Lice and nits – this is how you recognize them

When parents come into contact with the topic of lice for the first time, they are often unsure about many points. Where do the lice come from? And do you have to clean the apartment after the lice infestation? What parents should definitely keep in mind is that a head lice infestation has nothing to do with personal hygiene. Anyone can be affected by lice, and lice often prefer freshly washed hair. So mom and dad needn’t be embarrassed if their child has head lice. On the contrary – the lice problem should be addressed openly in school or kindergarten to prevent the lice from spreading further and to be able to get rid of the little pests quickly.

Thorough head inspection to detect lice

This requires an immediate and thorough check of the child’s head. Since lice are not only very small, but also agile and afraid of light, simply looking through the hair is often unsuccessful, especially since finding a single living louse is said to be a head lice infestation. Severe itching is often the first sign of a lice infestation, but this itching is not a reliable indication. Firstly, the itching caused by the lice’s saliva when they suck blood from the scalp does not occur in all those affected. Second, an itchy scalp doesn’t necessarily have to be caused by head lice. However, if parents discover reddened or inflamed areas on their child’s head, it is advisable to have them checked by a doctor.

Identifying lice: Indirect and direct head lice diagnosis

There are several ways to identify head lice and find out if a child has a head lice infestation. Nits are an indirect clue. The eggs of the lice, which are surrounded by a robust chitinous shell, are about the size of a pinhead and are usually found in the immediate vicinity of the scalp, as the temperature there is ideal for the larvae to develop. In addition, the lice prefer to lay their eggs in the neck or temple area and behind the ears, as the larvae find food there more easily after hatching.

Finding nits can be a sign of a head lice infestation, but diagnosing from the eggs alone is problematic for a variety of reasons.

• The lice eggs can be easily overlooked due to their large size. Also, because of their appearance, nits can easily be mistaken for ordinary dander. However, unlike dandruff, nits cannot simply be brushed off, but stick firmly to the hair.
• A current infestation cannot simply be inferred from nits. Since nits stick firmly to the hair, they can often be found in the hair for months as a remnant of a previous infestation. As a rule of thumb, nits that are more than an inch from the scalp are most likely to have no live eggs. This is because lice lay their eggs 1-2 millimeters from the scalp. The larvae hatch after about 6-10 days. A human hair grows about 10 millimeters per month. So if an egg is more than a centimeter away from the scalp, then it is either very old and the larva hatched earlier, or the larva was unable to develop at all because the temperature was too low.
• The diagnosis of the nits is not suitable for checking the success of a treatment that has already been started, since empty shells cannot be reliably distinguished from those with live eggs with the naked eye.

Direct head lice diagnosis

With the direct diagnosis method, the hair is systematically “combed” to discover and remove lice. It is superior to the indirect method via the nits in almost every respect, since it can be used to unequivocally infer a current head lice infestation. The “wet combing” method is very effective, well tolerated and not so painful and is therefore recommended by the Federal Center for Health Education (BZgA) and the Robert Koch Institute, for example.

• Before examining for lice, the child’s hair should be washed with a conventional shampoo.
• As a second step, a commercially available conditioner is applied to damp hair. This serves two purposes. Firstly, combing through the hair is not as painful and secondly, the conditioner prevents the lice from running away, as the moist mass temporarily immobilizes them.
• As a third step, the hair must be systematically combed out with a fine-toothed nit comb made of metal or plastic (available in pharmacies). It is important that individual strands are separated and combed through one after the other from the scalp to the ends of the hair. After each strand, the comb should be stripped on a light-colored cloth or a piece of kitchen paper to check whether the lice, the slightly smaller larvae or nits have been removed from the hair. Another advantage of the hair conditioner is that the lice and larvae, as well as the small nits, stand out clearly from the light mass and can therefore be easily recognized with the naked eye.

Tip: If parents are not sure whether the combed out “something” is really a louse or a larva – simply wait until the hair conditioner has dried and then hold a hair close to the supposed louse. If it holds on to it and climbs along it, it’s definitely a louse.

What to do if there are lice?

Depending on how the control turns out, different steps are necessary.

• Finding a single living louse is a definite head lice infestation that should be treated immediately. Here we have put together tips for the right treatment .
• If only larvae but no lice are discovered when treatment has already started, this indicates a continuing lice infestation, which, however, does not yet pose a risk of infection at this point in time, since the larvae have not yet left the head of their host. Nevertheless, consistent further treatment is required to prevent the larvae from developing into sexually mature lice that can lay eggs.
• If the check found only nits and no lice or larvae, there are two possibilities. If parents have already started the treatment, they should be continued according to the manufacturer’s instructions in order to kill any eggs that may still be alive. If treatment has not yet been started, the nits are most likely left over from a previous infestation as eggs cannot be transferred.

No matter how the control turns out, the issue of head lice should be taken seriously. If left untreated or not properly treated, lice can spread and become a long-lasting ordeal for the whole family.