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Head Lice Prevention & Treatment

What you should know about head lice

Lice, like ants at a picnic, are a part of nature. We dislike them and don’t want them in our hair or in our home.

Lice have three stages – the egg (nit), the nymph and the adult.

  • Nits are whitish-grey or tan and approximately the size of a grain of sand. Head lice lay their eggs on the hair shaft very close to the scalp with a waterproof “glue.” This makes it difficult to wash them off or brush them out like dandruff.
  • Nymphs are baby lice. They look like adult lice but smaller.
  • Adult lice are approximately the size of a sesame seed. They have six legs and are usually tan, grayish white or brown in colour. Lice move quickly and can be difficult to see.

Lice do not jump, fly, swim, or live on pets such as cats and dogs.

Lice are a nuisance but are not a health concern. They do not cause illness or disease.

The good news is that lice can be managed…and removed. There are ways and treatment options and steps you can take to stop lice from spreading.

How do I know if my child has lice?

  • tickling or itchy feeling on the head
  • feeling something moving in the hair
  • frequent scratching of the head

In very bright light, look for lice and nits (lice eggs):

  • close to the scalp
  • around the ears
  • near the forehead
  • near the base of the neck

Live lice can be seen moving in the hair close to the scalp. Nits (lice eggs) can be seen close to the scalp attaching to the hair stand.

NOTE: Unlike dandruff, nits don’t easily move and need to be removed using a comb or your fingernail.

How to prevent lice from spreading

To prevent getting head lice, avoid direct hair-to-hair contact with others and wear long hair tied up.

Do NOT share personal items such as:

  • brushes and combs
  • hair bands, ties, and elastics
  • head phones
  • hats or helmets
  • scarves or towels

If someone in your home is found to have head lice, check all other family members for lice as well.

Treating Head Lice

Lice shampoo products have been shown to be the most effective method for getting rid of head lice. Before using any head lice shampoo product, read the product inserts and carefully follow the instructions on the package. In some cases, multiple applications may be required to completely remove the lice.

For information about various shampoo options, or if you have questions about how to use the product, ask your pharmacist.

Other Treatments

Some people suggest home remedies for head lice, such as mayonnaise, petroleum jelly, olive oil, vinegar, mineral oil or tea tree oil. There is no evidence that products such as these work to effectively treat head lice.

NEVER USE WD-40, gasoline, kerosene or any other flammable liquid to treat head lice. These products do not work to remove or prevent lice, but they can pose a serious risk to health.

Where to Buy Lice Products

Head lice shampoo or crème rinse treatment products are available at most pharmacies.

People who receive government funding through Ontario Works (OW) or Ontario Disability Support Program (ODSP) can get lice treatment products for low or no cost from pharmacies with a prescription.

People who have health care benefits through their employer can ask for a prescription from their doctor to get a lice treatment product for a low cost.

Alternative option: Wet combing

Note:

  • There is limited evidence that wet combing works all on its own to completely get rid of head lice. It is not recommended as a primary treatment, but can be effective when combined with lice shampoo treatment.
  • Some people may not be able to use medicated shampoo treatments (e.g. due to a medical condition, or if you are pregnant or breastfeeding). If this is the case, wet-combing of the hair is a non-chemical way to attempt to treat head lice.

Wet combing is done by using a fine-toothed metal comb designed specifically to remove nits and lice from hair strands while the hair is wet with water and/or regular hair conditioner. It needs to be done EVERY FOUR DAYS FOR 14 DAYS to be effective.

Wet combing requires time and commitment for the routine to be successful. You may need to dedicate 30 minutes to one hour of time depending on the child’s hair.

Nit combs can be purchased at a pharmacy for approximately $5 – $10.

Wet combing method

  1. Collect all equipment; lice comb, hair conditioner, hair clips and small brush.
  2. Drape a plastic apron around the neck of the person being treated. A large garbage bag with a hole cut in the bottom to fit over the head will also work.
  3. Find a brightly lit area near a window, or have the child sit near a lamp or use a flashlight to see the scalp well.
  4. Have the child sit on a non-upholstered surface, like a plastic or wood chair.
  5. Wet hair fully with water, pat dry and add regular hair conditioner (this makes combing easier). Do not rinse conditioner out of hair.
  6. Separate hair into small sections, starting at one side of the head, and slowly work toward the other side.
  7. Using the lice comb, place the comb against the scalp at the top of the head. Pull the comb slowly and firmly on an angle from scalp to the end of the hair strand.
  8. Remove and any lice, nits, nymphs, egg shells found in the comb using a small brush.
  9. Rinse the lice comb in hot water after each stroke of hair.
  10. Repeat combing until no lice, nits or eggs are found in the comb. Clip the combed cleaned hair away from non-combed hair.
  11. Repeat this process until every section of hair has been combed.
  12. Once combing is complete you may shampoo with regular shampoo OR use a head lice shampoo and follow the package instructions.
  13. Repeat this process every four days for 14 days until no live lice, nits, or shells are found in the hair.

Cleaning Your Home

Lice can’t live longer than approximately 24 hours on non-human surfaces like carpets, hardwood floors, clothing, and furniture. However, if you have identified lice in your home, isolate and wash those items and areas within at least 72 hours.

Pay special attention to items that directly touch the head such as hats, pillowcases, car seat covers, combs and brushes. Wash these items in hot water and dry them in a hot dryer for at least 15 minutes, or store the items in an airtight plastic bag for two weeks.

Call your health care provider if….

  • Your child is under 2 years old
  • Has a seizure disorder
  • Has lice or nits on the eyebrows and eyelashes
  • Has open sores or wounds on the scalp
  • Has allergies

If you are pregnant or breastfeeding, call Motherisk at 416-813-6780 for more information.

Resources

Centre for Disease Control and Prevention, Head Lice information for schools

Canadian Pediatric Society

Copyright

This resource is intended as an information resource for use by schools administrators, teachers, parents and child care centres. This resource is a collaboration of the Haldimand-Norfolk Health Unit and the Brant County Health Unit. Permission to copy and distribute to non-profit organizations for education purposes is granted. Please credit the source of this material as noted above.

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