Head Lice
Prevention and Treatment
Ruth-Anne Morris
Public Health Nurse
September 2013
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.
The cycle of head lice
How do I check for head lice?
 To confirm a case of head lice, you need to find 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.
Head lice eggs on hair and head louse on fingernail
Description of Lice Eggs (Nits)
•oval, white-gray-tan-dark brown
cylinders about 1/16 inch long.
• glued to the side of the hair ¼ inch
(6mm) from the scalp.
•Older nits are found further from the
scalp due to hair growth.
Nits found ½ inch (12mm)
from scalp are considered
nonviable.
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.
Keys to Controlling Head Lice
• Two treatments, 9 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. Only treat those with lice.
• Cleaning personal and household items
family members with lice may have used.
Treatment Rational
• The first treatment will kill most lice and some nits
• Daily lice combing will remove adult lice who have
survived.
• Residual viable nits will hatch into immature lice
within 7 -10 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).
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 days post 1st treatment
• Continue checking family members regularly for at
least 3 weeks post second treatment.
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.
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.
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.
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.
How to prevent the spread of Head Lice
• Check
. your child’s head regularly:
1. once a week as part of your
routine
2. after every sleepover
3. 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.
Web Links
• The provincial Head Lice pamphlet ‘How to Find, Treat
and Prevent Head Lice’:
http://www.goc.ns.ca/hpp.publications/07135headlicepam
phleten.pdf.
• The Provincial guidelines for Head Lice:
http;//www.gov.ns.ca/hpp/publications.headliceguidelinesf
or treatment.
• HRSB policy:
http://www.hrsb.ns.ca/files/downloads/pdf/board/policy/se
ctionb/b.005-head-lice.pdf.
More Great Websites…
• The Canadian Pediatric Society:
http://www.caringforkids.cps.ca/whensick/headlice.htm.
• Pollack, Richard. Harvard School of Public Health:
https://identify.us.co./idmybug/head-lice/index.html.
• Rick Speare. James Cook University:
www.jcu.edu.au/school/phtm/PHTM/hlice/hlinfo1.htm.
• Center of Disease Control and Prevention:
www.cdc.gov/ncidod/dpd/parasites/headlice/factsht_head
_lice.htm.