1. Head Lice Prevention and Treatment Nicole Wallot Public Health Nurse
November 2012

2. How Is Head Lice Spread? Head lice spread through direct contact among
children (head-to-head),or indirectly on items such as : hats, combs, hairbrushes, headbands, helmets, and toques.

3. How do I check for head lice?
To confirm a case of head lice, you need to find live lice. Usually children have no more than 10 to 20 live lice.
Good lighting is important when you are checking.
Head lice move fast and are hard to see. They are usually found very close to the scalp, at the bottom of the neck and behind the ears.
To look for nits, part hair in small sections, moving from one side of the head to the other. Check carefully, looking close to the scalp.

4. The cycle of head lice Adult female: Size of a sesame seed(2-4mm)
Cement 6-10 nits each day
Nits: 1-2 mm from scalp and glued to the hair
Hatch in about 7-10 days
Nymphs: size of pin head, transparent and red
Head lice: Take days to achieve adult size. Won’t laid egg(nit) until adult stage.

5. Head lice eggs on hair and head louse on fingernail

6. Description of Lice Eggs
Lice eggs are called nits.
Nits are oval, white-gray-tan-dark brown
cylinders about 1/16 inch long.
Nits are glued to hairs ¼ inch (6mm)
from the scalp.
Older nits are found farther from the
scalp due to hair growth. Nits found ½
inch (12mm) from scalp are considered
nonviable.

7. Nit Removal
Expert opinion is that removal of nits is not necessary for adequate treatment, and prevention of the spread of head lice.
This opinion is based on knowledge of the life cycle of head lice.

8. Keys to Controlling Head Lice
Two treatments, 9-10 days apart, for every family member who has lice.
Daily lice combing between treatments.
Careful checking of everyone who has been in close contact with someone who has head lice.
Cleaning personal and household items family members with lice may have used.
Public Health Services recommends:
pyrethrin (found in R&C Shampoo, Pronto, Equate, or Licetrol.)
Permethrin with piperonyl butoxide (Nix Creme Rinse or Kwellada-P Creme Rinse)

9. Treatment Rational
The first treatment will kill most lice and some of the nits
Daily lice combing will remove adult lice who have survived.
Residual viable nits will hatch into immature lice within days post first treatment. Daily lice combing and the second treatment will remove/kill these immature lice before they are able to lay a second generation of nits.
The time and energies for treatment need to be focused on two adequate treatments 9-10 days apart and daily follow-up in between (rather than on nit removal).

10. How can head lice be treated?
Comb hair with regular comb to remove tangles.
Apply treatment as package describes on dry hair.
Rinse out the treatment over the sink, dry hair with clean towel.
Comb hair with regular comb to remove tangles
Comb for lice daily.
Apply 2nd treatment 9-10 days post 1st treatment
Continue checking family members regularly for at least 3 weeks post second treatment.

11. Combing for lice Pick a place to start, top of head or behind ears.
Part hair into thin, narrow sections, comb one section at a time.
Place lice comb against the scalp and pull it to the end of the hair.
Check the teeth of comb after each pull through hair. Rinse off any lice or nits under running water or wipe them away with a tissue, bag tissue.
Repeat combing until head is done several times.

12. Combing con’t
When completed wash the lice comb under the tap, use a nailbrush or toothbrush to get between the teeth of the comb. Any discarded tissue should be placed in a plastic bag, tied and trashed.

13. Household Clean-up
Wash all items used by infected people in the last 3 days (hair accessories, clothing, sheets, towels, pillowcases, stuffed toys etc.
Wash in very hot soapy water for at least 10 minutes.
Larger items that can’t be washed can either be placed in a plastic bag for 10 days, put in a hot dryer for 20 minutes, or place in the freezer for 24 hours, or ironed.

14. Do Not Treat Your Home
Lice live their entire life cycle on the human body.
Lice die within 2-3 days after falling off the host.
Treatment of homes with insecticidal sprays is unnecessary and may be hazardous.
Vacuum mattresses, carpets and furniture.

15. How to prevent the spread of Head Lice.
Check your child’s head regularly:
once a week as part of your routine
after every sleepover
every day during lice outbreaks at school
Keep long hair tied back or braided.
Teach your child not to share personal items that are used on their head:
things like brushes, combs, barrettes, headbands, elastics, towels, hats, helmets, toques, and scarves.
Teach your child to put their hats and scarves in their coat sleeves or backpacks when they take them off at school.
If your child has been in contact with someone who has lice, you need to check your child’s head carefully to see if they have caught lice.
Head lice spread easily, so if one person in the household has lice, others may have it too. Check on the same day.