It has been years since I had this sensation but suddenly I feel 38 again, mother of a five and seven year old. It’s that restless feeling, of things on the move…
Literally on the move, crawling across my scalp. I brush obsessively and eventually find a speck on a strand of hair. Is it an egg? Oh God, I think I’ve got nits again. I had this revolting condition on and off for nearly a decade between 2006 and 2014.
It’s the autumn terms I remember with the worst dread: that ‘Outbreak’ email from the school. Then your own head would itch and you would know that, once again, your children had generously shared their little friends with you.
After the first trial by louse, when I felt like I may as well have bubonic plague, there was no shame in those days: it was the nit rite of passage for our mum tribe and we simply shared our travails.
But to get nits at the age of 56, when my children are all grown-up and nit-free, does feel shaming and somehow grubby – how could this have happened? I decide to call in the professionals for an answer.
Emily Nackvi is known as the Nit Queen of the Home Counties, a title bestowed by hundreds of grateful clients since she started her company no-more-nits.com in 2021.
Mercifully, Emily does house calls, and soon she and her fellow delouser Gemma arrive, looking medical and professional in dark blue scrubs.
Gemma gets out a fine-toothed orange ‘NitNOT’ comb, and sections off my hair with pink hair clips. ‘Nothing so far,’ she says as she starts to comb.
Susannah Jowitt had nits on and off for nearly a decade between 2006 and 2014 but when she got the condition again aged 56 she decided to call in the professionals for help
Susannah is treated at her home by Emily Nackvi who started her company no-more-nits.com in 2021
It’s painstaking and comforting. I suddenly remember my small daughter taking just as much care when she used to comb my nits out years ago.
Emily explains the equipment. There are the magnifying glasses with a strong light, along with white cloths on which to wipe off the comb, to show the client the evidence: the tiny dark eggs that are the nits, and the lighter brown live crawlers that are the actual lice.
She also has a hair root heat machine and the treatment itself – a fragrance-free silicon-based lotion that is a far cry from the foul-smelling Hedrin of the 2000s.
‘Susannah, I’ve done a detailed examination and found no lice or eggs,’ says Gemma quietly.
In the mirror, that is being held over my head, she and Emily exchange a glance. ‘Sometimes these sensations happen for other reasons,’ she says.
Wait, what? I haven’t got nits?
It would seem I have ‘phantom lice’ – known as formication, from the Latin formica for ant – an actual syndrome whereby the sufferer endures tactile hallucinations of insects crawling over their skin.
And the culprit? This madness is just another symptom of the menopause – with lack of oestrogen making the skin of the scalp dry and tight, exposing nerve endings that then give misleading signals of itchiness.
I look at her in disbelief, my head still bristling. ‘Are you quite sure?’ I hear myself plead. ‘I was so positive I had them. I even saw an egg on my hairbrush.’
‘Listen, we’ll do the treatment anyway, just to make sure,’ Emily says soothingly as Gemma starts to comb through the lotion. But she doesn’t look convinced.
Marvellous.
So in addition to nuclear hot flushes, aching joints, brain fog and hormonal paranoia, I now have to endure this torture, too.
It turns out Emily and Gemma had suspected formication right away, given my age and the lack of small children in my close proximity, but they know not to say this straight up. Emily says: ‘It’s amazing how many cases we see, especially in women over 50, who are utterly convinced their grandchildren have given it to them, or they’ve sat too close to some children on a bus.
‘I have photos on my phone sent to me by clients, of endless shots of white cloths or hairlines with captions saying, “Combed out this many today!” and there isn’t a single nit or louse in any of the photos. Not one.
‘So there’s no way we’re just going to say, “Listen, there’s nothing there, it’s all in your head”. Because these women are genuinely convinced – we have to work with them to show the nits simply aren’t there.’
She tells me about one youthful, late-50s grandmother from Dorking in Surrey who was at her wits’ end, having tried to get rid of her ‘nits’ with every conceivable over-the-counter treatment.
Emily says: ‘When we got there, did the comb-through and found no evidence of nits or lice, she told us we had to be wrong and to do the treatment anyway.
‘For the whole of the next week, she sent agonising messages about how they hadn’t gone, how her head was on fire with itching and how we had to do the treatment again. So I booked her in, knowing we would have to handle the issue of formication sensitively.
‘The night before, she sent us pictures of a white muslin that had two or three tiny reddy-brown marks on it: squashed head lice, she said.’ When the client opened the door, Emily said they had to disguise their shock. She had raked at her head so brutally she had pulled out clumps of hair. Her scalp had scabs on it – the red-brown marks in the photo were blood.
‘She was frantic, going on about the shame of having nits, but it was formication and the resulting anxiety doing the real harm.’
Formication is now recognised as a type of delusional parasitosis more often seen in women over the age of 50.
Although milder than the formication from drugs withdrawal, Parkinson’s or conditions such as bipolar disorder, various Reddit threads make it clear that there are hundreds, if not thousands, of women like me out there, undiagnosed because of the stigma of both head lice and mental health issues.
‘Formication in menopause is real, physical and treatable, and should be tackled holistically,’ Emily says as she and Gemma pack up their equipment. ‘You could see a dermatologist, look into oestrogen HRT or even look at psychological support.
‘That client in Dorking did all three approaches. She still sends us notes thanking us for getting rid of her “imaginary nits”. At £85 per head treatment – we didn’t charge her for the second call-out – it’s cheap therapy.’
I don’t think I need professional help – I’m too busy being cross that, yet again, menopause is to blame – but while writing this article, I have gone back to scratching my head.
I go into the bathroom to find my old round Nitty Gritty comb, just to quadruple-check that the Nit Queens didn’t miss something. In the mirror, after all the hair-raking, I look demented – like a longer-haired Albert Einstein, but without the gleam of genius. So I give myself a right talking-to.
‘You have not got nits. It’s all in your head. You’re just obsessed with formication.’
I have to snicker, finally, at the word. Where there’s laughter, there’s recovery.
