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The Facts of Lice


imageLike everywhere else, there are head lice in Simcoe Muskoka. You may have received a letter from school, or a phone call to give you a "lice alert." You may feel angry, afraid, frustrated or itchy. Head lice cannot spread any disease and have nothing to do with being clean. But they can cause embarrassment and misunderstanding.

Your local pediatricians and the health unit want to dispel myths about head lice and offer this up-to-date information about how lice are spread, diagnosed, and treated.

First, don't panic. Be sensitive to your child's feelings. Remember, head lice are not a hazard to health.

People have been dealing with head lice for hundreds of years. Working together is the only way to keep head lice in check. This means that all families must do regular head checks and treat their child if head lice are found. Parents who have dealt with head lice, researchers and drug companies all have opinions on treating head lice. This fact sheet is an outline on the best ways to treat head lice, based on the most current recommendations of the Canadian Pediatric Society and the American Academy of Pediatrics.

Life Cycle of the head louse

Nits (shells containing eggs)

  • half the size of the head of a pin
  • shaped like a teardrop
  • stuck to the hair so you can 't blow, flick, or easily slide them off
  • start close to the scalp and hatch after about ten days, leaving empty shells to grow out with hair
  • feel like tiny knots on the hair

Image displaying life cycle


  • about the size of a sesame seed
  • very hard to see because they can crawl and hide-they CANNOT hop or fly
  • ready to reproduce ten days after hatching
  • females survive another two weeks or so, laying about ten eggs a day!

Checking for Head Lice

  • Sit your child in a well-lit area near a sunny window or a bright light.
  • Divide the hair into sections and look carefully, one section at a time.
  • Look carefully in the hair, behind the ears, nape of neck, hairline - "the halo" of the head.
  • Check the heads of everyone in the family.
  • Don't forget to have your own head checked.
  • If you find live lice, then you need to treat your child’s head.
  • If you don't see head lice, continue to check the head two times a week for a month, or more if there is an outbreak. After a month, continue to check once a week.
  • If you see anyone scratching their head or hear them say that their head is itchy, check their head.

    What you might find on the head

    • Dandruff
    • Residue from hair spray, gel or mousse
    • Dirt or sand
    • Nits (eggs)
    • Lice

    Image of insect on swing Who can get head lice?

    Anyone. School children get them more because they are often in head-to-head contact.

    If your child has lice

    Tell anyone your child has had contact with to have their head checked—babysitters, grandparents, the school, friends, parents, playgroup or sports group parents. This helps stop the spread of lice and protects your child from getting head lice again.

    Remember, head lice have nothing to do with being clean. And only people get head lice, not animals.

    How do you treat head lice?

    There are four approved treatments for head lice, three are with insecticides and one is not. They all can be harmful if used improperly so it is VERY IMPORTANT to read the instructions carefully, discuss their use with a pharmacist or physician, and use ONLY AS DIRECTED. This is especially important if you are pregnant, breastfeeding, or have very young children. They should never be put on an area with broken skin, and should be stored safely out of reach.

    When using a head lice treatment:

    • Read the instructions carefully, discuss their use with a pharmacist or physician, and use ONLY AS DIRECTED.
    • Timing is important. If the product is rinsed off too soon, lice may not be killed. Do not leave it on the head for longer than recommended. You don't want to expose your child to chemicals longer than necessary.
    • Rinse your child's hair under the tap instead of a shower. It will control how much of the product touches the skin and will stop your child from swallowing some of the product.
    • Do not use these products near the eyes, nose or mouth. Hold a towel tightly over the eyes during treatment to protect them.
    • Wear plastic or rubber gloves to avoid getting the chemical on your skin.
    • Store head lice products out of the reach of young children.

      Do I need to remove all nits after treatment?

      The Canadian Pediatric Society says that removing all nits by hand is NOT necessary to prevent the spread of lice after use of approved head lice products. Most of the remaining nits are now dead or empty.

      A few fresh laid nits may not be killed by treatment shampoos or crème rinses. That is why a SECOND TREATMENT is now recommended in the directions (7 to 10 days later).

      Some people will still want to remove the leftover nits to feel better or to reduce any misunderstanding that the child still has lice after treatment. Removing nits is time consuming—it can take several hours. After treating the hair with the product, comb it to remove tangles.

      Part the hair into at least four sections. Use a clip to hold each section. Look at one section at a time, checking small amounts of hair. Using your thumbnail against your finger, slide the nits from the hair roots right out to the ends and off. Then throw the nits out. Nit combs may be helpful. If the nits are hard to remove, dip the comb in vinegar. This may help the nits slide off more easily. Pin back that lock of hair and continue until all nits are gone.

      How do you stop head lice from returning?

      Make sure you have followed the directions of the recommended treatment, including the SECOND TREATMENT 7 to 10 days later.
      Check for any live lice 8-12 hours after each treatment—if there are live lice but moving slowly do not treat remove the live and dead lice from hair.  If the live lice are found and are as active as before the medicine is not working and will need to speak with your health care provider about the next steps.

      Lice are not likely to leave a warm head to lurk in clothing, furniture and bed linen where it is cold and there isn't any food. But as a precaution, wash bed linen and hats in hot water and dry in a hot dryer. Storing items in plastic for 10 - 14 days will also kill lice.

      Tell your children not to share personal things like hairbrushes and combs, or hats.

      Most important, set a routine to check for nits and lice regularly.

      Other Remedies

      There is no reliable research that suggests home remedies and natural products are effective in the treatment of head lice.  However, anecdotally the use of food grade oil and wetcombing treatment has been credited with some success. 

      Two alternatives we suggest are food-grade oil and wetcombing. See Alternative Treatments for Head Lice fact sheet for details.

      For more information talk with your doctor or pharmacist,
      or visit the Canadian Pediatric Society website at

      Endorsed by the Simcoe County Pediatricians and the Simcoe Muskoka District Health Unit.

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