Head Lice

Head lice can be a persistent and frustrating problem. New research, however, shows that head lice management can be straightforward and less time-consuming. It is essential to:

  • give 2 treatments 7-10 days apart, and
  • inform all close contacts so that cases can be identified and treated at the same time.

Head lice do not spread disease. Anyone can get them. They crawl from person to person by direct head-to-head contact. They are more common in children, as their heads frequently touch when they work and play together. Symptoms of head lice are mild; itching is the main complaint. Parents should check their children’s hair weekly for head lice – more often if there is an outbreak.

What to Look For

Lice are small, flat insects that live on the human scalp. They have no wings and cannot jump or fly. They are about the size of a sesame seed, greyish brown in colour and hard to see. It is easier to find their eggs (nits) since they are glued to the hair shafts and do not move.

Nits are very tiny – the size of a grain of sand – and oval in shape. Live nits, which are laid right next to the scalp, are tan to brown in colour, and are very difficult to see. White nits more than 1 cm from the scalp have likely hatched or died. They may look like dandruff but they cannot be flicked off.

Check carefully for nits by looking close to the scalp behind the ears and at the base of the neck. Use a bright light and a magnifying glass, if available. Act quickly if you find them. Children with head lice should not attend a school or child-care facility until their head lice have been treated.

How to Get Rid of Head Lice

Once discovered, head lice can be treated easily by following these steps:

  • Check all close contacts: If one person in the family has head lice, it is possible that other family members will also have them. Tell the school, day care and children’s groups (ie. sports clubs, Cubs, etc) so parents can be notified to check their children’s hair. An untreated source among close contacts is a common reason for getting head lice again. It is important that all individuals who have head lice be treated at the same time.
  • Talk to Your Pharmacist: Your pharmacist can help you choose a product that will kill head lice. It is important to read the list of ingredients and the directions very carefully. Consult your doctor if the person being treated is allergic to any of the ingredients, is pregnant or breastfeeding, is under 2 years of age or has open sores on the scalp. The following products have been proven to be safe and effective when used as directed: Nix, R&C, Kwellada, and PMS-Lindane. There are currently no published research studies showing the success or safety of alternative head lice treatments such as tea tree oil or Vaseline. The use of these and other alternative treatments is not recommended.
  • Give 2 Treatments 7-10 Days Apart: Research has shown that the first treatment will kill head lice but not all of the eggs. These eggs can continue to hatch over the next week. All products must be used again in 7-10 days. This will kill the newly hatched lice before they are able to move from head to head and reproduce. If you find head lice moving in the hair 24-48 hours after the first treatment, use a different head lice product immediately. Repeat this treatment 7-10 days later.

Important Points About Using Head Lice Products

Use only when lice or nits are present. These products do not prevent lice.

Timing is important; if you rinse the product off too soon, lice and nits may not be killed. If left too long, there is unnecessary exposure to chemicals.

Limit skin exposure. Wear rubber gloves. Rinse the hair under a tap instead of the shower. Cover the face with a towel during treatment. Store head lice products away from children.

Nit Removal

Nit removal is not necessary when using two treatments 7-10 days apart. Students may return to school or child care facility after the first treatment, even if nits still remain in the hair. However, removing the nits after treatment may avoid confusion at a later head lice check and will prevent over-treatment. It is also important for appearance sake.

Short sessions of nit removal over several days may be easier than one long session. Work with small sections of the hair using a bright light. With a fine-toothed nit comb or your fingernails, pull the nits from the hair strands starting from the roots right down to the tips. Wipe the nits onto a tissue, and place in a bag for disposal.

Cleaning Personal Items

Head lice and their nits do not survive away from the warmth and humidity of the scalp. As a result, extra housecleaning and use of insecticide sprays are not needed. You will probably want to wash combs and brushes, headgear, bed linen and towels in hot water. The sharing of hats, scarves, hair accessories and combs should be discouraged.

Head lice information and workshops are available by calling the Ottawa-Carleton Health Department Child and Adolescent Health Division at 722-2281.