Another Question Period

Still recovering from the busy holiday season, I'm trying to catch up on some questions I've received from commenters.  I have paraphrased and combined some questions just to get at the heart of what is being asked. Let's begin...

You say that a hair dryer is a good thing but I did a lice treatment and the instructions said a blow dryer is a bad thing.  Also, I've heard my child can't go swimming after a head lice treatment. Why?

I cover this in an earlier blog post but I still have been asked these questions recently.  The neurotoxic pesticide in many lice treatments doesn't kill lice instantly.  It kills over time.  But things like blow drying or the chlorination from going swimming may make the pesticide inactive. Which is fine by me because pesticides like permethrin are no longer that effective anyway which is why I never recommend them.

What is your personal lice checking routine with your family? Describe your spot checks?

My daughters get a quick lice check in the bath once a week. My son does his own lice checks now. When I say quick, I mean quick.  I don't even use a metal lice comb for it.  I have a regular plastic fine tooth comb and I comb through their detangled conditioned hair.  I check the comb after each stroke for signs of bugs. Takes about a minute. If I find an egg or a bug, then I bring out the lice comb and start combing while my child is still in the tub. This lice combing takes about 20 minutes. I used to then follow this up by blow drying my child's hair and then going through the hair strand by strand to get eggs but I honestly don't do this any more.  I just do another 20 minute combing in the bath 4 days later.  And another one 4 days after that.  And another one 4 days after that.  Though, I rarely find anything past the second lice combing.  As you know, that's all I do - I do no extra laundry, washing of bedding, vacuuming, braiding of hair, changing of schedules, staying up late - anything.  I find that routine lice checks make lice a non-issue.  You find the lice before anyone was even aware there was a problem and you deal with it while the problem is small and easily remedied.

I'd like to talk about spot checks because my position on these has changed.  If someone in the house was scratching their head, I used to stop everything and do a quick look at the scalp to see if there were any signs of head lice.  But now I think this is (a) paranoia inducing, (b) inconvenient, and (c) ineffective.  Visual lice checks only really work if you have a major lice problem and in my home, we never have major lice problems because we catch things early.  So, if someone scratches their head, I ignore it.  If someone scratches their head a lot or complains of itchiness, they get a quick wet combing because wet combings are way more effective than visual lice checks.

I cannot get a lice comb through my child's hair for various reasons.  (Or, I don't have access to a metal lice comb.) What do I do?

If your child is traumatized by the pulling of a metal lice comb even through detangled and conditioned hair, then just use a regular plastic fine toothed comb.  It will take out adult bugs and if you comb often enough you will get out the bugs before they lay eggs; this may take longer but you can still outrun their cycle. But if all combing is problematic, go through your child's scalp with your fingers and just take out what you can. Get under some good light (a head lamp is very helpful in this process.  My dollar store head lamp cost $2.50.) This is actually a very relaxing process for children.  We used to put on comfy clothes, put on a movie, and my children would lay down on the couch with their head on a pillow in my lap and I would just go through with my fingers.  For me, it was like knitting - very calming.  For my children, it was also relaxing - they would sometimes fall asleep and I would have to wake them up to turn over so I could look at the other side their head. As I mentioned above, you can also use a blow dryer; check out how here.  You know, if I knew of lice products that really worked so well that you didn't have to remove the bugs and eggs off the head, I would recommend them. Honest. But, I've been to homes where every lice product available in my country has been used correctly and repeatedly without success.  Manual removal is your best bet - it's cheap and can still be effective if you put in the time.

I'm combing with the lice comb and finding nothing but I feel still itchy.  I can feel something crawling on my head.  I'm sure I still have head lice!  What do I do?

The best thing you can do is to calm down.  Trust the comb.  Itching can be caused by many things that are not head lice, including hyper-awareness.  Everyone starts to scratch their heads at the thought of head lice, including me. If you are not finding anything in the lice comb, then you don't have a lice problem.  That said, still do regular combings once in a while just to make sure.  If the itching persists or gets worse, talk to your doctor.

My child has head lice and you say that I don't need to wash her bedding, vacuum her mattress,  or bag up her stuffed animals.  Are you $!#*% serious?


I'm combing my head and this white flaky, sometimes sticky stuff is in my comb.  What is that?

It is "not nits".  It may be dandruff. It may be the build up of some hair product. It may be something gross that the wind blew your way or that your toddler wiped on you.  Nits are uniform in shape; not flaky but oval.  When you get them off the head, they can sometimes even seem to have a teensy little tail - this is not the egg but a piece of your hair that was ripped off with the egg. The bugs always look the same - they just change in size. A louse the size of a speck of pepper looks just like a grown up louse when you check it out under a microscope. So any particles of varying size or shape should not be a major concern. 

My daughter's friend's mom just told me she has lice. My daughter has played with her friend recently.  Does this mean my daughter has lice? 

No.  Whenever I find out that someone we have hung out with has lice, I actually wait until our weekly routine lice check to follow it up. (Unless we have been feeling particularly itchy, then I will do a wet combing to check within the day.)  If nothing shows up in the routine check, I just wait until the next week to do another routine check.  And if I do find lice, I start the routine of wet combing every few days until we have had no sightings of nits or bugs for two weeks.

These head lice wouldn't bother me so much if they didn't bite me all over my body?  What can I do to deal with that?

Talk to a doctor or public health nurse because your problem isn't head lice.  Head lice only bite on the scalp or a bit down the neck or around the ears.  If you have bites somewhere else, you may be dealing with bed bugs, fleas, scabies, or an allergic reaction to something else.

And lastly, my favourite question:

What makes you a candidate for head lice?

Being human.


Anonymous said...

Hi Cathy - I'm a school teacher and am in the middle of my first lice episode (ugh)... I did a BIG combing session on Friday -- hours... And have combed everyday at least once since... As of this morning I'm still finding a couple tiny nits (it's Tuesday) ...is it normal for it to take this long? I'm so paranoid about the infestation coming back full force! When we checked my husband and toddler they each had 1 tiny bug and a couple nits. My husband promptly shaved his head, and we've been trying to comb out my toddlers hair as best as we can - it's hard when she's so squirmy! Any advice? Is it "usual" for it to take this long to "get em all?" Thank you!

Cathy, the Nice Lice Lady. said...

Yes, it is normal to take this long. That's why I don't want people to waste time on laundry or extra cleaning - the combing takes up enough time. But you are getting the job done! I'm glad to hear that you are only finding nits - it sounds like you've removed the bugs. However, even though a good lice comb can get out nits, they can be missed. That's why you have to keep combing every 2-3 days for at least 2 weeks with no new sightings - if you have missed some nits, they may hatch and you want to comb the bugs out before they mature in a week. But trust me, the combing will get easier and I am certain that after a few more combings, you will have gotten everything out.

As for combing your toddler, I know first hand that they don't want to sit still. When my own children were very young, I found it easier to sit with them in the bath tub for combings. Between the water, the bath toys, and the movie that I had playing on a portable DVD player, they were much more willing to sit while I combed. It also goes more quickly in the tub because you can just rinse the comb in the bath water (but do the final rinse of the head with water from the tap). Good luck!

Anonymous said...

Thank you SO much for your quick response - feeling more hopeful!

The Warrior Heart said...

Thank you for this blog post. We found lice on 4 of our kids yesterday. Our 6yo has insanely thick hair and she had so many nits. We are using a metal brush and loving it. However I'm having trouble cleaning it. It says to wipe with a cloth and rinse between swipes but I feel like I spend most of my time trying to clean every tiny thing off it . Any tips?

Cathy, the Nice Lice Lady. said...

If the wiping doesn't work and you find that debris, nits, or bugs are stuck between the teeth of the comb, don't pry the teeth apart - use dental floss to clean it all out. Also, as you may know, sometimes what looks like debris in the comb is just water droplets. Of course, these can stay put and do not need to be wiped away.

Another thing - if you are getting really tired of cleaning out the comb, worry more about getting the lice out of the comb than the nits. If nits are on the comb and you comb them back into the hair, they won't reattach themselves.

If the comb is really full of bugs and nits and you can't get them out easily, and you ran out of dental floss, put the comb in a cup and pour some boiling water over it. Let it sit for 20 seconds or so. That way, even if there is anything left in the comb, you know that it will not be a problem. Just make sure the comb is cool before combing through someone's hair.

Good luck!

The Warrior Heart said...

Thank you so much!

Wendy Dembo said...

Ever since my daughter was in pre-school, I have feared her getting lice. At one point, I was sure she had lice and did tons of laundry. Somehow, that made it seem like it wasn't so terrible.
For the last few days, I noticed that my daughter was scratching her head, something that she normally doesn't do. I looked the other day while her hair was dry and didn't see anything. But tonight she was really itching and I said I would check her hair in the bath. Whoa! Boy! I found about 6 lice and tons of nits.
I think that I would have normally freaked out.
But it was after 8. What could I do. It was too late to call the lice lady.
I found your blog.
And I went ahead and combed my hair. I may not have found everything, but I feel like I got a lot. Yikes!
I feel like this is a manageable process thanks to you!
Thank you for your calm assessment of dealing with lice.

Anonymous said...

My daughter brought home lice. I now I have it as well as my toddler. It's been 6 days. I'm combing every night. Still finding eggs in my older daughter's hair. This morning I got a live louse out of my hair. I'm feeling so defeated. I realize it's only been 6 days but I hadn't seen a live louse since day 2. It's so silly but I'm so stressed and upset about this. Thanks for your blog.

Shelley said...

Thank you, thank you!! Your blog has been a lifesaver. I got head lice last summer and didn't figure it out for a few months. I actually never saw a live louse, just nits. I followed your combing method and I was free of lice in a week. Fast forward, my 17 year old daughter with THICK THICK long hair found a live louse on her hair. A girl on her softball team had a bad case and they all share batting helmets 😳

Here is my question. I have combed four days in a row for hours with my Terminator comb and have found no nits, I use a magnifying light and I know what to look for, THe first and second day, I found one live bug. Last night I found a tiny nymph. But two nights, after I combed, a live louse crawled on her forehead!!! Is it possible to have live lice and no nits??? I am ready to use shampoo because she is so upset about the live lice, but I am really not sure she has that big of a problem. I am really having trouble coating her hair with conditioner because she has so much hair. Could that be the problem? Are the lice hiding from my combing activity and then coming out at night??? I can't find any information about live lice without nits. BLess you for your blog. I have shared it with many.

Cathy, the Nice Lice Lady. said...

I'm sure you have already dealt with your lice but here are my thoughts. Yes, you can actually find a bug and no nits. Because if you miss one viable nit in your last combing, and it hatches, voila! You have a lone bug. Or, there is also the chance that the bug you found is a new bug from someone else. Either way, I am so encouraged by the fact that you are finding the bugs. You truly do know what to look for. One bug does not an infestation make so don't panic. Just comb every few days (really - take full breaks in between combings) until you have found no lice for 2 weeks. Well done.

Anonymous said...

I am so glad to have found your blog!

We took our youngest to the hairdresser last night and almost at the end of her cut as he was blowdrying he found nits! Just at the nape of her neck.Usually i check my kids every week but hadnt in about 2 weeks... Anyhow. This is our first go around. He said it was just the beginning and no live bugs were found crawling around.

I treated her and used the nix comb to remove all the nits i found. There were not a lot but i still took 2 hours combing out her hair.

I have been crazy itchy on my scalp for a week or so but have dry skin too. Also have a rash.They checked me last night and said i was fine. Could they have missed something? I used a fine tooth comb this afternoon and didnt find anything either.

Two questions.

1. When you wet comb do you leave the conditioner in the hair or just make sure it has been conditioned well and rinsed off?

2. Any suggestions for me? I have had extreme skin itch and rash before without having any lice. It was an allergy. Just trying to know if it is lice or something else.

Any help i would be very grateful for. I am headed out tomorrow to go look for one of those fancy trusty combes.

One more question! I pulled offsomething this aft from her hair near the scalp. It was all white. Could it have been a louse? Quite small. Is there a way to know if it is dandruff or lice?

Shelley said...

Cathy, thanks for answering my question, I did not give into the lice shampoo with my 17 year old daughter. We persevered with the combing. We combed every few days for almost 3 weeks. It was so helpful to coat her hair with Cetaphil or conditioner and section it off. I was amazed how we continued to find tiny bugs and debris. I used a white paper towel to clean the comb and then my daughter would look at it with our lighted magnifying glass. I am happy to say that we are all lice free. After the 3 weeks, we checked once a week until 3 weeks went by with nothing, it is a battle that can be won. Just don't stop too soon!

Unknown said...

Hi, thank you for this blog! I was exposed to lice two months ago and 5 days later I found a dead lice on my head after flat ironing. I have been combing with a metal comb and conditioner every 2-3 days since. I have only found one other baby louse. For the last 4 weeks no bugs, but I see possible eggs. What I'm seeing is attached to the hair strand and is white in color. My scalp feels sensitive from all the combing and I don't know if this is excess oil from all the conditioner, possible product build up or eggs. My husband has been checking me and he can't tell.

Zequek Estrada said...

I'm a bit shocked that you don't need to wash the bedding or vacuum the mattress is you child has lice. Why is that? I've had so many people tell me that you need to do all those things. It would be a relief if you didn't since it means it's just one less thing to worry about. https://www.liceclinicphilly.com/lice-removal-services/

Anonymous said...

My daughter had lice 2 weeks ago. I have been checking her hair daily. I have not found a nit in 5 days. Then tonight I found one! I did not find any lice. I don't think I would have missed that one last night it was an easy fiND. Do you think she probably has a bug and I just have not found it? I spray a repellent with tea tree oil daily.

Anonymous said...

Hi Cathy,
So I wet comb my two daughters hair weekly. So far we've been clear. But on my older daughter, I skipped a combing on her for 2 weeks and when I combed her hair out this past Friday, there were at least a dozen adult lice! My question is, could I have missed this many or can all of these bugs been transferred from contact? I know that her school is infested with it. It just seems like a lot of louse to find if it was just from contact.

I didn't find any lice or nits on my other daughter or myself with our treatments.

Thanks for any clarification on this.

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Unknown said...

I like to just burn the bits and bugs with a lighter if your using a metal comb

Adileigh Taunton said...

My 4 yo daughter has very thick curly hair. 3 weeks ago a family member came over and ended up leaving lice behind. Luckily my husband and I are clear. But my daughter: initially I have only found 3 actual bugs (weeks ago). I used Nix and combed. I have been obsessive and checking her head constantly, and have been an anxious wreck. I haven't found any nymphs or louses since the initial few, however I am finding an occasional nit. For days I saw nothing. And today I pulled one from her bangs. They are staying to the top right of her head. Seems like if it had been there previously I would have found it, since it was an easy find. Considering I've checked her head so frequently and not seen any bugs why am I still finding occasional nits!??! I first used Permethrin/Nix. I have treated her head with YL tea tree oil and olive oil and shower cap left on for hours on end and repeated it for several days. I have used apple cider vinegar (which didn't sit well with my daughter) let it dry and combed through, then did coconut oil and shower cap all night. Didn't see anything for days after. But then eventually found a few more nits.. Most recently, I have used rx Spinosad. I've literally spent up to 3 & 1/2 hours at a time using my fingernail and running it down a few strands of hair at a time whether I saw any nits or not. Im exhausted, and yes a little crazy too. She's still scratching, which could be just dry scalp from all the torment. But there appeared to be a rash behind her right ear and nape of neck. Unsure if this was the result of the initial bugs and has just been further irritated?. I feel like I'm losing my mind. Please advise?

Tibs2008 said...

So do you have to do it for two weeks every two to three days even if seeing nothing?

Tibs2008 said...

Also can I do the combing myself or do I need someone else to do it?

Tibs2008 said...

What about tiny round dark things...how do you know for sure they're nits/bugs not a speck of something else...