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Head lice are tiny insects that live on the scalp, feeding on human blood. They lay eggs, called nits, which stick to strands of hair very close to the scalp.
Head lice are often not diagnosed correctly. Head lice are hard to see because they are tiny and move around. The nits are easier to see. Live nits are very small, about one-third the size of a sesame seed. They are "glued" to hair strands close to the scalp. Dead nits are found further down the hair shaft. Nits may look like dandruff, but they cannot be flicked off.
Head lice are not a health hazard,
and do not cause or spread disease. |
Anyone can get head lice. Having head lice does not mean a person is unclean.
Head lice are commonly spread among children and adults who may stay close together in one place, such as in child care settings and schools. Head lice cannot jump or fly from one person to another.
Although less likely, head lice can also be spread by children sharing hats, combs, hairbrushes or headphones.
Head lice can best be controlled through the cooperation of parents, children, and school and health care providers. Once parents learn how to recognize head lice, regularly checking your own and your child's hair is the best prevention.
Children should be encouraged not to share personal items such as hats, combs, hairbrushes or headphones.
The most common symptom is constant scalp itching. Other symptoms may include scratch marks or small red lesions like a rash. Some children who have head lice may have no symptoms.
Check your child's scalp if your child may have been exposed to head lice. Good lighting is important. Part the hair into small sections going from side to side with your fingers or a special head lice comb. Some people report that first applying hair conditioner is helpful in finding live nits or eggs.
Check the entire head carefully, looking close to the scalp. Live nits or eggs may be easier to find behind the ears and at the bottom of the hairline just above the neck.
If no lice or nits are found, repeat the above procedure again in one week. Repeat again after two weeks if someone else in the family has head lice.
Having head lice once does not protect your child from getting them again.
Call your doctor or public health nurse if the treatments using non-prescription medications are not successful. Treatment of pregnant or nursing mothers and of children less than two years of age should be given under the direction of a doctor only.
Treatment should be considered only if head lice or live nits are found. Head lice will not go away without treatment.
If one person in the family has head lice, there is a good chance other family members do as well. Check all family members and treat those who have head lice all at the same time. This will help to make sure head lice are properly treated and will not spread.
There are many different products and ways to treat head lice. If one treatment does not work to get rid of head lice, then try a different treatment. Parents, students and teachers are advised to work closely with local public health nurses on treatment options.
There could be resistance or a heavy infestation if live, active lice are seen 24 to 48 hours after the first treatment. Immediate treatment is recommended using a different product, followed by a second treatment seven days later.
Chemical treatments
Non-prescription medications - Shampoos, creams and rinses that contain an ingredient that kills lice are available at most pharmacies without a prescription. Follow exactly the directions for use on the label.
After treatment comb the hair well with your fingers or a special head lice comb to remove all nits or eggs. Thorough combing is just as important as the use of the medication.
The treatment may need to be repeated in seven to 10 days. Itching may last for seven to 10 days, even after successful treatment.
The medications should be kept out of the reach of young children. These medications cannot be used for infants. Pregnant or nursing mothers should only use head lice medications following advice from their doctor.
Non-Chemical treatments
Wet-combing - this method removes live head lice. Wet-combing is cheap and safe but takes time to complete. The combing steps must be followed carefully and completely. Combing treatments are done using generous amounts of hair conditioner and a special lice comb, every three to four days for a two-week period. Any young lice that hatch from eggs after the first session are removed at the second, third and fourth sessions. This is why it is important to do the full four sessions. Contact your public health unit for complete instructions on the wet-combing method.
Children may return to school or daycare after their first treatment. Children should receive their first treatment at home the first day that they are found to have head lice. Some schools have a "no nits" policy. In this case, the child can only return to school or daycare after nits or eggs have been removed. No nits policies are discouraged by the Canadian Paediatric Society. A child should return to class following the first treatment, but be encouraged to avoid head-to-head or close contact with other students.
Confidentiality should be maintained in order not to embarrass a child who has head lice.
If a child has head lice a second time, he or she likely has caught them from a person with untreated lice.
Treatment methods not recommended
Methods and products that should not be used because they are either not safe or do not work include: insect sprays, motor oil, gasoline, alcohol, flea soap, dyes, bleaches, heat applied to the scalp, garlic, essential oils, and shaving the head.
Head lice do not survive for long once they are off the scalp. Head lice do not pose a risk to others through contact with furniture or carpets. There is no evidence that a major cleaning of the house or car is necessary.
On the day you start the treatment, wash all dirty clothes, bedding, towels, brushes and combs in hot water. Items that cannot be washed, for example pillows or stuffed animals, can be placed in a plastic bag for ten days or in the freezer for 48 hours. A child's car seat may be vacuumed as a precaution.
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