Photo: RNZ
As parents, teachers and children start getting ready for term one, families will be on the lookout for itchy scalps caused by head lice.
iSpyNits founder Kate Ricketts. Photo: Supplied
iSpyNits founder Kate Ricketts, who created a world-first lice detection powder, says the six-legged insects thrive in the warmer weather and often spread when kids share hats or put their heads close together.
"We saw a real spike in it probably about a week after Christmas, and that would be because I would say a lot of families came together … And it dipped down again [after Christmas].
"I am anticipating in the next couple of weeks that it's going to explode again because of [kids] going back to school. But of course if you've got little siblings and they bring it home from school, there's a high chance you're going to get it as well."
The tiny critters can be tricky to get rid of; they can't be drowned, the louse camouflages her eggs with hair pigment making it harder to spot, and a lot of the treatments target the moving lice not unhatched eggs, she says.
So how can parents get on top of the problem? And what can they do if they cannot afford the costs of medication?
What's the best way to tackle nits?
Ricketts advises parents to check children's hair - in particular behind ears and around the nape of the neck - every week or two during warmer weather and every few weeks in winter.
"Some kids will say I'm itchy and that's because the lice has hatched and they're biting and the kids are feeling the sensitivity of the saliva … [but] some kids can have it and not feel any itching.
"What you're trying to avoid is looking at the head and it's teeming with lice eggs and insects, right? So the idea would be you could do regular checks, I would say every one to two weeks."
While you could reuse nit combs between people (making sure to clean it), parents should try to keep hair brushes separate, she says. But she understands that's not always possible.
Louise Robertson is a nurse with Mana Kidz which offers public health guidance and treatment at schools in south Auckland. She suggests wet combing using hair conditioner and a fine-toothed comb every three days for 21 days to interrupt the head lice cycle.
Is a nit comb or one treatment enough?
(file image) Relying on just a nit comb may mean you miss catching all the eggs, Kate Ricketts says. She advises people to also use their fingers to remove them. Photo: 123RF
Robertson says hair needs multiple treatments and combing to ensure all live lice and eggs are removed.
"Sometimes when there is bad and untreated infestation, scalp infections can occur from scratching, so the nurses will treat with antibiotics first and wait for the skin to heal before starting eradication of lice/eggs with dimethicone and combing." Robertson wrote in an email to RNZ.
"In terms of scalp infections, some whānau have seen good healing results from kawakawa or mānuka honey. They can discuss these options with the school nurse and can complement antibiotic treatment."
Australian public health physician Richard Speare told RNZ in 2015 that if you use a nit comb with no product, the lice can run away - as fast as 2cm a second. Using it in combination with a conditioner can help stun them in place.
But Ricketts says no matter how tight your nit comb's teeth are, you could be missing eggs - just one could mean another reinfestation.
"The only way [to make sure you get rid of eggs] is really removing them with your finger and thumbnail, basically by running it along the hair shaft because the mum actually glues it on with this really strong glue that, if you could bottle it, you'd be a trillionaire."
Do we need to get rid of our pillowcases?
Speare's 2002 study counted about 14,000 lice on more than 2000 schoolchildren's heads and looked for lice on school carpets. None were found on the carpets.
Lice usually die within a day of being off the human head, because they'll be lacking a source of nutrients.
But in a 2003 study focusing on pillow cases, he found a small percentage on the pillows - although most were dead.
The study found washing pillowcases in hot water or drying them in a hot clothes dryer for 15 minutes can kill the lice.
Do home remedies work?
Ricketts says some people may be resorting to olive oil or coconut oil under the impression that it works in a similar way to dimethicone - a silicone-based ingredient often found in conditioners, which can stun moving lice for a short time. But the effectiveness of using these as a lone long-term treatment has not been clear in research.
Ricketts, who often reviews research and literature on head lice from overseas, says conditioners usually contain a small amount of dimethicone - "it's what makes your hair feel slippery - so a high concentration is going to be much more effective".
Clinical dimethicone-based treatments can trick the lice into keeping their spiracles open so they're flooded with water and die, Ricketts says.
Speare told RNZ in 2015 that the risks of using kerosene - which is highly flammable - far outweighed any benefits.
"The herbal products vary immensely because there's a vast range of active ingredients. So one is based on tea tree oil, eucalyptus seem to have reasonable efficacy. Then there's a whole range of other of other products as well and they vary quite markedly about whether they kill head lice or not."
I'm struggling with the cost of head lice treatment, what can I do?
Charity KidsCan previously ran a programme called NitBusters which put people into schools to treat head lice. Although government funding for that programme ran out in 2017, KidsCan still provides assistance to schools and childhood centres. Last year, it gave 23,114 bottles of lice treatment and 18,894 nit combs.
Some head lice treatments can also be prescribed by a doctor and are subsidised.
Ricketts works with various foundations to fund her lice treatment kits through groups like Mana Kidz who can distribute them out to schools and places that need them the most.
"Encourage your school to get in touch with us because we will try and find what funding is available in that area … and then we can work with the school to put in an application to receive bulk lots of kits."
