Ask Your Pharmacist

September 20, 2023

Should I treat my kids with lice and pinworm medication now that they are back at school?


Children should not receive lice or pinworm medication when they do not have an active infection, or if they are not a close household contact of a person with a pinworm infection, as the medications for treatment do not prevent future infections. Tea tree oil and peppermint oil have shown some effectiveness at preventing head lice. However, regular use can irritate the scalp and cause dry, flaky skin, so use is generally not recommended. Our best defense is knowing how to reduce the risk of your child getting one of these infections, and being aware of the symptoms so you can catch the infection early and treat it immediately when an infection is present.

Lice are insects about the size of a pinhead that lay tiny yellowish, oval-shaped eggs called nits on individual pieces of hair close to your scalp. Lice will not jump from one person to another but can move when there is direct head-to-head contact. It is important not to share items such as hairbrushes, hats, scarves, headphones and hair accessories as lice can live on these items for up to 2 days. When lice bite your scalp, it causes the main symptom of a lice infection which is an itchy scalp. If you see your child scratching their head or complaining of an itchy scalp, immediately check the hairs behind their ears and at the base of their neck as these warm areas are where adult lice are usually found. Regularly check your child’s hair with a fine-tooth comb. If you see nits, they may look like dandruff, but unlike dandruff, they will not brush away, and you may need to pinch them with your fingernails to remove them.

Lice medication is available without a prescription at your pharmacy. Some of the products may be behind the pharmacy counter, while others may be available in the aisle. A consultation with the pharmacist will help you choose between pesticide treatments such as those containing permethrin or non-pesticide treatments such as those containing dimethicone or isopropyl myristate. The nits are not always killed with the first treatment, therefore a second application is required 7-10 days later using the same product to kill any newly hatched lice before they can produce new eggs. Wash all bedding, clothing, hats, scarves and hairbrushes in hot water. Vacuum rugs and furniture and seal away stuffed animals for 2 weeks or run them through a hot dryer cycle.

Pinworms are white parasitic worms that are approximately the length of a staple and live in the large intestine. During the night the female worm exits your body through your rectum and lays eggs around the skin of your rectum which causes the area to become itchy. When you scratch that itch, you pick up those microscopic eggs underneath your fingernails. Pinworms are spread when we unknowingly put the eggs in our mouth after we pick them up from contaminated foods and surfaces. It is important to teach children proper handwashing after they use the washroom, before they eat food and when their hands are visibly dirty. Keeping fingernails short and avoiding nail biting, thumb sucking and putting pens or toys in the mouth all help to reduce the risk of a pinworm infection. However, if you notice your child has rectal itching night after night which is sometimes accompanied by irritability and loss of sleep, and even less commonly accompanied by nausea or stomach pain, it is time to have a discussion with your pharmacist.

When treating pinworms, the entire household, including any close household contacts need to be treated at the same time because pinworms are so contagious, and some people can have an infection with no symptoms at all. For treatment, pharmacies offer pyrantel pamoate behind the counter without a prescription, and pharmacists in New Brunswick can also do an assessment and prescribe prescription-only medication such as mebendazole. Like lice treatments, the eggs are not always killed, therefore a second dose of the same medication is required in 14 days. If itching persists after the medication has been taken, it is completely normal, and the pharmacist can help you select a cream to help. Be prepared to do lots of laundry – wash bedding and towels in hot water every three days, and wash underwear and pyjamas in hot water daily for three weeks.

Although nothing will guarantee your children will not bring these infections home, following these tips can help to reduce the risk of these infections becoming a nuisance in your household this school year.

Erin Thompson (Bsc, BscPharm) is a graduate of Dalhousie University and a community pharmacist practicing at Shoppers Drug Mart in Quispamsis N.B. Her opinions expressed in this newspaper are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to

The Ask Your Pharmacist column appears in New Brunswick newspapers for educational and informational purposes only. These opinions are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. If you have a question you’d like to see answered, you can send it to