Four lice facts you need to know:

• Lice cannot survive more than 48 hours off a human scalp.
• Lice cannot jump. They only crawl, meaning the way you get lice is by direct contact, such as when you share brushes, combs, hats, headphones, hair elastics and by head-to-head contact.
• Children do not need to be sent home from school or daycare for head lice. Head lice do not spread disease. However, often schools and daycares may have their own policies and may require your child to be picked up. If your child has lice, notify the daycare and/or school to help prevent the spread. 
• Lice affect people in all socioeconomic classes.  Lice often carry a social stigma but anyone can get lice. It is not because of poor hygiene. Clean hair does not protect against getting lice.
• Animals do not get or spread head lice. 

What are head lice?

Head lice are small little wingless insects that live on the scalp, eyelashes or eyebrows. Head lice feed off the blood of people and do not live for long off the body. They do not cause illness or disease. They may look different depending on where they are in their lifecycle. 

Lice have stages: nits (eggs), nymphs (baby lice) and adults.

Nits (Eggs)

• Female lice lay eggs also known as nits. The nits are firmly attached (“glued”) to the hair shaft. 
• They are about the size of a pinhead and are found close to the scalp. 
• The nits are grayish-white, tan or yellow. Some can be the same colour as hair, making them difficult to see. 
• The nits (eggs) hatch into nymphs (baby lice) within nine to 10 days

Nymphs (Baby Lice)

• Nymphs are whitish-grey, tan, or brown 
• They look like small adult head lice 
• Nymphs take about one week (seven days) to mature into adult lice 

Adult Lice

• Adult lice are the size of a sesame seed and are tan to grayish-white in colour. They may look darker in people with dark hair. 
• They need blood to survive and can live up to 30 days on the head but will die within two days if they fall off the head. 
• Adult female lice can lay up to six nits (eggs) per day.

How do you get head lice?

Head lice are spread from one person to another when there is some sort of direct or indirect contact such as: 

• When heads are close together lice crawl very quickly from one head to another. 
• Sharing hats, combs, towels, hair accessories or headphones. 
• Sharing a bed or lying on a couch or pillow that has recently been in contact with an affected person. 

What should I look for if my child has head lice? 

• Your child may have an itchy scalp and sores on the scalp from scratching. 
• Nits may be present on the hair shaft (close to the scalp). 
• Movement in the hair – live lice are more common behind the ears or near the back of the neck. 
• Live lice may be found on items that have touched your child’s head such as hats and towels. 

How do I check for head lice?

• Use good lighting. (Tip: Daylight works best, so try sitting by a window or outside, weather permitting). 
• Look through the hair for lice. This can be difficult because they like to hide, are small and move fast. 
• Use a magnifying glass and fine-tooth comb (you can buy “nit combs” at your local pharmacy; the metal ones usually work better than the plastic ones). 
• Look for nits that are firmly attached to the hair shaft and within one centimetre from the scalp. Part the hair into small sections to look through the hair.
  • Sometimes nits can be mistaken for dandruff or hair spray residue (nits will only come off when you pull them with your fingernails or with a nit comb, whereas dandruff or hair spray will fall off if touched).

How are head lice treated?

Talk to your doctor, pharmacist or public health nurse about using a head lice product. Treat only the person who has head lice. There are non-prescription treatments that can be applied to hair. Treatment is available from your pharmacy. Your pharmacist can help you choose a head lice product. These treatments contain insecticides and are only effective on live lice, not nits. Do not treat anyone with a head lice product unless you find live lice in their hair. 

Be sure to: 

• Contact your health-care provider or a pharmacist before using head lice treatment if you are pregnant, breastfeeding/chestfeeding, have allergies or for a child under two years old.  
• Follow the product directions carefully. 
• Not wash hair with shampoo or conditioner for 24 to 48 hours after using head lice treatment. 
• Repeat the treatment seven to 10 days after the first treatment. This second treatment will help to kill any new lice that may have hatched.  
• Check for nits and lice daily after each treatment. This includes up to seven days after the second treatment. 

How to remove all head lice and nits from hair: 

• Use your fingernails or a head lice comb to pull off the nits from the hair. 
• Separate hair into sections then pick up a few strands at a time to remove the nits. 
• Check each section closely before moving to the next (especially behind the ears, neck nape and close to the scalp). 
• Repeat daily until there are no nits or lice. (This feels like a never-ending task, but keep at it as it is the only way to get rid of them). 
• Wet-combing Head lice (Beyond the Basics)  

Clean all objects and surfaces that have been in contact with the head

• Wash clothing and bedding used in the last two to three days by the affected person in hot water and dry in a hot dryer. 
• Items that cannot be exposed to hot water should be placed in a hot dryer for at least 15 to 20 minutes or placed in sealed bag for two weeks. 
• Vacuum or wash areas where there had been direct head contact such as: couches, beds, car seats and highchairs. 
• Put all combs, brushes and hair accessories in hot, soapy water for 10 to 15 minutes. 

Avoid other treatments that are not recommended

• Some people suggest home remedies such as mayonnaise, petroleum jelly, olive oil, vinegar or margarine. These products may make it hard for lice to breathe, but they probably won’t kill them. 
• There is little evidence that just combing out the nits without treatment works on its own. 
• There is no evidence that products such as tea tree oil or aromatherapy work to treat head lice. 
• Ivermectin is a drug that can be taken by mouth or used as a cream, but it is not approved for use in Canada. 
• Never use gasoline or kerosene. These products can be extremely dangerous. 

Do I need to keep my child at home? 

Head lice are common among young children. Many days of school would be missed if children had to stay home. Your child does not need to be kept at home from daycare or school, but it is important that the daycare or school are notified and the head lice are treated. Your daycare or school will advise you what their policy around head lice and attendance is. 

Who should I tell if my child has head lice? 

• The parents of other children who your child has recently played with, stayed for a sleepover or had head-to head contact with. 
• Your child’s daycare or school and any caregiver that may have had head-to-head contact with your child. 
• Other members in your household who had close contact with your child. Check for live lice and if any are found, treat them at the same time as your child to prevent ongoing spread in your home. Only treat those who have active head lice.  

Alerting others allows them to check for lice and treat them promptly if lice are found. This will reduce the spread to others. 

How do I prevent head lice? 

• Teach your child to avoid head-to-head contact. 
• Children should not share combs, hairbrushes, toques, hats, headphones or hair accessories. 
• If the daycare or school notifies you about lice in their facility, complete a head lice check.  If your child has long hair put it up in a ponytail or bun. 

For more information:

Call Health Links-Info Santé (Winnipeg 204-788-8200 toll-free 1-888-315-9257). You can speak to a nurse 24/7, 365 days of the year in over 100 languages. They can answer your health questions and help you find health services in your community.  

References:

• Head Lice – Caring for Kids 
• Head Lice Factsheet – Government of Manitoba 
• Communicable Disease Head Lice – Winnipeg Regional Health Authority 
• About Head Lice – Centre for Disease Control 
• Pediculosis Capitis – Up to Date