Head lice (pediculosis)
Clinical basis & sources
- Primary source
- OCP Expanding Scope of Practice
Sources used
- Minor Ailments PrescribingOntario College of Pharmacists · 2026
- Expanding Scope of Practice - Minor AilmentsOntario College of Pharmacists · 2026-05-28
- Ontario Regulation 133/26: GeneralGovernment of Ontario · 2026-05-11
- Executive Officer Notice: Update to Funding for Minor Ailment Services in Ontario Pharmacies (Effective July 1, 2026)Government of Ontario · 2026-05-19
- Treatment of Head LiceCenters for Disease Control and Prevention · Accessed 2026-06-01
- Head lice infestations: A clinical updateCanadian Paediatric Society · Accessed 2026-06-01
- How to treat head liceAlberta Health Services · Accessed 2026-06-01
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Allowable drugs under Schedule 4 (6)
Drugs an Ontario pharmacist may prescribe for Head lice (pediculosis) under O. Reg. 256/24, Schedule 4. Choice still depends on the assessment, contraindications, allergies, and product availability — this is the eligible list, not a recommendation.
- Cyclomethicone
- Dimeticone
- Isopropyl myristate
- Permethrin
- Piperonyl butoxide
- Pyrethrins
Symptoms this assessment screens
- Live head lice or likely viable nits close to the scalp identified
- Itching, tickling sensation, sleep disturbance, or minor scratching consistent with head lice
- No fever, painful swollen nodes, pus, extensive sores, eyelash/eyebrow involvement, body lice, pubic lice, or suspected scabies
- Age, pregnancy/lactation if relevant, allergies, asthma, scalp integrity, and product-label fit reviewed
- Household contacts, close contacts, prior treatment timing, combing, and reinfestation risk reviewed
Red flags — any positive means refer
- Fever, painful swollen lymph nodes, pus, impetigo, extensive sores, severe scalp inflammation, or suspected bacterial infection
- Lice on eyelashes, eyebrows, body, pubic area, or suspected scabies/another infestation
- Infant below product-label age, pregnancy/lactation with uncertainty, major allergy concern, or unsafe scalp condition
- Diagnosis uncertain, only distant old nits seen, dandruff/hair casts suspected, or no live lice despite repeated checks
- Live lice persist after correctly completed treatment and retreatment, or repeated recurrence despite contact management
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