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Condition
Head lice, lice
Class
Skin
Description
Lice are small, wingless, insects that feed on blood from the human body. There are three types of lice that live on different parts of the body: the head louse, body louse and pubic louse.

Fully-grown adult head lice are greyish-brown in colour and are about the size of a sesame seed, they feed on blood from the human scalp. Head lice eggs are creamy brown in colour and are glued tightly to the base of individual hairs close to the scalp. The eggs are very small (about 0.8mm long) and oval-shaped. After 7-10 days the eggs hatch and leave empty egg cases (nits). These are white and shiny and are usually found further down the hair shaft. Once hatched it takes a further 7-10 days for the growing louse to be capable of laying its own eggs.

Body lice are slightly larger than head lice and they live in cloth fibres rather than on body hair.

Pubic lice, which are 1-2 mm long, live in pubic hair and sometimes eyelashes.
Causes
Head lice cannot jump or fly. Transmission is by prolonged head to head contact, where the lice simply walk from one head to another, which is why infestations are common among school children. Head lice cannot be passed via towels, bedding, clothes, furniture or pets.

Body lice infestation is associated with poor hygiene and overcrowding. They may also carry disease.

Pubic lice are usually transmitted through sexual contact and more rarely through clothes and bedding.
Symptoms
Head lice are elusive and are well camouflaged so they can be hard to see. Persistent itching of the scalp, caused by an allergic reaction to the lice, commonly occurs but is not always present so many people will be unaware that they are infested. The best way to detect head lice is by using a fine-toothed comb on hair that has been washed and treated with conditioner. It should be possible to see the lice on the comb. Small black specks of digested blood excreted by the head lice may also be seen on pillows. If a louse is found, other family members should be checked and, if necessary, treated.

The symptoms of body lice infestation include itching on the shoulders, buttocks and stomach and small red puncture marks in the skin in these areas.

Pubic lice bites appear as small, non-itchy, blue-grey bumps among the pubic hair.
Treatment
Head lice can be removed without the need to use insecticides or other ingredients. A product called 'Bug Buster' is available free on prescription to children, or it may be purchased from local pharmacies or via the internet. The Bug Buster kit contains a specially designed fine-tooth comb which works with normal shampoos and conditioners to rid the hair of head lice. Following the instructions, using the comb on hair wet with conditioner and while the hair is still wet after the conditioner has been rinsed off will remove all of the head lice. Repeating, the process four times spaced over an interval of 2 weeks, removes any lice that may hatch from eggs before they are sufficiently mature to lay eggs themselves, and so helps break the life cycle of the head lice.

Other products that can be used to remove head lice without the need to use insecticides or other ingredients include the Robi Comb. This is a battery operated electronic comb which kills the head lice on contact as it is combed through the hair.

Lotions, liquids, mousses or creams containing the insecticides malathion, permethrin and phenothrin are also available. As lice can become resistant to insecticides, local health authorities have a policy where different insecticides are recommended on a rotational basis - the local pharmacist or school nurse will know which particular insecticide is currently being used. To reduce the risk of resistance, insecticide products should not be used unless a live louse has been found on the head.

Hedrin is a solution containing dimeticone which is not an insecticide but works by upsetting the head lice's ability to secrete water. It has an advantage of remaining active against head lice that are resistant to insecticides.

Insect repellent sprays containing piperonal are also available to prevent infestation. The spray should be used once daily when infestation is likely, but if head lice are already present, it should not be used as it does not kill the lice. Some head lice preparations can also be used for body and pubic lice.
When to consult your pharmacist
All of the treatments for head lice, body lice and pubic lice are available from your local pharmacy without the need for a prescription. When buying any of these over-the-counter remedies let your pharmacist know the number of people in the family affected, their ages and whether they may be pregnant or breast feeding or have any other conditions such as eczema or asthma. Your pharmacist will be able to recommend a product that is best suitable for you and which fits in with the local rotational policy.
When to consult your doctor
If you have tried an over-the-counter treatment and it has failed you should see your pharmacist, nurse or doctor who will recommend an alternative. See your doctor if the person being treated is either a child under 6 months of age, is suffering from asthma or allergies or is a woman who is pregnant or breastfeeding.
Living with lice
You should not be ashamed if you or your child has head lice. Head lice infestation is common in children and in families with school children, it is not a reflection of poor hygiene. Do not let embarrassment delay your action to treat head lice, it only risks spreading head lice to other school children and to other families. Whatever method you use to treat head lice follow the instructions provided about repeating treatment to break the head lice's life cycle, and check all members of the family to determine if they need to be treated too.

If you decide to use products containing insecticides, be careful as some are alcohol-based and are inflammable and so must never be used near a naked flame and the hair should not be dried with a hair dryer on a hot setting. Alcohol-based preparations are not recommended for very young children or people with asthma, may cause stinging when applied and can make eczema and itching worse.
Useful Tips
  • A child with head lice should be treated immediately. Tell the school nurse so that other school children can be checked and treated
  • If a member of your family has head or body lice the rest of the family should be inspected and treated if necessary
  • If body lice are found wash all bedding and clothes in hot water and iron them to kill the lice
Further information
Further information may be obtained from Community Hygiene Concern (CHC), a not-for-profit charity set up in 1988 to protect people, especially children, and pets, from parasites commonly found in the UK.

Community Hygiene Concern
22 Darin Court
Crownhill
Milton Keynes
MK8 0AD

Help Line: +44 (0)1908 561928
email: bugbusters2k@yahoo.co.uk
www.chc.org


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