Head Lice

As neither head lice nor nits (lice eggs) spread disease, there is no medical reason for excluding an individual with nits or live lice from work, school or child care. They may remain at work, school or child care.

Still, it's important to handle the situation sensitively to minimize any embarrassment to the individual. Best practice indicates that they can go home at the end of the day, be treated and return after treatment has begun. However, the facility decides whether to send an individual with live lice home.

About head lice

Head lice are tiny insects that live on the scalp of humans. They are not found on pets. Lice nits (eggs) can be found on the hair close to the scalp, often behind the ears or on the nape of the neck. It's much more likely to find the nits, as the lice crawl quickly and are often difficult to see.

Nits hatch in eight to days. Once hatched, lice must feed on blood to survive. It takes about nine to 12 days for the young lice to mature into adult lice. An adult head louse can live about 30 days on a person's head but will die within one or two days if it falls off.

Head lice do not cause illness or spread disease. However, they can be irritating because they cause discomfort and spread easily from person to person.

Lice do not jump or fly but crawl very quickly. They spread by direct head-to-head contact and less often by sharing items like combs, brushes, scarves, hats, pillows, bedding, towels, etc. Anyone can get head lice. It's not a sign of poor personal hygiene or an unclean environment.


If you would like a printable PDF, email Healthy Schools or visit head lice at Caring for Kids.

Steps to take

  1. Notify close contacts.
    • All individuals in the household who have head lice should be treated at the same time. An untreated source among close contacts is a common reason for getting head lice again.
    • Tell your child's school, daycare and children's groups (sports, clubs, babysitters) so other parents can check their children's hair.
  2. Provide head lice treatment to those affected
  3. Clean household and personal items should on the same day as the scalp treatment
  4. Check for lice using the Wet Combing Method daily for two to three weeks to be sure all lice and nits are gone and remove any that are discovered

More information

  • What head lice looks like

    Head lice:

    • Tiny wingless insects that cannot fly or jump
    • Size of a strawberry seed
    • Greyish-brown in colour

    Nits (lice eggs):

    • Attached to the hair shaft very close to the scalp (within six mm)
    • Size of a grain of sand
    • Do not come off the hair strand easily
    • Brownish white in colour when alive, white when dead or hatched
    • Nits more than one cm from the scalp are likely dead or hatched

    The white shells of the nits stay on the hair shaft even after the eggs hatch.

    Dandruff isn't a sign of head lice. Dandruff can be easily moved from the hair strand whereas as head lice is difficult to remove before treatment. Don't mistake dandruff for nits or lice.

    The primary symptoms include:

    • Intense itching or a tickling feeling of something moving in the hair
    • Nits on hair shafts
    • Scratching and / or small, red sores caused by lice, which could become infected
    • Irritability and difficulty sleeping; head lice are most active in the dark
    • Lice visible on the scalp
  • Lice treatment

    Talk to your health care provider or pharmacist to find out which head lice treatment is best for you. Special considerations may apply for:

    • Children under two years
    • A person with a seizure disorder
    • A person with a scalp infection
    • A person who is pregnant or breastfeeding

    Live head lice

    1. Begin with a chemical treatment purchased from a pharmacy
      • Ask a pharmacist for directions on how to use specific products and for guidance on treatments based on the age and health status of the person
    2. Apply the medication to the head as directed on the product packaging
      • Medication for lice includes lotions, cream rinses and shampoos. Both pesticide and non-pesticide products are available.
      • Most products need two treatments. The first will kill the head lice but not all nits. The second treatment, given seven to 10 days after the first, will kill the lice that have hatched since the first treatment.
    3. Wash and rinse hair in the sink, not in the bath or shower to avoid getting the treatment product on other parts of the body
    4. Do not use regular shampoo and hair products for 48-72 hours after first and second treatments to allow the treatment product to continue working.
    5. Always follow the chemical treatment with the Wet Combing Method to remove lice and nits
    6. If you still see live lice 48 hours after the second treatment, contact your health care provider

    Nits (lice eggs)

    After chemical treatment, daily nit removal using the Wet Combing Method is key to getting rid of head lice. Even with careful nit picking some live nits and lice can be missed.

    Wet Combing Method

    Wet combing helps find and remove head lice and nits by combing through the hair using a fine-toothed nit comb. Use a bright light and magnifying glass if available.

    Remember, lice or nits are found close to the scalp, particularly around the ears, at the back of the neck and forehead.


    1. Wet hair for easier removal as this slows adult lice movement, which makes it easier to see and catch the lice
    2. Part hair into small sections to see the hair strand down to the scalp. For longer hair you can clip sections to the side to better see the scalp.
    3. With a fine-toothed nit comb (usually included with treatment shampoos) or your fingernails, pull the nits / lice from the hair strands starting at the roots down to the tips
    4. Wipe the nits / lice onto a tissue after each stroke through the hair
    5. Place tissues with nits / lice in a bag for disposal

    After finishing all sections of the head, wash your hands with soap and water and soak the comb in hot soapy water.

  • OHIP+ covered treatment

    Specific head lice treatment products may be covered under OHIP+ with a prescription from a doctor.

    For children 24 years and under who are not covered under a private drug plan, OHIP+ covers the cost of certain prescription drugs.

    Seek assessment from a health care provider.

  • Household and personal items

    Treatment / cleaning of household and personal items should be done on the same day as a scalp treatment to prevent lice re-infestion.

    • Launder all personal items that could have been in contact with an infected person's head two to three days before noticing the lice. Items such as hats, towels, bedding and pillowcases should be washed in hot water (above 55 C or 130 F) and dried in a hot dryer for about 30 minutes.
    • Dry clean or seal in plastic bags non-washable items such as pillows for 14 days to kill lice. Head lice survive less than one to two days if they fall off a person and cannot feed; nits cannot hatch and usually die within a week if not kept at the same temperature as that found close to the human scalp. Spending a lot of time and money on housecleaning activities is not necessary to avoid reinfestation by lice or nits that may have fallen off the head or crawled onto furniture or clothing.
    • Don't use a pesticide spray to "disinfect" your house. These products can be toxic and don't help control head lice.
    • Soak all brushes and combs in hot water for five to 10 minutes or wash them with a head lice shampoo
    • Vacuum thoroughly items such as rugs, furniture, mattresses, pillows and any other surface where someone infested may have rested their head within the last two to three days. Remember to treat car seats.
  • Head lice at school / child care

    Parents must check their children's hair for head lice and nits and provide proper treatment if any head lice is found.

    Schools and child care facilities should let parents know if their child is thought to have head lice or if someone in the class or group has head lice. If your child has head lice, anyone who may have been in contact should be notified and checked.

    Each facility may have policies and procedures around head lice that families would need to follow.

  • Head lice prevention

    To help prevent head lice:

    • Don't share hats, scarves, headphones, combs, brushes, barrettes, headbands, hair elastics, towels or bicycle helmets, and investigate any head itching.
    • Keep long hair tied back and away from the face
    • Teach children to avoid head-to-head contact
    • Check children's hair regularly, such as weekly, especially if they are scratching a lot

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