The common modern habit that causes head lice. You should warn your kids about it – while doctors reveal the best way to treat them

As a mother of four school-aged children, Jennifer Barton is a master at making sure school uniforms are clean, homework is done on time, and everyone comes to school with a healthy lunch every day.

But every year, and especially at this time, she suffers from head lice.

Over the past ten years, her children Diana, 14, Liv, 11, Stella, 9, and Ada, 7, have suffered from bullying at least once or twice a year.

This not only affects them, but also Jennifer and her husband Will, 40, who works in the financial sector.

Head lice affect thousands of households in this country every year and while the number of cases has fallen during the pandemic, it is now soaring.

Jennifer Barton with her daughter Liv, who is now 11. Jennifer checks her children’s hair every day because she has lost count of the number of times she has gotten head lice from them.

The first sign, she says, is the “dreaded itch on the scalp.”

‘Even if only one of our children has lice, we treat the whole family with a head lice treatment based on dimeticone [a silicone-like compound which smothers the bugs] until the lice are eradicated, because they spread so easily.’

She also checks her children’s hair every day. “We learned years ago that this is the only way to keep everything under control,” she says wearily.

Head lice affect thousands of households in the UK every year, and while the number of cases fell during the pandemic, they are now soaring – if the market for head lice products is any guide (Superdrug reported sales of treatment sprays rose 121 per cent compared to a year ago).

And the problem is more relevant than ever, as children once again have a lot of contact with each other in classrooms.

Jennifer says: ‘I was stressed when my oldest first got nits because it felt overwhelming. I wasn’t prepared for how common they are, even as children get older’

Most parents dread the email they receive weeks into the school year announcing a new outbreak.

But while parents are often embarrassed to admit their child has head lice, it’s “very common and nothing to be ashamed of,” says Dr Sharon Wong, a dermatologist and spokesperson for the British Skin Foundation. “It’s nothing to do with personal hygiene.”

Lice are actually one of our oldest parasites, adapting to changes in human behavior. As David Reed, associate provost at the University of Florida and an expert on the genetics of mammals and their parasites, recently told National Geographic, this is evident in the size of their claws, which are about the diameter of human hairs.

Their adaptability is evident from the fact that lice evolved in two forms when we started wearing clothes: body lice and head lice.

“People often call them nits, but they are actually the empty shells of head louse eggs,” Dr. Wong explains.

An earlier Dutch study from 2016 showed that the trend of young people putting their heads together and taking selfies is the cause of the increase in the number of cases.

This is something Dr. Wong says is “possible,” as head-to-head contact is the most common way head lice are spread. Sharing personal items like hats or hairbrushes is less likely, according to research from James Cook University in Australia in 2010.

The same goes for bedding: the NHS advises that ‘washing clothes and bedding at a high temperature is unnecessary as it is unlikely to prevent the spread of head lice’.

The popularity of long hair may also play a role. A study earlier this year by the University of Valencia in Spain suggested that short hair halves the risk of head lice.

However, Dr. Wong explains, “People with all hair lengths can get head lice, although lice are easier to see and remove on short hair.”

Despite their small size (an adult louse is about the size of a sesame seed), they can spread with frightening ease. ‘It only takes 30 seconds of contact and that can be easily done in homes and schools,’ says Dr. Wong.

That’s why they can become so ubiquitous among children in playgroups, schools, clubs – and are passed around during play dates and sleepovers.

Jennifer, 42, has lost count of the number of times she has gotten head lice from her children. Her first infestation was when her eldest, Diana, was in daycare.

“The first time my oldest got nits, I was stressed because it felt overwhelming,” she recalls.

“I had heard about them, but I wasn’t prepared for how common they still are, even as children get older and go to high school.”

Jennifer suffered from head lice when she was pregnant with her youngest child.

After being alerted to the possibility by another mother, she immediately checked her own daughter – and found a few lice.

She was concerned about using chemical treatments, so she enlisted her husband’s help to tackle the problem with conditioner and wet combing, which involves combing wet hair with a fine nit comb and a thick conditioner, which effectively traps the lice and helps remove them and their eggs.

Dermatologist Dr. Sharon Wong says it takes just 30 seconds to spot head lice — and even teens who put their heads together for a selfie could be at risk

“Luckily we caught them really early, so there were only a few lice and we were able to get them out,” Jennifer says.

While some parents swear by the old wives’ tale of combing with vinegar, Dr. Wong says home remedies aren’t as effective as chemical treatments. The best way to get rid of head lice, she explains, is to use products containing dimeticone, which “is derived from silicone oil and works by suffocating the lice.”

In fact, lice consume more water or fluid than they actually need, which they excrete through their respiratory system. Dimeticone blocks the airways, preventing the lice from releasing excess fluid, “which then kills them,” says Dr. Wong.

And because it is not an insecticide, it is not harmful to the scalp.

Dr. Wong also suggests using the wet comb method as a sort of belt-and-suspenders approach, as dimeticone typically requires two applications, one week apart.

In the UK there are two insecticides, permethrin and malathion, which work by attacking the insect’s nervous system.

However, head lice have increasingly become resistant to both. In the 1980s, permethrin had a nearly 100 percent clearance rate, but a study published in the BMJ in 2007 found it cleared up only 13 percent of cases. It’s a similar story for malathion.

The rise in insecticide-resistant ‘super lice’ “is a global problem,” explains Ian Burgess, a medical entomologist at Insect Research and Development in Cambridge, a centre that advises the NHS on parasites and tests new products.

“Malathion was introduced in 1991, and in 1993 we discovered resistance to it,” he says. “In the clinical trials of permethrin in the late 1990s and 2000s, at most 30 percent of people were cured.”

Ian Burgess says there are new treatments on the horizon, but he can’t give any details yet: ‘I’m only getting them for testing, I don’t know what’s in them.

‘But even if they are better, we still have to be careful and make sure that lice do not get used to it. We have seen occasionally that lice become resistant to dimeticone.’

Prevention is better than cure: but counterintuitively, shaving your head won’t work – ‘unless you do it every day,’ says Ian Burgess.

While some parents swear by the home remedy of combing with vinegar, Dr. Wong says chemical treatments with products containing dimeticone are the most effective

‘We did a study in Bangladesh, where children shave their heads in the summer months because it is so hot. In one place, twin girls with long hair both had lice and one of them cut her hair until she was bald.

‘The girls shared a bed and within two days the one who had shaved her head had stubble and lice again.’

For the Barton family, preventing head lice is a military operation, with parents regularly checking for new signs of an infestation.

“My husband is great at removing it by combing. We also treat at the first lice and repeat after a few days, with daily combing in between,” says Jennifer.

“Hair stays in ponytails, brushes are disinfected, sheets, pillows, and clothes are washed. You have to stay on top of it. Our nine-year-old got them at a sleepover recently and it’s taken weeks to get rid of them.”

Dr. Wong agrees that such vigilance is essential, along with treating all family members simultaneously, regardless of whether they are infected.

And most importantly, she adds, “be patient.”