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8 October 2020

How to spot head lice and nits

Use our expert guide to work out whether your child has head lice or nits, and how to keep them away
Scratching head 438919
WhichEditorial team

The key to keeping nits and head lice at bay is spotting them, treating them and then making sure you follow up treatment by staying alert. 

Read on for how to identify whether your child has head lice, how you can tell whether it's nits or dandruff, and the five key things every parent needs to know to keep their children nit and head lice-free. Are you wasting money on expensive treatments that don't work? Find out about the best nit and head lice treatments.

Head lice and nits: what to look for

Head lice and nits are, unfortunately, a common experience for kids: 70% of parents with children aged under 12 have bought a head lice treatment in the past two years, our 2020 survey revealed.

Our gallery, below, makes for grim viewing – but take a look and discover exactly what to look for, and how to spot nits and head lice. It may well make you itch, though!

Three things you need to know about nits

  1. Head lice need effective treatment to get rid of them successfully, and they're nothing to be embarrassed about. 
  2. Head lice are the small brown lice you see on the hair, despite many of us calling them nits.
  3. A nit is the egg case, which sticks to the base of the hair shaft, rather than the live louse. The white specs you can spot in a child's hair are the empty egg cases, and are usually the first indication that your little one has unwanted visitors and needs a bit more of an inspection.

Head lice and nits are unwanted visitors, but very common ones for most children. Don't despair – we can help. 

Four steps to stop head lice and nits coming back

1. Check hair regularly

The days of the nit nurse are long gone, so regularly checking your child's hair is the best way to spot the first signs of head lice, and treat them effectively.

If your child has them, do tell your child's school, child minder or nursery so they can alert other parents and ask to get their children treated as soon as possible, to help stop the spread of head lice.

If you don't, you run the risk of your now lice-free child being re-infected by someone they gave the lice to.

How to spot nits and head lice - not sure what to look for? Head to our picture gallery to see what nits and head lice look like, or use our questionnaire below to see whether it's dandruff or nits.

2. Follow the rules on when to treat

Treat head lice as soon as you see a live one. Check all the family and treat anyone who has lice.

And remember, if you choose to use a medicated product, use it only when you see live head lice. Do not use a medicated product as a preventative method, otherwise head lice can build up a resistance.

3. Repetition is key

We've said it before and we'll say it again – repeat, repeat, repeat.

Always follow up any treatment method as directed by the instructions on the product you're using. Even with treatments that are claimed to kill head lice after one application, the Department of Health suggests checking for lice again after three to five days, and again 10 to 12 days after using the treatment. This is because not all the eggs may be killed by the first application.

If you choose the conditioner-and-nit-comb method, repeat this at regular intervals until all the nits and lice have gone. Regularly combing through your child's hair and checking will help to prevent a re-infestation.

In a 2020 survey of 701 parents, 31% of parents used a nit comb and carried out a repeat treatment when treating their child's head lice.

Head lice treatment and brands - find out what's on offer, plus money-saving tips

4. Don't let embarrassment get in the way

Head lice are extremely common – they're nothing to be embarrassed about. They're spread when children (or adults) put their heads together and the lice walk across. This means any games that involve children playing close to each other, sleepovers, or even something as simple as them taking some phone selfies can mean head lice are able to move from the host to someone new.

Failure to carry out a follow-up treatment can also increase the rate that head lice spread, as the child will go back to playing with their friends in the belief that they're clear, when in fact they still have head lice and pass it on to more people.

Head lice treatments

There are four main types of treatments for getting rid of head lice and nits. We explain the pros and cons of each below.

1. Combing

You can use a nit comb to detect lice in the hair, and to get rid of an infestation. It's one of the cheapest nit treatments available – basic nit combs start at around £2 – and combs are easy to use. You simply cover the infected hair in conditioner (so the lice will lose their grip and it's easy to pull the comb through) and start at the roots, pulling the comb all the way to the tips of the hair. After each stroke, check the comb and clean it on a tissue to see if there are any lice on it.

You need to comb the hair for at least 30 minutes and repeat four more times over the following two weeks to ensure all the head lice are removed, and to capture any head lice that may hatch between combing sessions. A general rule is to continue combing until you haven't seen any full-grown lice for three sessions.

This treatment is quite time-consuming. And, depending on your child and their hair type, it may be tricky trying to keep them still long enough to do a thorough job.

Battery-operated combs can be used on dry hair. These kill lice on contact, but there is limited evidence to show they really work. They are much more expensive than basic nit combs, costing around £15 or more.

Pros No resistance concerns, reusable, no insecticides, also used to detect lice

Cons Fiddly, takes about two weeks, metal combs can hurt, electric combs not proven to be effective

Nits truths and myths you need to know – find out whether hair straighteners kill nits, whether you can use mayonnaise as a treatment, and more.

Watch our video of how to comb through hair using a nit comb and conditioner

2. Synthetic chemical insecticides

Insecticide products, typically sold in chemists, contain chemicals designed to kill head lice by various methods. Some poison the lice, while others will paralyse their nervous systems.

You should use this type of head lice treatment only if you have found a live head louse in the hair, rather than as a preventative measure because you've received notification of an outbreak at your child's school.

This is because the product can build up on the scalp, exposing the head lice to a non-lethal dose – which means lice can become resistant, and the product will no longer work when your child actually gets infected.

Always read and follow the instructions exactly. And even if a product is claimed to be able to treat head lice in one application, current advice is to check hair a week later to see whether you can spot any head lice that may have hatched, and follow up with another treatment anyway.

Some treatments are described as 'alcoholic lotions' and are flammable, so don't use a hair dryer on anyone who has been treated with one. Always read the instructions to check.

Pros Easy to apply, various trials have shown they work

Cons Can be prone to resistance, varying effectiveness in clinical trials, some smell horrible

3. Physical action to kill lice

Some products kill lice by physically coating them in liquid and drowning or dehydrating them. These types of products include Hedrin and Full Marks Solution and are becoming the most popular form of medicated treatment.

Because these products kill lice through a physical action, head lice cannot become resistant to them. Some don't kill the eggs (nits), though, so it's vital that the treatment is repeated after a week to kill any lice that have hatched since the first application.

Pros No insecticides, resistance unlikely, odourless

Cons Trials have shown degrees of efficacy but more evidence is needed, reapplication is needed a week later

4. Natural and herbal products, and essential oils

Natural and herbal remedies include products such as tea tree oil or green tea shampoo.

Some remedies involve mixing, say, tea tree oil to a specific ratio. Depending on what you use, the smell can be very strong and you need to be careful to get the ratio right.

Natural over-the-counter products include Puressentiel Anti-Lice Treatment Lotion, Nitty Gritty solution or tea tree shampoo.

Pros Resistance less likely, easy to apply

Cons Little clinical research into efficacy of treatments, potential side-effects not known