I felt a horrible crawling sensation on my scalp. I was convinced it was nits… until I discovered it was this little-known ‘phantom’ condition that affects women in their 50s. Read the telltale signs you can’t ignore

It’s been years since I’ve felt this feeling, but suddenly I felt like I was a 38-year-old mother of a five- and seven-year-old child again. That restless feeling of things in motion…

I am literally on the move, crawling on my scalp. I brush obsessively and eventually find a stain on a strand of hair. Is this an egg? Oh my god, I think I have nits again. I experienced this disgusting situation on and off for almost a decade, between 2006 and 2014.

The autumn semesters I fear the most: the ‘Epidemic’ email from the school. Then your head will itch and you will realize that your children have once again generously shared their little friends with you.

After the first try with lice, when I felt like I might catch the bubonic plague, there was no shame in those days: It was a rite of passage for our mother tribe, and we just shared our pain.

But buying vinegar when I am 56 years old, my children are grown and I am free from vinegar, to do I feel shameful and somehow dirty – how can this be? I decided to call in the professionals for the answer.

Emily Nackvi is known as the Nit Queen of the Home Counties, a title bestowed upon her by hundreds of grateful customers since she founded no-more-nits.com in 2021.

Luckily, Emily makes house calls and soon she and her lice removal friend Gemma arrive; They look medical and professional in dark blue scrubs.

Gemma pulls out a fine-toothed orange ‘NitNOT’ comb and cuts my hair with pink hair clips. ‘Nothing so far,’ he says as he begins scanning.

Susannah is being treated at home by Emily Nackvi, who founded no-more-nits.com in 2021.

It is challenging and relaxing. I suddenly remember that my little daughter took the same care when combing my nits years ago.

Emily explains the equipment. There are magnifying glasses that cast strong light to show the customer the evidence, and white cloths to wipe the comb: tiny dark eggs that are nits, and light brown live crawlers that are actual lice.

There’s also the hair follicle heating machine and the treatment itself, an unscented, silicone-based lotion that’s a far cry from the foul-smelling Hedrin of the 2000s.

“Susannah, I did a thorough inspection and found no lice or eggs,” Gemma says quietly.

He and Emily look at each other in the mirror held above my head. ‘Sometimes these feelings arise for other reasons,’ he says.

Wait, what? I I didn’t Are there nits?

Apparently I have ‘ghost lice’; Latin origin, known as formation formica for ant – a real syndrome in which the patient suffers tactile hallucinations in which insects crawl on his skin.

So who is guilty? This frenzy is another symptom of menopause; Lack of estrogen leaves the scalp dry and tight, exposing nerve endings, which then gives misleading itching signals.

I stare at him in disbelief, my head still standing on end. ‘Are you quite sure?’ I hear myself begging. ‘I was so sure I had them. ‘I even saw an egg on my hairbrush.’

“Listen, we’re still going to do the treatment just to be sure,” Emily said soothingly as Gemma began combing the lotion. But he doesn’t seem convinced.

Great.

So now I have to endure this torture, along with nuclear hot flashes, aching joints, brain fog, and hormonal paranoia.

It turns out that Emily and Gemma are immediately suspicious of theft, given my age and the lack of young children in my immediate area, but they know better than to say so outright. Emily says: ‘It’s surprising how many cases we see, particularly in women over 50, who are completely convinced that their grandchildren gave it to them, or that they sat too close to some children on the bus.

‘I have photos on my phone sent to me by clients, endless shots of white fabrics or hairlines with the words ‘I combed this much today’. and there is not a single nits or lice in any of the photos. Not one.

‘So there’s no way we can just say, ‘Listen, there’s nothing there, it’s all in your head.’ Because these women are truly convinced; We must work with them to show that the nits are not there.’

He tells me about a young grandmother from Dorking in Surrey, in her late 50s, who is out of her mind, trying to rid herself of the ‘nits’ with every over-the-counter treatment imaginable.

Emily says: ‘When we got there, we did the scan and found no signs of nits or lice, she told us we were wrong and should have done the treatment anyway.

‘For the whole next week he was sending painful messages about how it wasn’t going away, how his head was burning from scratching and how we needed to do the treatment again. I registered it because I knew we had to handle the issue of formation sensitively.

‘The night before he sent us pictures of a white muslin with two or three small reddish-brown spots on it: crushed head lice, he said.’ When the customer opened the door, Emily said they had to hide their surprise. He had combed his head so brutally that he had torn out strands of his hair. There were crusts on his scalp; the red-brown marks in the photo were blood.

‘He was mad, talking about the shame of eating vinegar, but it was the cheating and the resulting anxiety that did the real damage.’

The formation is now recognized as a type of delusional parasitosis that is more common in women over 50.

Although drug withdrawal is less severe than that resulting from disorders like Parkinson’s disease or bipolar disorder, various Reddit threads make clear that there are hundreds, even thousands, of women like me who go undiagnosed for both head lice and mental health issues.

‘Menopause formation is real, physical and treatable, and should be addressed holistically,’ Emily says as she and Gemma gather their equipment. ‘You could go to a dermatologist, look at estrogen HRT, or even look at psychological support.

‘The client at Dorking did all three approaches. He still sends us notes thanking us for getting rid of the “imaginary nits.” ‘£85 per head treatment – we didn’t charge him for the second call – it’s cheap therapy.’

I don’t think I need professional help – I’m too busy being angry that menopause is again to blame – but I’m back to scratching my head as I write this article.

I go to the bathroom to find my old round Nitty Gritty comb to quadruple-check if the Nit Queens have missed anything. I look crazy in the mirror after all that hair combing; He’s like a longer-haired Albert Einstein, but without the flash of genius. So I give myself the right to speak.

‘You don’t have any nits. It’s all in your head. You’re just obsessed with formation.’

I end up having to snicker at the word. Where there is laughter there is healing.