Head lice treatment: What does it mean if nits don’t clear?

Head lice are very common in young children and are usually picked up from head-to-head contact. 

They can be difficult to spot, but when you do see them, they appear as grey-brown insects about the size of a sesame seed. 

Head lice eggs can also indicate and infestation - these appear yellow, brown or white and are often empty shells attached to the hair. 

Shampoos, lotions, sprays or special fine-toothed combs, available from pharmacies, are one way to get rid of them. 

But what does it mean if head lice do not clear? 

There are several reasons why things may not get better after treatment, according to the British Association of Dermatologists: 

  • The diagnosis of head lice infection may have been incorrect 
  • You may not have followed the treatment instructions correctly 
  • The lice may have been resistant to the chosen treatment 
  • You may have picked up a new infestation immediately after the treatment finished 

There are a couple of things you can do after treatment to make sure nits don’t return: 

  • After the treatment is complete you should check every week, for a month, to make sure the lice are clear 
  • Make sure that everyone who has been in contact with an affected person is examined to ensure that they have not got head lice too - this especially apples to members of the same household and to close school friends 
  • All affected members of the household should be treated at the same time
  • The combs and brushes of an infested person should be washed in hot water daily

Can head lice be prevented? 

The NHS advises: “There’s nothing you can do to prevent head lice. You can reduce the risk of lice spreading by avoiding head-to-head contact. 

“Don’t use medicated lotions and sprays to prevent head lice. This can irritate the scalp. 

“There’s no need for children to stay off school, or to wash laundry on a hot wash.” 

These are the signs of a head lice infestation. 



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