Wet or dry hair? You can check for lice in either wet or dry hair, but we recommend wetting the hair and preferably adding conditioner. The lice do not move as much and they attach more easily to the lice comb (10, 13).
Detection combing can be carried out on dry or wet hair. Dry combing takes less time, but wet combing is more accurate because washing with conditioner stops head lice from moving. To use the wet detection method: wash the hair with ordinary shampoo.
Use fingers to separate hair and create a part. The part should allow you to clearly see the person's scalp. Look for lice crawling on the scalp where the hair is parted or on the hair shaft. The lice will be dark in color and the size of a poppyseed.
How soon do symptoms appear after exposure? Some people may not have symptoms, particularly with the first infestation or when the infestation is light. It may take 4-6 weeks for itching to appear the first time a person has head lice.
Wet-combing
Combing wet hair with a fine-toothed nit comb may remove lice and some nits. Studies show that wet-combing results vary. Start by wetting the hair and lubricating it with hair conditioner or olive oil. Comb the entire head from the scalp to the end of the hair at least twice during a session.
The conditioner does not kill lice but stuns them for about 20 minutes enabling easier removal. The long toothed metal comb will remove nits and the stunned head lice. Wipe the comb on a white tissue and check for any lice or nits. Keep combing until no more appear on the tissue.
Body lice, close relatives of head lice, die when exposed for 5 min to a blow dryer delivering air at 50°C. Researchers in Salt Lake City, USA (Brad M Goates and colleagues. Pediatrics 2006;118:1962–70) have assessed six different methods of killing head lice using hot air.
Can someone have nits but no lice? It may be possible to have nits but no lice. If a person cannot find any nymphs or adult lice in the scalp and the nits are more than a quarter of an inch from the scalp, these may be dead and from an old infestation. However, the lice could be in hiding.
Not everyone feels lice moving around on their scalp, but some people do. Dr. Garcia says that most of her patients say they “don't feel anything,” but others may get a creepy, tickling sensation as lice move around their head.
Many people start by searching the front of the scalp—easily viewed in a single mirror—but head lice don't linger there. Two facing mirrors, with good lighting, will give you the best possible view of the nape of your neck and the area behind your ears.
Using your finger to check for and extract nits (eggs, each of which houses a baby louse) is an integral part of a lice check and can be helpful when treating an infestation. You can actually feel the nits stuck to the hair shaft; each one will feel like a bump on the hair.
Wash the hair well, dry it with a towel, then comb with a regular comb. The hair should be damp so it doesn't become “fly away”, which can make it harder for the lice or nits to stick to the comb.
Children can have a few nits without actually having a case of head lice. Usually children have no more than 10 to 20 live lice. Good lighting is important when you are checking. Head lice move fast and are hard to see.
After each treatment, checking the hair and combing with a nit comb to remove nits and lice every 2–3 days may decrease the chance of self–reinfestation. Continue to check for 2–3 weeks to be sure all lice and nits are gone. Nit removal is not needed when treating with spinosad topical suspension.
DO NOT over treat. Some louse shampoos can be neurotoxic and overuse can damage the nervous system. Wear gloves when treating more than one person with head louse shampoo. If more than two treatments are required to control an infestation, talk to the School Nurse(s) or the Health Department about alternative methods.
The head lice may have become resistant to the treatment. If the treatment used does not kill the head lice, your health care provider and pharmacist can help you be sure the treatment was used correctly and may recommend a completely different product if they think the head lice are resistant to the first treatment.
After treatment, your skin may still itch for a week or more. This is because of your body's reaction to the lice. Follow-up care is a key part of your treatment and safety.
Untreated head lice may degrade the scalp and affects it health and that of the hair. If the follicles become blocked, then hair loss may occur. It is hard to have well-conditioned hair if it is covered in head lice eggs, lice and bacteria.
Head lice cannot live for long on pillows or sheets. It is possible for a live louse that has come off a person's head to crawl onto another human host who also puts their head on the same pillows or sheets.
Avoid head-to-head (hair-to-hair) contact during play and other activities at home, school, and elsewhere (sports activities, playground, slumber parties, camp). Do not share clothing such as hats, scarves, coats, sports uniforms, hair ribbons, or barrettes. Do not share combs, brushes, or towels.
Hairspray makes it harder for the louse to grab hold. The smell of hairspray and the use of solvents (sad but true) in them can also deter creepy crawlies from finding their way in. Not to mention that if you're tying longer hair back, you've got a double whammy.
There are two reasons for a recurrent lice infestation: The lice treatment you used didn't work. You or someone in your family came in contact with lice again.
Anyone who comes in head-to-head contact with someone who already has head lice is at greatest risk. Spread by contact with clothing (such as hats, scarves, coats) or other personal items (such as combs, brushes, or towels) used by an infested person is uncommon.