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The symptoms

Your child :

• frantically scratches his head and ears;

To be sure his hair is infested with lice, you need to find live insects on his head. Scratching alone is not enough to make a diagnosis. Even if you find eggs, it doesn’t mean your child is infested.

• your child’s scalp has sores that look infected.

• the treatments applied are not effective.
• applied treatments cause intense itching.

What is a head louse?

The head louse that attacks humans is a small insect (Pediculus capitis) with 6 legs, measuring 2 mm to 4 mm. It cannot fly or jump, but can crawl very quickly. It’s a parasite that can only live in human hair, close to the scalp or on the eyelashes. These are the only places where it can survive and reproduce. It keeps warm and feeds by sucking very small quantities of blood from the scalp. In the event of infestation leading to skin lesions (“pediculosis”, in medical terms), a child’s hair may contain 10 to 20 adult lice, sometimes fewer.

Although the presence of head lice can be itchy and annoying, this little insect does not transmit any disease to humans. However, scratching can irritate the skin on your child’s scalp, causing lesions that can become infected. Some children are more sensitive to head lice than others, and experience severe itching; others do not suffer from their presence.

Contrary to popular belief, having lice doesn’t mean you’re unhygienic. The louse is simply a tenacious parasite that has been particularly well adapted to humans for centuries. They settle just as easily on a clean head as in unkempt hair. It makes no distinction between races or social classes.

The louse cannot survive for more than 2 or 3 days anywhere other than on a human head. Unfortunately, when it finds one, it clings firmly to it, and the female lays her eggs, called nits, on it. Over the course of her life (3 to 4 weeks), she may produce 5 or 6 nits a day.

Each nit is firmly attached to a hair, close to the scalp, or to an eyelash. If fertilized and able to live, it hatches 9 or 10 days later. It releases a nymph, which becomes an adult louse in 15 days. Surviving lice quickly seek out another human head to settle on and multiply.

How to treat?

The doctor’s prescription

For a variety of reasons, over-the-counter products may not be able to eliminate the lice infestation. Your doctor may then recommend other measures.

Care and practical advice

How do you examine your child’s hair?

If your child has an itchy scalp, or if you know there are lice around, check his or her hair every day. You’ll need a fine-toothed comb. This type of comb is sold in pharmacies. Some manufacturers of anti-lice products supply them in their packaging.

• Place the head in good lighting. As lice avoid light, it’s possible to see them moving around with the naked eye. You can also use a magnifying glass to see them better. Nits are more visible because they are immobile. To be sure your child has lice, you need to find live insects in his hair.
• Wet hair before combing. Applying conditioner makes it easier to find lice. However, the use of conditioner is contraindicated when using Kwellada-P® 1% or Nix® 1%, as it reduces the effectiveness of the treatment.
• First, look for nits by separating the hair into small sections, moving from one side of the head to the other. Look closely at the scalp. Nits are grayish-white. They are oval-shaped and look like dandruff. But, unlike dandruff, they are firmly attached to the hair. Look first behind the ears, on the nape of the neck, then on the top of the head.
• If you find nits, you may have live lice. They could also be from a previous infestation and no longer viable. So continue your exploration with care, looking for at least one live louse.
• If you find at least one live louse on his head, notify his daycare or school, as well as the parents of any children who regularly play with him.
• Examine the hair of other members of your family (including adults), and treat anyone you find with live lice in the same way. Ideally, anyone you know who is infested should be treated the same day, to avoid reinfestation.

Treat only people with live lice or nits.

The different treatments

If you find live lice or nits, you need treatment. The Ministère de la Santé et des Services sociaux du Québec (MSSS) recommends the 2 product categories below, which are available over the counter in pharmacies. Other treatments are also available, but their effectiveness has not been proven.

2-application treatments that kill lice and nits

• Kwellada-P® 1%, Nix® 1% or NYDA®.

These 3 products are not recommended for children under 2.

• Pronto® or R&C®

These 2 products are recommended for children under 2.

3-application treatments that kill lice but have little or no effect on nits

• Zap® and Resultz®

These 2 products are not recommended for children under 2.

Regardless of the product used, the treatment consists of several applications of the same product. It’s important to follow the manufacturer’s instructions exactly if you want the product to be effective. Even if you no longer see nits or lice, make all the recommended applications.

If, however, you see live lice 17 days after the 1st application of the product, it is recommended to start again with a different product:

• if you have used Kwellada-P® 1%, you can use the other products mentioned above except Nix® 1%;
• if you have used Nix® 1%, you can use the other products mentioned above except Kwellada-P® 1%;
• if you have used Pronto® , you can use the other products mentioned above except R&C® ;
• if you have used R&C®, you can use the other products mentioned above except Pronto®;
• if you have used NYDA®, you can use all the other products mentioned above;
• if you have used Zap®, you can use all the other products mentioned above;
• if you have used Resultz®, you can use all the other products mentioned above.

How do I remove nits?

• First, wet the child’s hair by wrapping it in a damp towel for 30 minutes.
• Comb through hair, strand by strand, from scalp to ends. Pay particular attention to the back of the ears and the nape of the neck.
• Soak the fine-tooth comb in hot water after each stroke.
• To remove a nit that resists the fine-tooth comb, use your fingernails or tweezers to slide it along the hair.
• Repeat this procedure daily for the duration of the treatment. This is necessary to remove any nits that are not destroyed by the treatment.
• If you see lice or nits on your eyelashes, you can apply a greasy substance – Vaseline, for example – 2 times a day for 1 week.

Personal items

There is little risk of lice being transmitted through personal objects. However, if you receive a notice from the school or day-care center, you can treat objects used regularly by the infested person (bedding, combs, brushes, hats, etc.) using one of the following methods:

Soak objects in undiluted lice shampoo or hot water (65°C or 149°F) for 5 to 10 minutes.

• Put the clothes in the dryer on high heat for 20 minutes.
• Place in a tightly sealed plastic bag for 10 days.

How to prevent?

• As far as possible, ask your child to avoid pressing his or her head against that of others.
• Get her into the habit of tucking her hat and scarf into the sleeve of her coat.
• Keep long hair tied back as much as possible.
• Check your child’s head regularly.