using a fine-toothed comb, which will help to identify the lice or nits.

5. How are head lice and nits treated?
Treatment involves medicines called pediculicides, which kill lice, and manual removal of all nits. Some medications are available over-the-counter, but others require a prescription. It’s also important to wash all bedding, clothing, and personal items that the person with lice has used to prevent re-infestation.

6. Can head lice lead to any complications?
While annoying, head lice don’t spread disease and aren’t a serious medical condition. They don’t lead to any severe complications, but incessant scratching can cause sores which can get infected.

7. Can head lice fly or jump?
No, they cannot. They crawl, and hence, direct contact is necessary for them to spread.

8. Who can get head lice?
Anyone who comes into close contact with a person who already has head lice, contaminated clothing, or other belongings can get head lice. They are most common among pre-school and elementary school-age children and their families and caregivers.

9. Are head lice more common in dirty hair?
No, head lice infestation is not related to cleanliness. They can infest anyone’s hair, regardless of its condition or length.

10. Can you prevent head lice?
Preventing head-to-head contact during play and other activities can prevent the spread. Avoiding sharing personal items like combs, brushes, hats, and headphones can also help. Regularly cleaning items that an infected person used can also prevent the spread.

Please remember that this is general advice, speak to a healthcare professional for precise information.

Useful links

Head lice and nits are commonly encountered parasitic infestations, especially among school-aged children. They can cause significant discomfort, but have no actual harmful health implications. Here’s a detailed analysis of these parasites, including some useful research links to better understand their biology, lifecycle, spread, and effective methods of treatment.

  1. https://pubmed.ncbi.nlm.nih.gov/21575285/
  2. https://pubmed.ncbi.nlm.nih.gov/29521258/

Remember, always consult a healthcare professional when dealing with head lice and nits for accurate diagnosis and treatment. These resources are merely to expand your knowledge and understanding.

Complications of Head lice and nits

Head lice and nits (their eggs) can pose several complications if not treated promptly and appropriately. Here are a few possible complications:

1. Intense itching: Anytime there’s a head lice infestation, itching, also known as pruritus, is usually the first noticeable symptom. This itching can sometimes become severe and lead to discomfort and even disrupt sleep.

2. Skin infections: Another complication of head lice is skin infections. This generally occurs as a result of excessive scratching of the scalp, which can lead to open sores. These open wounds are prime breeding ground for bacteria which can cause infection.

3. Allergic reactions: Some people may also have an allergic reaction to lice bites, which can result in swollen lymph nodes and reddened skin.

4. Psychological impact: Apart from physical complications, head lice can create psychological distress. The social stigma attached to having lice can lead to embarrassment, humiliation or social exclusion, especially for children at school.

5. Treatment resistance: Some lice have developed resistance to over-the-counter treatments which means they can be more difficult to eliminate. This is often called ‘super lice’, and this can complicate treatment and lead to prolonged infestation.

Some of these complications can be managed with appropriate treatment and preventative measures. If you suspect a lice infestation, it’s always advisable to consult with a healthcare professional to guide on treatment and help prevent spread to others.

Home remedies of Head lice and nits

Treating head lice can sometimes be a challenging process, but there are a number of home remedies you can try:

1. Wet-Combing: This is one of the most effective methods of removing head lice. Wet the hair and use a fine-tooth nit comb to remove lice and eggs. Repeat every few days for at least two weeks.

Head lice

2. Essential Oils: Essential oils like tea tree, neem, lavender, eucalyptus and anise oil have insecticidal properties. Mix 15-20 drops with 2 ounces of olive oil, apply to the scalp and hair, leave in for at least 12 hours, then comb out and shampoo.

3. Vinegar: Vinegar can potentially unstick lice eggs. You can try rinsing the hair with vinegar before and after shampooing.

4. Garlic: Garlic smell can kill lice. Grind 8-10 garlic cloves into a paste, mix with 2-3 teaspoon of lime juice, apply to the scalp and hair, leave in for 5-6 hours, then wash off.

5. Neem Oil: Neem oil is another natural insecticide. Add a few drops of neem oil to your shampoo, use as normal, and rinse.

6. Olive Oil: Olive oil can suffocate lice. Apply to the hair before bed, cover with a shower cap, and wash out in the morning.

Remember to wash all bedding, clothing, and soft toys to prevent re-infestation. Note, if these remedies do not work or if the person is allergic to any of these, it’s recommended to consult with a doctor or a certified health provider for over-the-counter medicated treatment.

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Last Update: January 3, 2024