Time to wage war on head lice. Jane Bartlett explains how

A battle cry is being sounded in primary schools nationwide and parents are being encouraged to fight a war against an enemy that’s the size of a sesame seed, but remains, despite all our efforts, a huge great nuisance: lice, otherwise known as nits.

This is a heroic attempt to rid our young children of this itchy parasite. The problem is widespread – ask any primary school teacher –because reservoirs of infestations go undetected. Lice have also developed immunity to many conventional pesticide treatments.

It’s hard to quantify the scale of the epidemic – sales of pesticide treatments are our best indication. They leapt from a market worth £14million in 1995 to £29 million in 1998.There’s a lot of scratching going on out there, particularly amongst children between the ages of four and eleven.

What are lice?
The head louse or, to give it its grand name, Pediculus capitis, is a parasite that lives on human blood and is found in scalp hair. They are caught by close head-to-head contact with an affected person and, contrary to popular belief, they do not leap from person to person. Nor do they prefer dirty hair. In fact, clean locks are more to their taste.

Here’s the nitty-gritty: they have six legs and hold onto hair with their claws. Theireggs, which are known as nits, are firmly glued to the hair shaft, often several along one hair, which is why in the past they were known as ‘pearls of poverty’. Today, however, the social stigma attached to nits is fast disappearing. Anyone can get them, no matter what their background.

Fully grown, a louse is about the size of a matchstick head and is visible to the naked eye. They can cause itching and are unpleasant, but are not generally harmful.

How do you know if your child has them?
The nits, or eggs, are often the most visible sign of infestation. You can find them on the hair close to the scalp, especially around the nape of the neck and behind the ears. Your child may start itching, but not always. Usually, there are only ten lice or less on the head in the initial stages, so the onset of itching is delayed. Parting dry hair to look for lice is not reliable because they often scamper away. So always wet comb if you want to find out whether or not a scalp has been invaded.

Bug busting
Bug busting, an ancient technique updated, involves the regular wet combing of hair with a special fine toothcomb and regular hair conditioner. Promoted by the Department of Health, it has become the accepted way to tackle this itchy menace.

Make sure you use the comb specially created for the Bug Busting campaign, because it’s believed to have the most effective design. Twice weekly combing sessions are needed for a total of four sessions. The first combing session should remove all the adult lice. Thereafter, you should only snare baby lice. However, if during later sessions you find big ones reappearing, your child has been re-infested and you will need to keep on combing for a few more sessions. Success demands time and commitment. Keep at it.

Recently, bug busting has come in for criticism, following new doubts about its effectiveness. A study among 4,000 schoolchildren in North Wales, published in the Lancet , summer 2000, found that wet combing cured only 38% of louse cases, compared with 78% for insecticide lotions which are washed into the hair.

Bug busting can work but it simply takes too long, says Ian Burgess of the Medical Entomology Centre, Cambridge. In his research he has found children crawling with as many as 250 lice and estimates that to remove that number in a large family of six would take six hours a week. However, Joanna Ibarra, the Programme Co-ordinator from Community Hygiene Concern, the charity which organises Bug Busting Day, is critical of the report in the Lancet, claiming that participants weren’t using the latest state-of-the-art comb (which has a special slant making it easier to lift out lice from near the scalp), and that a longer term view is needed. She sees the Bug Busting success rate of 38% as a positive result, especially given that the participants weren’t offered any particular encouragement.

Insecticide medication
This is available over the counter or from your GP. Active ingredients contain malathion, permethrin, phenothrin or carbaryl. Occasional use is not a problem but be cautious about using these products repeatedly. Studies have shown that the active ingredients in high concentrations are human nerve poisons and can affect the immune and hormonal systems. However, Ian Burgess of the Medical Entomology Centre, Cambridge, believesthat insecticide lotions are safe and points out that no serious side effects have been reported in 70 trials worldwide.

However, lice resistance to insecticides is building and CHC dispute the manufacturer’s claims that the products kill all lice and eggs in one application. To make sure the treatment has been effective The Department of Health advises you should check hair using the bug busting method for baby lice hatching 3–5 days after application.

Natural medication
Hair products containing aromatherapy oils or herbal extracts are becoming very popular for use in the wet combing technique. Community Hygiene Concern believes that most are unlikely to kill eggs, and it is the wet combing technique which is really doing the work. The lice may look dead when you drag them out of the hair, but this is merely because they become immobilised when wet. Leave them to dry out on tissue paper and within 24 hours they will be scuttling around, full of beans again. The products are also very expensive. Ian Burgess, however, believes there is strong evidence that tea tree oil may be beneficial.

Electronic combs
These are battery-powered fine toothcombs which promise to electrocute the blighters with a minute electric current. CHC reckons they are difficult to use on anything other than short, straight hair and they are hard to keep clean. They are also pricey at around £20. The combs still need to be used regularly, with recent tests recommending daily combing for one week, followed by combing every three to four days.

CHC runs a bug-busting helpline on 020 8341 7167 and a website at www.nits.net You can purchase a Bug Buster kit, which includes a comb, cape, reward stickers and full instructions from the helpline number, and they are also often available from primary schools. Price: £4.95. Send cheques or postal orders to Community Hygiene Concern, 160 Inderwick Rd, London N8 9JT.