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Pyrethrin Resistance in Lice: A New Approach to Treatment and Control 


The infestation caused by Pediculus humanus capitis is a common public health problem worldwide, especially in school-age children, their families and their living environments. Traditionally, neurotoxic insecticides (for example, permethrin and synergized pyrethrins) have been used as the first-line treatment for controlling head lice infestations. This strategy, along with poor compliance with treatment and insects’ tremendous capacity to adapt, has contributed to the development of mechanisms of resistance to these products. The phenomenon of resistance in lice to neurotoxic insecticides is currently on the rise globally. North America and Canada are no exception, with a number of studies reporting the presence of genetic mutations associated with pyrethrin resistance in nearly 100% of specimens examined.

In order to eliminate the infestation in those affected and protect the population in settings at risk of an outbreak, the approach to the treatment and control of head lice infestation needed to be revised. Under the auspices of the Institut national de santé publique du Québec (INSPQ), a group of experts from Québec proposed a new control strategy, which was published in the form of guidelines by the Ministère de la Santé et des Services sociaux du Québec in 2012. One of the areas for action of the new strategy is to educate stakeholders so that they can diagnose and treat the infestation effectively, but also raise awareness in at-risk populations about the harmful effects of treatments that are not recommended and about the myths and fears that stigmatize the children and families affected.


Training initiatives have been offered to school nurses. However, fewer initiatives have been designed for other professionals concerned by the problem. This course is intended for pharmacists and physicians who work in the public and private sectors. It may also be appropriate for stakeholders in health care and public health settings who are interested in improving their expertise in this area


This is an online course and will take about five hours to complete. Learners will have two weeks to revise the learning modules.


  • Develop a knowledge of the biology, transmission, clinical forms and epidemiology of the infestation;
  • Categorize recommended pediculicides, describe their mechanisms of action, indications and contraindications.
  • Understand the mechanisms of pediculicide resistance in lice.
  • Examine the causes of treatment failure and assess pyrethrin resistance in lice.
  • Develop a knowledge of new therapeutic approaches for treating the infestation.
  • Defend the principles underlying the MSSS’s new strategy for the control of head lice.
  • Develop an ability to think critically about so-called alternative products or home remedies that are not recommended.
  • Use available tools and resources to support actions to prevent and control the problem..


  • Pascal Bédard, Pharm. CH Ste-Justine.
  • Jacques Gendron, Pharm. M.B.A., Le groupe Jean Coutu
  • Rinda Hartner, B. Sc. Centre de santé et des services sociaux Jeanne-Mance
  • Julio C. Soto, M.D., Ph.D. Direction des risques biologiques et de la santé au travail, INSPQ
  • Marc Steben, M.D., Direction des risques biologiques et de la santé au travail, INSPQ
  • Annick Trudelle, M Sc. Direction des risques biologiques et de la santé au travail, INSPQ

Recognition of Continuing Education

Québec Order of Pharmacists

This continuing education activity has been accredited by the Québec Order of Pharmacists which will award 5.00 CEU to pharmacists that will have successfully completed the training. 




  • $75 (taxes included) for physicians and pharmacists
  • $50 (taxes included) for nurses and other health professionals.

The fee includes the certificate of participation.

Payment can be made by credit card (Visa or Mastercard) at the time of online registration: https://netevent.ccnpps.ca/netevent/default.aspx?id=cQIkplUkJl8%3d&f=359&lng=en


This training is made ​​possible by the technological support of the Virtual Campus of the INSPQ, it received an educational grant from Pediapharm Inc.

For further information, please contact the Virtual Campus by email: campus.virtuel@inspq.qc.ca