Head Lice A Nit-Pickin Nuisance

1. Head Lice A Nit-Pickin’ Nuisance

2. What are Head Lice? Insects that live and reproduce on your head Head lice feed on blood from your scalp Head lice are a common nuisance, but are not considered a health hazard Life cycle: - Egg is laid on hair shaft, close to scalp. Egg is called a 'nit'. - (nymph) Louse emerges after 6-7 days. - Adult lice live for 20 days, and the female can lay between 50-150 eggs. Life cycle: - Egg is laid on hair shaft, close to scalp. Egg is called a 'nit'. - (nymph) Louse emerges after 6-7 days. - Adult lice live for 20 days, and the female can lay between 50-150 eggs.

3. Who can get Head Lice? Anyone who has close head-to-head contact with someone who has head lice More common among preschool & elementary school-aged children & their families Personal hygiene or cleanliness in home or school has nothing to do with getting head lice Head lice cannot live on pets or animals, only on humans Head lice can affect anyone - it is most common among preschool and elementary school aged children (3-10 yrs) because of their close contact/play - Adults CAN get head lice! Head lice can affect anyone - it is most common among preschool and elementary school aged children (3-10 yrs) because of their close contact/play - Adults CAN get head lice!

4. How do Head Lice Spread? Head lice crawl quickly from one head to another when in close contact Head lice cannot fly, jump or hop Head lice can be transferred when personal objects are shared (e.g. combs, brushes, hats) Personal objects - i.e. combs, brushes, towels, hats, stuffed toys, pillows and clothing Personal objects - i.e. combs, brushes, towels, hats, stuffed toys, pillows and clothing

5. Recognizing Head Lice Tickling feeling on scalp Itchy scalp Feeling of something moving in the hair Irritability Sores on head from scratching Presence of nits (eggs), nymphs or adult head lice Tickling and persistent itching is caused by an allergic reaction to head lice saliva Sores on head from scratching can become infected Tickling and persistent itching is caused by an allergic reaction to head lice saliva Sores on head from scratching can become infected

6. What do they look like? Adult head lice: Tiny wingless brown insects; size of a sesame seed Live for about 20 days If a louse crawls off of a head, it dies within 2 days Adult Head Lice Grayish-brown in colour Have hook-like claws that hold onto the hair shaft Adult Head Lice Grayish-brown in colour Have hook-like claws that hold onto the hair shaft

7. What do they look like? Nymphs: Are baby head lice Smaller than adult head lice Mature in about 1 week Adult Head Lice Grayish-brown in colour Have hook-like claws that hold onto the hair shaft Adult Head Lice Grayish-brown in colour Have hook-like claws that hold onto the hair shaft

8. What do they look like? Nits (eggs) Tiny specks; about the size of a knot in thread Firmly attached to the hair close to the scalp Usually found on the hair behind the ears, at the back of the neck, and above the forehead Do not mistake for dandruff, which can be easily blown off

9. Treating Head Lice Ask your pharmacist for a recommended treatment product Only use treatment when nits or head lice are present Head lice products do not prevent head lice Follow product instructions carefully to avoid re-infestation Treat head lice immediately Use a commercial head lice product - available over-the-counter (without a prescription) - R&C and Nix are covered under Ontario Works with a prescription Treat head lice immediately Use a commercial head lice product - available over-the-counter (without a prescription) - R&C and Nix are covered under Ontario Works with a prescription

10. Treating Head Lice Products kill the head lice and many eggs A second treatment is needed 7 to 10 days after the first treatment to kill any newly-hatched lice before they mature Treat head lice immediately Use a commercial head lice product - available over-the-counter (without a prescription) - R&C and Nix are covered under Ontario Works with a prescription Treat head lice immediately Use a commercial head lice product - available over-the-counter (without a prescription) - R&C and Nix are covered under Ontario Works with a prescription

11. Steps to Treating Head Lice… Before applying treatment shampoo child’s hair over a sink with regular shampoo Do NOT use conditioner or combination shampoo/conditioner Many products require you to damp-dry hair with a towel or blow dryer

12. Wear plastic or rubber gloves to avoid unnecessary exposure to treatment product Wrap a towel tightly over the child’s eyes to protect them

13. Apply the head lice product according to product directions * Timing is important: If product is rinsed off too soon, head lice and nits may not be killed If left on too long, there is unneeded product exposure may need to use a second bottle of product if child has long hair – ask your pharmacist may need to use a second bottle of product if child has long hair – ask your pharmacist

14. Rinse child’s hair under tap, not in shower or bath, to minimize product exposure on the rest of the body Wash your hands well after using product Do not re-wash hair for several days after treatment

15. A second treatment is required 7 to 10 days later to kill any newly-hatched lice If you see live head lice 24 – 48 hours after treatment, then immediately treat again with a different product Treating Head Lice

16. Treating Head Lice Talk to your family doctor: If a child is under the age of 2 If you are pregnant or breastfeeding If a person has a seizure disorder If a person has broken or infected skin on the scalp If lice are on eyebrows, eyelashes or facial hair

17. General Product Information Follow the directions Timing is important Do not mix products Rinse child’s hair under tap Products should not be used near the eyes, nose, or mouth

18. General Product Information Wear plastic or rubber gloves Wash your hands after using product Store products away from children Do not apply to open or infected skin

19. Treating Head Lice… All nits should be removed after treating with product Head lice products are not 100% effective; they may not kill all of the nits Removing nits: will reduce hatching of eggs that were not killed with treatment will allow you to notice if a new infestation occurs

20. To remove nits: Part and lift hair to check for nits or lice Work under a good light (window or lamp) Live lice can be removed with scotch tape wrapped around your finger

21. To remove nits: Use fine-tooth nit comb or thumbnail/first finger to grab nit & slide it off hair shaft Place nits in a plastic bag; when done, seal or tie up the bag and put in garbage Take frequent breaks, especially with young children Check & remove nits daily for 2-3 weeks To remove nits: - have person sit in a comfortable chair in a room with bright, natural light - comb hair to remove tangles - part and lift strands of hair to remove nits and lice - If using nit comb, comb hair from the scalp to the ends, repeating until all nits and head lice are removed - Not all nit combs are effective. Use your thumbnail against your first finger to grab the nit and slide it along the hair shaft. To remove nits: - have person sit in a comfortable chair in a room with bright, natural light - comb hair to remove tangles - part and lift strands of hair to remove nits and lice - If using nit comb, comb hair from the scalp to the ends, repeating until all nits and head lice are removed - Not all nit combs are effective. Use your thumbnail against your first finger to grab the nit and slide it along the hair shaft.

22. Treating Head Lice Avoid home remedies – no scientific proof of effectiveness Do not use flea control products, turpentine, paint thinner, etc. If your child has head lice, tell the school/child care facility & child’s close contacts immediately to prevent further spread

23. Housecleaning Wash in hot, soapy water: Headwear, combs, brushes, pillowcases, towels, bed sheets Excessive housecleaning is unnecessary Do not use insecticide sprays To prevent re-infestation of head lice: - Wash combs and brushes with soap and hot water To prevent re-infestation of head lice: - Wash combs and brushes with soap and hot water

24. Controlling the Spread of Head Lice Discourage head-to-head contact and sharing of hats, scarves, brushes, combs and headwear Check heads of all people in close contact Treat all family members with head lice at the same time

25. Controlling the Spread of Head Lice Check young school-aged children weekly for head lice; more often if there is an outbreak If head lice continue to return, call your local health unit

26. Recommended Websites: Centre for Disease Control http://www.cdc.gov/ncidod/dpd/parasites/lice/factsht_head_lice.htm Canadian Paediatric Society http://www.caringforkids.cps.ca/whensick/HeadLice.htm University of British Columbia www.healthcare.ubc.ca/lice/intro.html

27. Harvard School of Public Health www.hsph.harvard.edu/headlice.html American Academy of Pediatrics http://aappolicy.aappublications.org/cgi/reprint/pediatrics;110/3/638.pdf Please note that information about head lice varies among sources

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