Head lice can be difficult to spot just by looking in the hair, especially considering their size, colour and the fact that they move quickly. Plus, head lice don’t usually cause any symptoms. Some people complain of an itchy scalp, but itching only develops if the person is allergic to the lice and their droppings. An itchy scalp may be due to other conditions such as eczema, psoriasis or dandruff.

Other possible symptoms of head lice include:

• A crawling sensation on the scalp 
• A rash on the back of the neck
• Pillows that appear dirtier than usual.

Nits can be easier to spot – they look like dandruff, but stick strongly to the hair and can’t be removed easily by brushing. However, the presence of nits only really shows that the person has had head lice at some point – it is not proof that they are currently infected.

Detection combing

The only way to determine if live lice are present is to find them by detection combing. This can be done on dry or wet hair, but when lice are wet, they remain still, so wet detection combing is easier. It requires a fine-toothed detection comb with teeth about 0.2-0.3mm apart.

Advise customers to:

• Wash the hair using ordinary shampoo and apply conditioner. Use a regular comb to detangle and straighten the hair
• Switch to a detection comb and, ensuring that the edges of the teeth touch the scalp, comb down to the ends of the hair
• After each stroke, check the comb for lice. Wipe or rinse the comb before combing through again
• Work methodically, section by section, until the whole head has been checked. This may take 10-15 minutes
• Areas to check carefully include close to the scalp, the back of the neck and behind the ears
• Rinse out the conditioner and repeat the combing on the rinsed hair. If live lice are found, everyone else in the home should be checked and those infected treated at the same time. 

Remember that an infected child does not need to be kept away from school but the school should be informed so that other parents can be vigilant.