To Cut Or Not To Cut...

Does having long hair increase your chances of getting head lice and more difficult to get rid of it? Increase your chances? Maybe, as longer hair has a longer reach and can brush the hair of others more easily. More difficult to detect and get rid of? Another maybe, but don't reach for the scissors. You just need to take more time to deal with the problem. There are things you can do to reduce your chance of infestation and increase your chances of removal.

First, putting the hair up in a braid, a bun, or a ponytail is a good idea. This will help to keep the hair from going all over the place and brushing against others who have head lice. If the hair already has little "guests" crawling around it, putting the hair up will help keep the lice from travelling.

Second, if the person with long hair already has head lice, the purchase of a good lice comb is a worthwhile investment (and the combs that come with the lice treatments don't count!). Read about my favourite comb, the LiceMeister, here. With lice combs, you have to comb from root to tip in one continuous motion. If you stop, you give the bugs that you have scooped up a chance to crawl off of the comb. So separate the long hair into small, manageable sections, remove all the tangles with a normal brush or comb, and then use the lice comb on wet hair one small section at a time. Wet hair helps immobilize the bugs; you can add a bit of hair conditioner throughout the hair to prevent it from drying while you are combing.

After you have combed through every strand of hair, you NEED to go through the hair again, strand by strand and manually pick out any bugs or eggs that the comb has missed. Read my blog post about nit picking right here. If you are still not sure what you are looking for, look at some pictures here.

Something you should know. It is unlikely that any nit (egg) that is more than a few inches from the scalp will hatch as newly laid eggs are right near the scalp. You may want to remove them all for cosmetic reasons, but you really just need to direct your energies to activity near the scalp.

With long hair, this whole process can take hours, so take lots of breaks, and don't be afraid to do it over a couple of days. Lice can only lay up to 10 eggs a day, and even with multiple bugs, you can pick faster than they can lay. Just keep combing/picking everyday until you get to the point where you see no bugs or nits. Then, keep checking thoroughly for another 7 days, just in case you missed something.

Once the person with long hair is lice free, make sure you do regular lice checks. These checks can be done quickly, but you must be sure to really lift up all the hair and peek in all different areas of the scalp. Do the quick check every day and a thorough check once a week. If you see new lice activity, do thorough combing, picking, and checking everyday until you have removed the problem.

So think twice before you cut the long hair - you may be in for a longer battle but it still takes longer to grow out the hair again than it does to just deal with your lice problem.

I have a small problem with Alberta Health Services...

My daughter got another notice from school that someone in her class has head lice (no, it wasn't her). We get these green information sheets sent home fairly frequently. Maybe you've seen these information sheets before. These handouts have been created by someone at Alberta Health Services (formerly Capital Health in Edmonton). I think it is great that notices are sent home. I don't like all of the information given:

The pamphlet says: "You will need...Shampoo, 1% Permethrin lice treatment, and a regular comb or brush."
Oh please. I fight head lice all the time. I do not use ANY lice topical treatments. None. Zippo. This is not a "need". Even if you did use the lice treatment, the directions on the pamphlet are different than the ones given in the box. Whose advice should you follow? I would think you should follow the advice of the maker of the product. If you use the product, that is. Which I don't.

"Nits that are more than 1/2 inch from the scalp will not hatch."
Not necessarily so, though anything past a few inches is certainly not viable.

"In fact, lice really like clean hair"
Lots of people say this and you can read one of my old posts about this idea here.

"Wash hats, scarves, combs, brushes, hair barrettes, bed sheets and pillow cases in hot soapy water."
I used to recommend this too.  But don't do it.  It is a waste of your energy and not proven to have any effectiveness.  Lice don't want to be on things.  They want to be on people.  Put all your attention on the head.

If after 48 hours, live lice are still seen, and "if steps were missed or hair products with conditioner were used...repeat the treatment with the same product immediately..."
Permethrin is a pesticide.  And there are many studies to show it is no longer effective.  It just doesn't work.

This pamphlet implies that if you do a proper second treatment in a week, then you will have solved your problem. The steps end with the phrase, "That's it - you're done!"
Are you kidding me? The huge majority of my business comes from people who have tried these "shampoos" 2, 3, 4, or more times! They've followed every direction, cleaned every surface, and gone mad because the lice remained a problem.

"Hair dryers, hair conditioners, vinegar rinses and chlorinated swimming pools should be avoided for 7-10 days..."
Hair dryers and hair conditioners can actually have a place in the fight against head lice. I discuss the topic of hair dryers in this post. For my post on hair conditioners, click here.

This pamphlet has a some good advice, but its emphasis on the use of lice "shampoos" is part of what I believe is causing so many cases of head lice in our schools. In step #4 of "How to Treat", it tells you to remove the eggs, but it doesn't really explain just how time consuming or how absolutely essential this step is. It doesn't tell you that you will have to manually remove the bugs as well. In my mind, you could get rid of almost every step in this pamphlet except step #4, and then you should have it repeated again and again.

One more note. If a doctor or a health nurse tells you that you have head lice, but then a lice removal professional comes over and says that you don't, trust the lice removal professional. I was once called in to see a woman to offer a third opinion. This woman had seen her doctor who told her that she definitely had head lice (even though he barely looked at her head). Then she had called another lice removal professional to remove the lice, and was told that she didn't have head lice. Then the woman called me and I told her that she could probably trust the other lice removal professional, but she wanted me to come in anyway. I went to see her and found that she didn't have head lice. Unfortunately, she still believed her doctor and called me a week later to check again. She still didn't have head lice, but she did have an itchy scalp from the useless half-dozen treatments she had given herself in the meantime.

Another good website...

Another good website with sound research about head lice infestations has been developed by The Journal of Paediatrics and Child Health and you can see it here. While this site seems to promote the use of pesticidal treatments (which I do not recommend), it also mentions some of the research that shows that lice have become resistant to these treatments in some countries (there is no Canadian research, but our situation is similar to the United States). It also mentions that many of these treatments can be toxic in certain situations.

I like that this site is that it discusses the idea that you can have nits but NO infestation. I hope you will read about this and realize that you don't need to reach for a bottle of pesticide every time you see an egg. I also like that this site says that going into an super-insane cleaning frenzy is unnecessary. (OK, I may have paraphrased that, but the idea is the same.)

What I don't like about this site? It says that wet combing has not been proven effective in the fight against head lice, but there is another study that says it has (and you can see it here.) All in all, this site has some good information. Remember though, in my book, no lice shampoo is good lice shampoo. You would do better (and be richer) if you would just take the time to pick/comb everything out.