Lice eggs, commonly known as nits, are the initial stage of a head lice infestation. Their small size and strong attachment to hair make them challenging to remove. Effective removal is important because nits represent the future generation of lice, ensuring the infestation continues.
Identifying Lice Eggs (Nits)
Nits are oval-shaped, about the size of a pinhead, and appear yellowish-white or translucent before hatching. Unlike flakes of dandruff, nits are firmly glued to individual hair strands with a strong, cement-like substance secreted by the female louse. They are most commonly found close to the scalp, within a quarter-inch, particularly behind the ears and at the nape of the neck, where warmth aids their development.
Rapid Removal Methods
Wet-combing
Wet-combing is a primary mechanical method for quickly reducing nits. This involves saturating hair with water and conditioner, which helps a fine-toothed nit comb glide easily. Hair should be divided into small sections, and the comb drawn from the scalp to the end of the hair strand repeatedly, wiping it clean after each pass to remove any captured nits or lice. Thoroughness is important, as it physically removes nits that chemical treatments might not affect.
Over-the-counter (OTC) Treatments
Over-the-counter (OTC) pediculicides primarily target live lice, preventing new eggs from being laid. Products containing ingredients like permethrin or pyrethrin work by disrupting the nervous system of lice, leading to their death. While effective against live lice, these treatments often have limited ovicidal (egg-killing) properties, meaning they may not kill all nits. This necessitates a second application about 7 to 10 days after the first to eliminate newly hatched nymphs before they can mature and reproduce. Some lice populations have developed resistance to these common chemicals, making diligent follow-up crucial for overall eradication.
Prescription Medications
For cases where OTC treatments are not effective, prescription medications offer stronger alternatives. These options are recommended by a healthcare professional after an initial treatment failure. Such prescriptions might include lotions or oral medications that work through different mechanisms to kill lice. They require precise adherence to instructions and often a re-treatment schedule.
Home Remedies
Some home remedies, such as applying mayonnaise, olive oil, or vinegar, are sometimes suggested for lice and nit removal. These methods are generally considered unproven or limited in their effectiveness for quickly eradicating nits. While some substances might suffocate live lice or help loosen nits, their efficacy is not consistently supported by scientific evidence for rapid and complete removal. These approaches can also be messy and time-consuming, often failing to achieve the swift results of proven mechanical or chemical methods.
Ensuring Complete Eradication
Ensuring complete eradication of nits and preventing re-infestation requires consistent follow-up and environmental management. Daily nit-combing should continue for at least two weeks after the initial treatment to catch any newly hatched nymphs before they can mature and lay eggs. This ongoing physical removal directly disrupts the lice life cycle, as eggs typically hatch within 7 to 10 days. If a pediculicide was used, a second treatment is often recommended around day 7 to 10, aligning with the expected hatching window of any surviving nits.
Environmental cleaning plays a supportive role in preventing re-infestation, though extreme measures are usually unnecessary. Head lice and nits cannot survive long off the human scalp; adult lice die within 24 to 48 hours without a blood meal. Nits require the warmth and humidity of the human scalp to hatch and will not develop off the head. Therefore, practical steps include washing bedding, clothing, and other items that have been in contact with the infested person in hot water (at least 130°F or 54°C) and drying them on a hot cycle. Combs and brushes can be soaked in hot water (at least 130°F) for 5-10 minutes; unwashable items can be sealed in a plastic bag for two weeks to ensure lice or nits die.
Finally, checking all close household contacts and family members for lice and nits is important for preventing re-infestation. Even if symptoms are not present, a thorough inspection can identify asymptomatic cases. Treating all infested individuals simultaneously helps break the cycle of transmission within the household.