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What are they?

Head lice are tiny insects with flat bodies. They are 1-2mm long, grayish-brown in color and hard to see. They have no wings and cannot jump or fly but they crawl quickly. Adult female lice lay many eggs which are called nits. Nits are very tiny eggs, half the size of a pinhead and oval in shape. They can vary in color from grayish-white to brown. Nits may look like dandruff but they are firmly glued to the strand of hair and cannot be flicked off.

How do they spread?

They usually spread through direct head-to-head contact with someone who has lice. They can occasionally spread by sharing personal items, such as hats, combs and brushes, towels, or pillows.

What should I look for?

• Nits on the hair shaft.
• Itching and scratching of the scalp although not everyone will have symptoms.
• Tiny red spots (bites) or scratches may be seen on the scalp.
• Live lice. These are often not seen because they move very quickly.

How do I check for head lice?

Check the child and all family members using the following steps:

• Use a bright light.
• The hair should be separated so that the individual strands of hair close to the scalp can be seen.
• Carefully examine the hair for nits, especially behind the ears, on top of the head and at the back of the neck.

How do I get rid of head lice?

Buy a lice killing treatment from the drugstore, which does not require a prescription. Ask your pharmacist to help you choose the right treatment and explain how to use it properly. If you are pregnant or breastfeeding consult your physician or call the Motherisk Program at 1-416-813-6780. If you are treating other people, wear rubber gloves. Consult your doctor before choosing a product for treatment of children under age 2, if lice are discovered on eyelashes, eyebrows or beard, or if skin or scalp is broken or infected.

• Remove nits. Head lice products kill many of the nits but one treatment usually does not kill all nits. Removing the nits after treatment makes it easier to see any new infestations.
• Treating head lice requires two treatments 7 days apart. Apply a second treatment in one week to kill any newly-hatched lice before they can lay eggs.
• Check all family members but only treat those with signs of lice. Continue to check for head lice daily for two weeks to make sure hair remains free of nits.
• Tell the school or childcare facility and the parents of close playmates to also check their children for head lice.
• Wash personal items, such as combs and brushes, bedding, towels, and clothing used within the past two days in hot soapy water. Teach your children not to share combs, brushes, hats, or helmets.

Remember: Two treatments one week apart are needed to get rid of head lice. Check your child's hair weekly as a regular routine. Head lice infestation is easier to treat when identified early.

An alternative treatment is based on a recommendation by Dr. Moshe Ipp, Hospital for Sick Children, Toronto. It can be used when 2 treatments, given 7-10 days apart, with Nix, R & C, Kwellada-P or PMS-Lindane are not effective.

• Soak the child's hair with a solution of 50% oil (mineral oil has less of an odor than other vegetable oils) and 50% vinegar.
• Test the mixture first by putting it on a small patch of skin on the arm and observe for 15 minutes to make sure the child is not sensitive to it.
• Cover the hair soaked with the solution with plastic for approximately one hour. Please note that plastic can cause suffocation. Do not leave your child unattended during treatment.
• Thoroughly rinse the child's hair with several applications of regular shampoo. Do not use conditioner or a shampoo that contains conditioner.
• Make sure the mixture does not get into the child's eyes. If it does, wash the eyes with plain water for 2-5 minutes.
• Use a comb soaked in vinegar to remove the nits from the hair shafts.
• This treatment may be repeated whenever necessary as side effects are unlikely.
• The theory of this treatment is that the vinegar loosens the nits from the hair shaft and the oil helps with combing out the nits. The oil is also thought to suffocate any live lice that may be present.

For further information on lice treatments (Pediculocides) contact your local pharmacist.

Source: Region of Ottawa-Carleton, Health Department