Pediculosis Humanus Capitis (Head Lice) James Sullivan UPEI School of Nursing November 2009 Edited by Lindsay Williams November 2011

What is Head Lice? Head Lice or “Lice” are tiny insects that are typically found living on the scalp. Head lice feed themselves by biting the scalp of humans. Approximately 6-12 million people worldwide get head lice every year between the ages of 5-12 Adult lice lay eggs that attach directly to individual strands of hair (nits).

What is Head Lice… (Continued) Lice have three different life stages (egg, nymph, and the adult).

Life Stages Of Head Lice Eggs (commonly referred to as “nits”) are oval shaped and approximately the size of a grain of sand. - Whitish/grey or tan in color. - Nits stick to the shaft of the hair close to the scalp (for warmth). - Nits look similar to dandruff but are firmly attached to the hair strand. - Nits hatch in approximately 9-10 days.

Life Stages of Head Lice (Continued)…. Nymphs are baby lice (after hatching). - They look similar to adult lice but much smaller. Nymphs mature into an adult about 7 days after hatching.

Life Stages of Head Lice (Continued)…. Adult lice have 6 legs and are approximately the size of a sesame seed (2 to 4mm) and are tan in color. Once hatched, lice are often difficult to see as they change their color to match the environment. - If untreated, adult lice can live for up to 30 days on a human head. - Adult lice do not survive away from the scalp (will die within 3 days).

Transmission (Spread) of Lice Head lice is very communicable (spreads easily) in situations where people are in close contact with other people. Head lice is most common amongst school age children or young children attending child care services (1 in 10 children).

Transmission (Spread) of Lice (Continued)… FACT: Lice are spread through direct hair to hair contact. Head lice is also commonly spread by indirect contact such as sharing things like hats, combs, hairbrushes, hair accessories, and headphones.

Transmission (Spread) of Lice (Continued)… MYTH: Head lice do not fly (wingless) or hop (however, they can crawl quickly). Nits (eggs) are firmly attached to hair strands and do not fly from one head to the next. MYTH: Head lice that live on humans cannot live on pets (cats or dogs etc).

How will I know if I find lice? Often times, the first sign that someone may have head lice is an extremely itchy scalp caused by a reaction to the bites. Other symptoms include tickling feeling (something moving in hair), irritability, and sores on the head caused by scratching (these sores can sometimes become infected). It is possible to have head lice without any sign or symptom. Prevention (screening) is the best way to reduce the spread of infestation.

Checking for Head Lice…. Ensure good lighting is available. Have the child sit upright while the examiner either sits or stands behind the client. Head lice can move quickly through the hair and can be difficult to see (as they adapt color), Nits are sometimes easier to see as they do not move. Lice are typically found close to the scalp particularly at the bottom of the neck (nape of neck) and behind both ears.

Checking for Head Lice…. (Continued) Using 2 wood applicators (non-sterile) per child is recommended. Dispose of applicators following each child and wash / disinfect hands. Begin by part hair in small sections and move from one side of the head to the other. Check carefully by looking close the scalp.

Checking for Head Lice…. (Continued) Nits often appear similar to hair dandruff. It is important to note that nits are firmly attached to hair strands (like glue) while dandruff is often not attached directly to the hair. If it is easily dislodged from the hair, it is most likely dandruff and not an egg.

Important Tips…. While screening children, if you think you may have found nits or lice contact your team leader or school health nurse for additional support. Confidentiality! Ensure sensitivity surrounding the child’s feelings.Anyone can get lice and no one is immune (children or adults). Lack of cleanliness does not cause head lice (stigma).

Found lice? There are treatment options! Canada currently has approved the use of three insecticides to treat head lice. - Pyrethrin - Permethrin - Lindane Nix and R&C were the most commonly recommended products by pharmacists in your area! Lindane can be toxic. This product should be avoided on infants and children younger than 2 years of age. Prescriptions are not required.

Treatment... (Continued) A noninsecticidal product (Resultz) has also been approved for use in Canada. This product should only be used in children over the age of 4. This product works by breaking down the exoskeleton (skin) of lice.

Treatment Tips… Read and carefully follow the directions on the package. Do not leave the shampoo / rinse on any longer than directed. Rinse hair (cool water) in the sink and not in a bath or shower to avoid other body parts coming in contact with the product.

Treatment Tips... (Continued) It is important to remember to repeat the treatment in 7 to 10 days following the initial treatment (to ensure any newly hatched lice are killed before maturing). Do not treat anyone with a head lice product that does not have a confirmed case. Check all family members if someone in the house has head lice. Carefully check all sections of the head. Remove nits by using fingernails to drag nits down the hair shaft. As no product is 100% effective against killing the nits

Other Treatments? Home remedies such as mayonnaise, petroleum jelly, olive oil, tea tree oil, vinegar, or aromatherapy have been shown to make it hard for lice to breath. No evidence suggests it effectively kills all nits or lice.

Home Disinfection Although head lice do not live long off the scalp; to avoid re- infection or transmission to other person it is recommended to clean all hats, combs/brushes, pillowcases, bed sheets, stuffed animals etc. Avoid the use of insecticide sprays. - Wash items in hot water and dry in a hot dryer for 15mins. - Store items in an airtight plastic bag for 2 weeks. - Vacuum surfaces where heads may have rested (sofas, helmets, car seats, etc).

Help control the spread of head lice… Discourage head to head contact. Avoid sharing of scarves, hats, hair brushes, and hair accessories. Tie long hair back in braids. Check young children regularly for head lice. Start lice screening today!

Questions? Thank You