Itchy and scratchy

IT is never nice to discover that your child has head lice. Maria Fooks still recalls with a shudder finding the small brown insects crawling in her daughter India's hair. It was a year ago, when India was two and a half. "And it was a bit of a shock," says Maria, from Fulford. "They were quite big, just crawling about in her hair. You don't expect them in children so young."

Maybe not. The truth, however, seems to be that head lice are getting more common. According to Internet health site The Little Surgery, probably one in ten children in UK primary schools is infected every year. "This problem has got worse recently, and head lice are much more common than they used to be," the site adds. So at some time in their life, most children will probably get them.

Complementary therapist June Tranmer, of the Healing Clinic in Fulford Cross, York, says parents often feel upset and a little guilty when they find their children have lice - or else the eggs that lice lay, known as nits - in their hair.

"They feel it is their children's fault, and that everybody else is going to get them," she says.

It is true that lice do spread from child to child - which is why schools are such a good place for passing them on. But June stresses they are not a sign of poor hygiene.

On the contrary, she believes lice don't like dirty hair and are more likely to be found in hair that is clean. York GP Dr David Fair thinks that may be a bit of a myth - but there is evidence that they don't care whether your hair is dirty or clean, he says. The Little Surgery agrees: "Lice can live on long hair, short hair, dirty hair and on very clean hair."

The key to eradication is quick detection (see panel, right) and prompt treatment, before the lice can spread to the rest of your family. Treatments fall essentially into three categories: orthodox pharmaceutical remedies; alternative 'natural' remedies; and 'bug-buster' kits which rely on regular combing with special fine-toothed nit combs to get rid of nits and lice.

Orthodox treatments

Your first port of call, Dr Fair says, should be your local pharmacist who will be able to advise you on the treatment that might be best for you.

It is important to ask for advice - if your child has already had lice and they have come back, for example, it may be that they have built up resistance to the first treatment used, and so you may need to try something else.

"And if, for example, they suffer from eczema, there are certain treatments that should be avoided in those circumstances," Dr Fair says.

Fulford pharmacist Michael Hepworth says a number of orthodox applications can be used to get rid of lice and nits. Many of them, such as Derbac M (malathion), are essentially insecticides. "They are just like what you use on your roses to get rid of greenfly," he says. Others are synthetic versions of naturally-occurring insecticides, such as those found in the plant pyrethrum.

Whichever treatment you choose, it is vital to consult a pharmacist first, Mr Hepworth says. As well as helping choose the right medication, he or she can explain proper application.

That's important, Dr Fair agrees, because one of the most common reasons why people fail to clear up nits is a failure properly to follow the instructions on their medication.

"We can advise on exactly how to use it and when," says Mr Hepworth. "If you are clever, you can make use of the natural reproductive cycle of the lice (see panel) to make sure you catch them all. After the first treatment, some eggs may survive. If you do it again at the right time, you get a 100 per cent kill."

Complementary treatments

A range of complementary treatments is available for those who, like Maria Fooks, prefer a more natural remedy. These include everything from aromatherapy treatments to homeopathic remedies such as staphysagria, and a number of lotions that use essential oils such as tea tree.

In aromatherapy, a blend of rosemary, geranium and lavender oils in a base of beeswax and castor oil can be effective, suggests aromatherapist Louise Roberts of the Healing Clinic.

Most good health food shops, as well as many pharmacists, will stock a range of such remedies.

At Tullivers in Colliergate, York, for example, you can choose from Riddance, an easy-to-use head lice repellant shampoo which contains natural ingredients such as neem seed extract, chlorophyll, rosemary and eucalyptus; tea tree oil, available either as a concentrate to add to your child's favourite shampoo or in ready made-up shampoo form; and Chinese Whispers, a 'naturally based' remedy which contains grape seed oil, essential oils and grapefruit extract.

Again, stresses the shop's assistant manageress Hilary Simpson, it is vital to follow carefully the instructions for use. Chinese Whispers, for example, is a two-step treatment in which you spray your child's scalp with lotion, massage it in and leave overnight, then shampoo in the morning.

Combing

Combing with a special nit comb can be a very effective, if time-consuming, way to combat nits and head lice - when used in conjunction with a natural or pharmaceutical remedy. It is especially recommended, says Michael Hepworth, if your child suffers from some kind of skin condition that may make a shampoo or lotion inadvisable.

Nit combs are fine-toothed combs which can remove the tiny eggs laid by lice. You can buy them at most pharmacists, sometimes as part of a Bug Buster or Robi Comb kit.

The key is to comb regularly and patiently - and to use the correct method. Dr Fair says to be sure of getting rid of nits and lice, you will need to comb thoroughly 30 minutes at a time, twice a week, for several weeks.

The technique is important, too. Wash the hair, and apply conditioner.

"Then, using a nit comb, begin at the hairline at the back of the neck, part the hair into very thin strands and search the whole scalp systematically through the hair," says June Tranmer.

It is important to go right down to the roots, because many nits stick close to the skin, she says, and then comb upwards.

"And after withdrawing the comb each time, push it through a piece of gauze to catch the nits and throw away."

Updated: 10:01 Monday, October 13, 2003